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hpv Q&A
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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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hpv Q&A

hello doctors. thank you for helping all of us deal with some
difficult stuff. quick background- i dated a girl who after a few
months told me she had hpv and needed a leep procedure. i
wasn't mad, but i think she struggled to tell me this from the beginning.
we did have protected sex many,many times prior to disclosure. since
she had LEEP, i assume that she carried high-risk hpv. we ended up
breaking up. years later, i dated a couple different girls. I didn't
tell them about my exposure. two of those, a few months after we broke up,
girls ended up telling me that they had hpv and needed a colposcopy.
i had protected sex maybe 4 or so times with each girl. here are my
questions about my situation.

1) Of the people who know they have HPV, what percent in your estimation
don't have the courage, or don't care enough, to inform their partners? I know my ex-girlfriend didn't
have the courage to tell me and then I didn't have the courage to tell my latter
partners. I feel very ashamed for this and struggle each time to tell my future partners.
I'm not very good with rejection, it really *****, so I usually dont say anything.

2) Do you think, from my history, that I gave those latter two girls hpv? the
first girl was 2-3 years after my exposure and the second girl was 4-5 years later.
I know the statistics are above 85% have or will have hpv, and chances are that
they were infected before they met me. one was 26 years old and the other was
in her 30's.

3) do you think a therapeutic vaccine will become available within the next 15-20 years?

thanks for this.

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239123_tn?1267651214
I'll try to help settle your concerns.  Although I understand you are alarmed at the possibility that you might be an HPV carrier who has infected up to three partners, that's actually quite unlikely.  This conceivably could be the case, but most HPV infections clear up within 1-2 years, so it is unlikely you are still infected with the HPV strain that was responsible for the first partner's infection.  It probably is statistically more likely for one man to have 3 HPV-infected partners by random chance than it is to carry a single HPV infection for several years.

In addition, your partners were not necessarily infected with high-risk types.  More severe dysplasia, of the kind that requires LEEP, indeed are due to the high risk types, so the first partner likely had a high-risk HPV type.  But not necessarily the next two partners, since up to half of HPV infections causing abnormal pap smears are due to low risk HPV, not high risk.

Those comments take care of question no. 2.  As for question 1, I haven't a clue what proportion of people with diagnosed HPV infections inform their partners.  Probably it is higher (and should be) for partners soon after the time of diagnosis but probably is rare (and should be) for infections diagnosed more than a year earlier.  It's undoubtedly more common in committed relationships or those likely to become so than for casual partnerships.  That also is appropriate, in my opinion.  Warning partners about diagnosed HPV infections does little to modify their risk of getting HPV -- because for every partner with a diagnosed HPV infection, most people have several other partners with undetected HPV.

In other words, most people are going to be exposed anyway, so what's the point?  This is essentially why the HPV vaccine is so important as a prevention strategy.  No sexually active person should expect to avoid HPV on the basis of information exchanged with their sex partners.  Therefore, I do not believe you have a definite ethical obligation to inform future partners that you might be infected with HPV.  However, some experts would disagree with me, and you could look on informing partners as a kindness, if not an obligation.  But certainly you should inform "the one" if and when it looks like you're going to settle into a permanent relationship -- if only to avoid a more difficult discussion later if she also develops evidence of HPV.  Until then, of course you should be routinely using condoms anyway, which provide good (if not perfect) prevention against HPV transmission.

Question 3:  Certainly there will be no therapeutic HPV vaccine in the next decade.  I can't predict for 15-20 years, but I'm not optimistic.  But for the reasons discussed above, I don't think this issue is particularly relevant to your situation.

You might want to try posting the "do I inform all partners" question on the HPV community forum.  You don't get any more definitive answers, but you'll certainly hear lots of viewpoints about it.

I hope this helps.  Best wishes--  HHH, MD
3 Comments
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the word I choose wasn't a bad one that got censored. i dont know why. sorry.
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239123_tn?1267651214
Sorry.  It's MedHelp's conservative anti-smut software.  Sexual slang should be OK on forums dealing directly with sex and I have complained about it many times, but they can't set standards differently for one forum versus others.  My guess is that ***** was the word used for drinking through a straw.
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University of Washington
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