HPV Concern - Ex Girlfriend has Cervical Cancer

[mich2000]

I'm a 34 year old heterosexual male and I was recently informed that my previous girlfriend of 3 years ago had recently come down with cervical cancer, she also recently informed me that she had an abnormal PAP test 10+ years prior to meeting me which lead to her Doctor performing a slight "scrapping" of her cervix over a decade ago.

The relationship I had with my previous girlfriend was very short – only about 2 months.  However, we were sexually active in terms of oral sex (giving and receiving) without a condom, but we only had actual intercourse three times, and I used a condom each time. However, one time I believe I stuck my penis inside her vagina without a condom for just a few seconds (5 at most).

I have not had any symptoms of any kind of STD infection. For the past 3 years my current girlfriend and I have had an active sex life and very rarely used condoms. My current girlfriend recently got a PAP test and an HPV test. The HPV test was negative and the PAP test was normal.

1) If I had high-risk HPV, wouldn't my current girlfriend by now (3 yrs)?
2) Is a person is less likely to clear the high-risk HPV virus as they get older?
3) Should I inform a future partner of my previous girlfriend's cervical cancer at all?  
4) What do you think are my chances of having a high-risk HPV?  Worrying too much?
5) Lastly, when you say that a person is almost sure to have been infected with HPV if they have had more than 3-4 sexual partners, are you referring to high-risk HPV?

[H. Hunter Handsfield, M.D.]

Having a partner with cervical cancer is not a sign of increased HPV risk in men, or increased risk of transmitting HPV to other people.  Oral HPV infection can occur by genital contact, but appears to be uncommon and virtually never causes symptoms.  As a sexually active person, the odds are good you have been infected with HPV in the past, including infection with high risk (cancer-causing) types.  That you happen to know of one such partner, but not the others, does not alter your risk and should not be of concern to you.  Condoms are not recommended for partners in which the woman has cervical HPV infection, with or without cervical cancer or pre-cancerous lesions.

To your questions:  1) Your exposure says little about the risk a later partner would catch high-risk HPV from you.  You might not have been infected; or if you were, your infection might have cleared up before having sex with your current partner; or she might have been infected but nothing ever showed up on paps or other exam; or she might have not been infected, because she was immune owing to some past infection she didn't know about.  You will never know which of these explains the absence of a problem in your partner, and it really doesn't matter.

2) No, clearance efficiency does not decline with aging, as far as I know.  2) There is no need to inform future partners of anything.  4) Whether or not you ever actually were infected with a high-risk HPV type it is unlikely you continue to carry it.  You definitely are worrying too much.  5) The statistic that 70-80% of people acquire HPV during their first 3-4 lifetime partners refers to all HPV types.  But high-risk types are among them.

Bottom line:  Everybody with concerns about HPV should keep their antennas up for future developments.  It is a rapidly moving field, and some of today's truths could prove wrong.  But it truly is fair to say you have no reason to be worried about HPV.

Good luck--  HHH, MD

[CuriousInVA]

Hey Mich,

I'm not a doctor, but I have done quite a bit of research on HPV lately because I was told I had it about 2 months ago.  I had an abnormal pap, and they told me I had a high risk strain of HPV.  So now I have to go back every three months for awhile to make sure that my paps come back normal, as to catch it before I get cervical cancer.

Here is what I know.

1. Almost every sexually active person has or will have HPV at least one time in their lives.  I think the percentage is up to 80%.  Which means if you have had sex with 4 different people, most likely you have HPV.  
2.  3 out of 4 people who have HPV don't know it and will never develop symptoms.  There are currently no tests for males, and if its the strain that causes cervical cancer and NOT warts, there is no way for a man to know.
3.  You can have HPV for years and years, and never have any symptoms.  In addition, you can get symptoms (abnormal pap or warts) years later from an infection you had previous.
4. Just because you have HPV doesn't mean you will ever develop warts OR cervical cancer.
5.  Although condoms do help, you can get HPV by sex with a condom, because the virus is in the skin.  

Lastly... HPV is NOT a big deal.  Trust me, I thought it was at first, and my anxiety levels were outrageous.  But for me, it just means that I have to have paps on a more regular basis to be sure they come back normal.  And if they don't, because I"m cautious I can catch pre-cancerous cells before they become cancerous.  I have already had an additional pap, a colposkopy and a biopsy and all came back normal, this only months after they told me I had it.  My body may come immune to the virus and I may never have sympotms agai.  Knock on wood, I hope this is the case.  But I could have gotten HPV the very first time I had sex and never known it.  

