Aa
Tough Ethical Question
Doctor,
I have HPV that has manifested itself in actual warts. I have treated them several times over about ten years (perhaps never consistently enough), but they always come back. Until very recently, I have always disclosed the condition to sexual partners before engaging in intercourse. Three nights ago, however, I met a girl and we became EXTREMELY intoxicated and had sex. I did not disclose my STD to her beforehand. The girl (who is a friend of a friend) flew out the next morning, and it is not very likely that we will be seeing one another again.
Doc, should I track down the girl to disclose the fact that I have HPV?
To my belief, there are few elements at play here: First, according to a lot of the literature I've read, many, many sexually active people are exposed to HPV. One line of thinking weighs in favor of not contacting the girl, because why needlessly worry her if she did not contract the virus? The best thing that could happen in that scenario is that she worry about it and never test positive for HPV. On the other hand, if I do contact her, just having information about the risk would clearly allow her to (1) get screened sooner than her next annual and treat any symptoms that may arise, and (2) disclose the risk to her future sexual partners.
Interestingly, I find that the law creates the wrong incentives in my scenario, i.e. it encourages non-disclosure, because if I now disclose my condition post-hoc, the girl contracts HPV, and she is angry and decides to take legal action, she will actually know who to direct a law suit against. Whereas if I say nothing, she clearly would not know who was responsible for passing HPV to her (assuming that I was not her first drunken one-night-stand). All in all, I want to do what is right, so I am not really concerned with legal ramifications at this point, just wanted to make the observation.
While my concern is directed toward the girl, I realize that I engaged in very risky, maybe even reckless behavior, and that I am at risk too. Thank goodness I have been able to avoid that for the most part over the past ten years, but I hope this forum serves as a good learning tool--that people can read about this mistake on my part and learn from it. Thanks for your input, Doc!
This discussion is related to Handsfield 6 month disclosure guidelines.
I have HPV that has manifested itself in actual warts. I have treated them several times over about ten years (perhaps never consistently enough), but they always come back. Until very recently, I have always disclosed the condition to sexual partners before engaging in intercourse. Three nights ago, however, I met a girl and we became EXTREMELY intoxicated and had sex. I did not disclose my STD to her beforehand. The girl (who is a friend of a friend) flew out the next morning, and it is not very likely that we will be seeing one another again.
Doc, should I track down the girl to disclose the fact that I have HPV?
To my belief, there are few elements at play here: First, according to a lot of the literature I've read, many, many sexually active people are exposed to HPV. One line of thinking weighs in favor of not contacting the girl, because why needlessly worry her if she did not contract the virus? The best thing that could happen in that scenario is that she worry about it and never test positive for HPV. On the other hand, if I do contact her, just having information about the risk would clearly allow her to (1) get screened sooner than her next annual and treat any symptoms that may arise, and (2) disclose the risk to her future sexual partners.
Interestingly, I find that the law creates the wrong incentives in my scenario, i.e. it encourages non-disclosure, because if I now disclose my condition post-hoc, the girl contracts HPV, and she is angry and decides to take legal action, she will actually know who to direct a law suit against. Whereas if I say nothing, she clearly would not know who was responsible for passing HPV to her (assuming that I was not her first drunken one-night-stand). All in all, I want to do what is right, so I am not really concerned with legal ramifications at this point, just wanted to make the observation.
While my concern is directed toward the girl, I realize that I engaged in very risky, maybe even reckless behavior, and that I am at risk too. Thank goodness I have been able to avoid that for the most part over the past ten years, but I hope this forum serves as a good learning tool--that people can read about this mistake on my part and learn from it. Thanks for your input, Doc!
This discussion is related to Handsfield 6 month disclosure guidelines.
COMMUNITY LEADER
Well, the only thing I can see that might help her is that she would be able to pay attention for any signs of it, but as you said, its very prevalent.
It is a tough call, and one only you can make.
Aj
It is a tough call, and one only you can make.
Aj
AJ,
No, we did not use protection, and I did have actual warts, which is why I feel somewhat obligated to make a disclosure, although with the prevalence of HPV, I think the issue is on the margin. I would really be tipped toward disclosure if odds of the girl preventing anything serious were enhanced by her having the information.
It was extremely risky behavior, as I pointed out, and I do fully plan to get tested. Thanks for your feedback.
No, we did not use protection, and I did have actual warts, which is why I feel somewhat obligated to make a disclosure, although with the prevalence of HPV, I think the issue is on the margin. I would really be tipped toward disclosure if odds of the girl preventing anything serious were enhanced by her having the information.
It was extremely risky behavior, as I pointed out, and I do fully plan to get tested. Thanks for your feedback.
COMMUNITY LEADER
Hi there -
This isn't the doctor's forum, but I'll give you my thoughts.
Did you have actual warts and did you use a condom?
Ordinarily, I am a big proponent of informing partners. However, casual sex seems to have different rules. Casual sex has inherent risks. You don't know the person enough to trust them, and you don't know the person long enough, usually, to ask for testing to be done.
Personally, I think her health is her own responsibility, and if you are having casual sex, then you have to assume that your partners are positive for something, and you are taking that risk.
Also, if she has casual sex, and she gets warts, then she wouldn't ever be able to pinpoint who she got it from.
The thing about drunk sex, most often, is that people aren't always all that careful about protection. You might want to get tested for chlamydia, gonorrhea, etc.
Aj
This isn't the doctor's forum, but I'll give you my thoughts.
Did you have actual warts and did you use a condom?
Ordinarily, I am a big proponent of informing partners. However, casual sex seems to have different rules. Casual sex has inherent risks. You don't know the person enough to trust them, and you don't know the person long enough, usually, to ask for testing to be done.
Personally, I think her health is her own responsibility, and if you are having casual sex, then you have to assume that your partners are positive for something, and you are taking that risk.
Also, if she has casual sex, and she gets warts, then she wouldn't ever be able to pinpoint who she got it from.
The thing about drunk sex, most often, is that people aren't always all that careful about protection. You might want to get tested for chlamydia, gonorrhea, etc.
Aj
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