Aa
Confused about hpv interpretation
I’m male and have been in relationships with women who’ve had abnormal paps due to hpv infection. I’ve also had a genital wart removed without recurrence. I’ve shared this info with both my GP and my urologist. My GP is insistent that I share this info with new partners. Her stance is, “you can never be sure”. My urologist is at the other end of the spectrum. He believes that, because hpv is so widespread, there is no obligation to discuss past issues as long as there is no active infection – once it’s gone, it’s gone. He also stated that most gynecologists don’t even broach the topic of disclosure with patients with active infections with their partners. Why is this? The more I’ve read, it seems that my GP’s stance is extreme and lacks flexibility. I believe it’s important to be responsible and disclose if necessary, but what information is correct? Do I need to identify every exposure to hpv I've had, or simply state I've had hpv myself and been in relationships with women who've also had hpv? The varying degrees of interpretation on hpv couldn’t be more frustrating. Thanks in advance
MEDICAL PROFESSIONAL
I'm not sure what you mean by "keeping it general". If I were you, I probably would say I had genital warts. But it's a pesonal choice and I can't say any more than I did above.
Thanks a lot, Dr. H. I really appreciate your time. It certainly would be much easier if everyone was running around with this fuzzy, gray-shaded virus, wouldn’t it? Sure would take the anxiety out of having to address it. I think for me, it’s best that I discuss with future partners – just personal preference. Would you suggest keeping it general to avoid any anxiety a partner might have? And where can I obtain that CDC research on partner notification for std’s?
MEDICAL PROFESSIONAL
Your questions are among the most common asked in relation to HPV infections. Just yesterday I answered in great detail; rather than repeating it all, please take a look at that thread: http://www.medhelp.org/posts/show/763292
As you will see there, my thoughts and advice are more in line with your urologist. However, I don't agree with the urologist's characterization of most gynecologists' approaches. A recent research study of providers' attitudes about partner notification for STDs showed that most gynecologists in fact talk to their patients about the sexually transmitted nature of HPV, and many (most?) advise referral or examination of partners. But I disagree, and so does CDC, which conducted that research study.
However, two caveats: First, the other thread and the CDC/gyn experience refer primarily to HPV detected in women by pap smear; and the context of the other thread is distant past partners, i.e. several years earlier. When a newly diagnosed HPV infection obviously was recently acquired -- as when new warts appear -- it is at least a courtesy, and some would say an obligation, to inform recent partners, i.e. those who might be the source of the infection and others who might have been exposed to it. It is true not much can be done, but many persons will appreciate being advised to be on the lookout, so they can see their docs promptly if warts appear.
Second, it is reasonable to consider the nature of the relationship. Most important, it's probably wise to tell current or future committed partners, e.g. when a long term relationship seems on the horizon, about past STDs. In the event such a partner later develops an HPV problem -- say warts or an abnormal pap smear -- it's generally better to have had "the talk" well ahead of time, and not in response to a new diagnosis and possible emotional crisis.
In summary, the main reason I disagree with your GP is his apparent black/white stance. At the same time, your urologist's attitude seems too cavalier. This is an issue colored in shades of gray, and one size does not fit all. Common sense about the nature of the diagnosed HPV infection, when and where it was acquired, timing, and the nature of the relationship all should influence a particular person's approach.
Inconsistent advice from various sources? Yes indeed. Frustrating? Ditto. But that's in the nature of the infection, as well as the rapid growth of knowledge, that naturally leaves some providers less informed than others, and which also fosters widely varying yet equally valid opinions.
So there you have it -- a fuzzy, gray-shaded answer to a fuzzy, gray-shaded problem!
Good luck-- HHH, MD
As you will see there, my thoughts and advice are more in line with your urologist. However, I don't agree with the urologist's characterization of most gynecologists' approaches. A recent research study of providers' attitudes about partner notification for STDs showed that most gynecologists in fact talk to their patients about the sexually transmitted nature of HPV, and many (most?) advise referral or examination of partners. But I disagree, and so does CDC, which conducted that research study.
However, two caveats: First, the other thread and the CDC/gyn experience refer primarily to HPV detected in women by pap smear; and the context of the other thread is distant past partners, i.e. several years earlier. When a newly diagnosed HPV infection obviously was recently acquired -- as when new warts appear -- it is at least a courtesy, and some would say an obligation, to inform recent partners, i.e. those who might be the source of the infection and others who might have been exposed to it. It is true not much can be done, but many persons will appreciate being advised to be on the lookout, so they can see their docs promptly if warts appear.
Second, it is reasonable to consider the nature of the relationship. Most important, it's probably wise to tell current or future committed partners, e.g. when a long term relationship seems on the horizon, about past STDs. In the event such a partner later develops an HPV problem -- say warts or an abnormal pap smear -- it's generally better to have had "the talk" well ahead of time, and not in response to a new diagnosis and possible emotional crisis.
In summary, the main reason I disagree with your GP is his apparent black/white stance. At the same time, your urologist's attitude seems too cavalier. This is an issue colored in shades of gray, and one size does not fit all. Common sense about the nature of the diagnosed HPV infection, when and where it was acquired, timing, and the nature of the relationship all should influence a particular person's approach.
Inconsistent advice from various sources? Yes indeed. Frustrating? Ditto. But that's in the nature of the infection, as well as the rapid growth of knowledge, that naturally leaves some providers less informed than others, and which also fosters widely varying yet equally valid opinions.
So there you have it -- a fuzzy, gray-shaded answer to a fuzzy, gray-shaded problem!
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
