STDs Expert Forum
Risk of HPV
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Risk of HPV

Dear Doctors,

I was referred to your board by a friend.  I am 42 years old and divoriced last year after 15 years of marrage.  During that time I was completely monogomous with my husband.  I've now re-entered the dating world and have become sexually active again.  Now that I'm on the market so to speak, I'm learning a lot of new information about the risks of STI's.

About four months ago, I made a mistake and had unprotected sex with a friend.  He is single and I know he has been fairly active sexually.  I have spoken to him and he tells me he has been tested and is STI free.  What I'm worried and wondering about is the risk of HPV and cervical cancer, especially as I potentially have more partners.

I have two questions I would appreciate your insights.  First, before I was married, I was fairly sexually active.  I estimate I had between 15 and 20 partners between the ages of 16 and 27.  The vast majority were protected vaginally, but not orally.  I was never diagnosed with genital warts, but from what I've read lately I very likely encountered HPV.  If I indeed was exposed when I was younger, would I have developed antibodies that help prevent me from becoming infected now?  I read that condoms don't protect against HPV and it can also be contracted through oral sex.  How worried should I be about the risk of HPV and cervical cancer and what can/should I do to be active and safe?

Thank you for you insights.
Tags: HPV
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Welcome to the forum and thanks for your question.  I understand your concern.  The newer information about STD risks since you last were single and dating, including concerns about HPV, can seem overwhelming.  But the bottom line is that things are as bad as they may seem!

Since you had several sexual partnerships before your marriage, you are correct in assuming you have been infected with HPV -- probably more than once, perhaps with several different strains.  (If your husband was not monogamous as your marriage was failing, you could have been at risk more recently as well.)

The large majority of HPV infections are asymptomatic, remain that way, and don't cause anything abnormal -- no warts, no abnormal pap smears, etc.  It is generally believed that infection with any particular type makes a person immune, or at least highly resistant, to a new infection with the same type.  Whether such immunity remains protective after 15-20 years isn't known, but probably it does.

So in your new dating life, you can expect to be exposed to HPV.  However, new HPV infections are quite uncommon in women after their mid-20s, both because of the reasons above (most have already been exposed to the most common types) and perhaps because of poorly understood factor related to age itself. (This is why the HPV vaccines are generally recommended only for people age 26 and lower.)  And in the event you are infected with a new strain, the same rules apply:  mostly harmless and asymptomatic.

My advice to all sexually active people is to not let fear of HPV get in the way of romance and rewarding sex.  Of course you need to always plan on following standard guidance for pap smears, so if someday you are one of the minority who gets abnormalities that need follow-up to prevent overt cancer.  And of course you should plan on consistent comdom use with new partners, until and unless a relationship matures to mutual commitment.  (Condoms reduce HPV risk, but are not completely protective because of skin contact above condom range.)

I hope this has helped give you some perspective.  Let me know if there is anything you don't understand.

Regards--  HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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