ALSO even if your currect girlfriend DOES have hpv, and later comes down with symptoms does NOT mean she got it from you.  Assuming she was sexually active before you, she could have gotten it from anyone.  

Make sense?  The more I read about HPV, the more I realize its a very livable thing, and nothing to stress over.  Though it is very good to be cautious.  Its so common, that soon I wouldn't doubt if EVERY sexually active person has one strain or another.

[nyc07]

Do you have any general rules for dealing with HPV/ abnormal PAP's (non-wart manifestations) with regards to counseling patients?  

I think that I could surmise a few based upon what I have read.  What do you think of the following?


For women. . .
HPV +/ LSIL/ HSIL women -  Tell partners until 6 months of normal tests

ASCUS women-  No need for disclosure (ASCUS is too non-specific as a result)

For men. . .
No need for disclosure regarding any previous partners status.  You'll never know if you have or had it.  (And you've probably had it.)


I'm bringing this up because both the CDC and ASHA are wishy-washy about this and I feel that the Digene website for the HPV test is too commercial.

[LiveLearn]

I contracted and dealt with HPV several years ago.   Since then,  I have told all of my partners.  I have not yet had a single person scream "run away, run away".  So, bottom line gentlemen, if you know you have previously contracted it, tell your partners.  

[mich2000]

Thanks for the information! This helps...

LiveLearn - the problem is men don't know if they contracted the non-wart causing type of HPV since there are no symptoms or tests.

I understand your argument if you have the wart causing type of HPV that keeps popping up reminding you that you are indeed infected. Your partner will eventually visually find this out on his/her own. I think.

However, men that do not have the wart causing type (or perhaps don't have any type for all they know) never really know if they contracted it, or contracted it and resolved it by their immune process.

According to the Doc, we do know that 70 - 80% of all sexually active people come in contact with HPV (all types) at some point, then again that still doesn't tell us men if we contracted the non-symptom type or if we contracted it and resolved it by our immune process - we just don't know.

Me, on the other hand, had a previous girlfriend that likely had a high-risk type HPV infection (since she had cervical cancer), but I still don't know if I have it or had it. I know that I'm sexually active, so I may have contracted it at some point - maybe with my previous girlfriend or someone else. I really don't know.

I'm not sure if telling a future partner that I had a previous girlfriend that likely had a high-risk HPV is any more informative or useful than telling her that most sexually active people (including me) come in contact with HPV at some point in their lives. In either case, you may have contracted it, and in either case you still don't know what you don't know.

[mich2000]

Curious - thank you as well. Very helpful. :)

[mich2000]

Just so everyone knows:

I know absolutely nothing about all of this stuff. That's why I posted my question to the Doc. Please don't take my comments as being correct, I'm just as uninformed about HPV as anyone else. My comments and assumptions could be (and probably are) incorrect in some way or another.

  

  

[cyn17]

I feel compelled to tell my story, as HPV has been a recurrent hell for me. I keep reading in other posts that HPV is no big deal, but for me it is a big deal...a big enough deal that it's made me fearful of having a sexual relationship for the past 4 years. I have had maybe 10 partners in the past 25 years.

First experience with HVP, 21, had laser surgery on my cervix.

Second experience, 31, had biopsy on cervix which removed all the abnormal cells and no further treatment required.

Third experience, 34, had cervical biopsy and LEEP procedure. Had a horrendous experience with the LEEP procedure and swore I would NOT EVER go through this again.

Fourth experience, 37-38, anal warts, tried treating with Aldara with no luck. Had two surgeries to remove warts. Have been clear since. Also experienced tearing of the perinium every time I had intercourse. Doctor didn't know how to treat...got other opinions and no one knew what to do except to suggest k-y or other creams.

Fifth experience, 43, just recieved second abnormal pap in 4 months. Went to gyno to discuss the pap results and tearing of perinium. Turns out the pap showed abnormal endometrial cells from my uterus. Also, under the microscope my doctor could see two tiny ulcerations on the perinium. Both the lining of my uterus and perinium are infected with HPV and required biopsies (Very painful). I am now facing surgery to repair the perinium to remove the area that keeps tearing and I'm waiting for results on the uteran biopsy to see if I need a hysterectomy.

So, men and women, when debating whether to discuss HPV with your partners, my recommendation is YES and to use a condom until you believe your relationship will be long term. This will at the very least be a considerate thing to do for your partner. Even though the percentage of people that have an experience like mine is very small, we are out here and we are in pain...both physically and emotionally.