How to proceed after getting HPV positive

[indochine]

Hello,

I'm a 26 year old female - today I was told I returned positive on an HPV test, but my pap came back normal. This is the first time I've been positive with HPV. As a precautionary measure, I was started on the vaccine today as well.

It's not clear which strains I have, and though I have some clues as to who I got it from, I'm more curious about the piece of advice my doctor gave me. He said that 50% of cases go on to develop cervical cancer, and in 50% of cases, it goes away on its own. To be certain that I'm in the latter group, he said, I would have to have unprotected sex for the rest of the year, until a next pap exam is scheduled. He said it would be important to "isolate the cervix" to protect the cells against repeat infection.

I have a new sex partner of just over a month, and I've told him today. Our issue now is, if we are in a monogamous relationship, is the unprotected sex still an issue? I know returning to condoms will be difficult for us.

In the meantime, I'm not planning on having any other sex partners. Other than the recent HPV I'm healthy and not on any medication. I have an IUD which has given me little to no trouble. I am just frustrated at finding the same statistics over and over on the internet, but not many details on how to proceed after finding out your results.

Any advice would be appreciated. Thanks!

[Edward W Hook, MD]

Welcome to our Forum.  I believe your doctor's statistics are not correct.  At least 90% of HPV infections will go away on their own, without treatment, within two years of getting them, not just 50% and in later years (after the two years have pasted) additional infections will also go away by themselves. Furthermore, even if you are in the quite small proportion of women in whom the infection persists, the chance of progressing to cancer is low and with regular PAP smears, should the infection persist and progress, it should do so slowly, again over a period of years, allowing treatment. As a result, it would be recommended that you have regular PAP smears to make sure that there are no signs of progression which require treatment.

I would also add that there is no evidence that you and your current partner, if engaged in a mutually monogamous relationship, need to use condoms going forward.  I think your doctor is being a bit overly conservative about this.  

I'm a bit surprised that you were tested for HPV at all unless you requested it.  At the present time, for women of your age, HPV testing is not recommended for women with normal PAP smears.  

I am also pleased that you are getting the HPV vaccine.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  The vaccine will be very effective for prevention of new infections.  That leaves your current infection to deal with and, as I said, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.

To summarie then, I suggest:
1.  Don't worry.
2.  Get regular (yearly) PAP smrears.
3.  Complete your vaccination witht he HPV vaccine

I hope these comments are helpful. EWH

[indochine]

Sorry, *protected sex, not unprotected sex.

[indochine]

Also, I might add that neither I nor my partner has seen any warts or symptoms yet.