photo by db*photography
An anonymous poster on our site — calling themselves “medical knowledge” — recently wrote the following in response to an edition of our advice column about HPV. So we asked our own Dr. Kate — of Gynotalk.com — to clear things up, as it were. First, the anonymous comment:
80% of sexually active people have HPV. Although it is transmitted sexually, that does not make it an STD as most of the strains of HPV do not cause “disease” at all. If you do not have warts or abnormal paps it is really not necessary to tell a partner because… TADA… you don’t have the strains 16 and 18 that cause cervical cancer or 6 and 11 that cause warts. I’m assuming the letter writer has an abnormal pap because that is the only medical reason for getting tested for HPV in the first place. In this case, I would tell him that you may have a strain that transmits cervical cancer, and encourage him to tell all his past and future girlfriends to visit the doctor once a year to prevent the disease. I would then keep your own appoitments. Oh and in men, strains 6 and 11 also cause warts, but strains 16 and 18 do nothing in 99.9% of men. If you are a man and have 16 and 18, however, you will likely cause abnormal paps in any future partners so it is VERY important to tell these partners to go to the gynecologist every year to prevent progression to cervical cancer. For a clue if you have 16 and 18, look to past partners and ask them if they have had abnormal paps. And BTW, the HPV test CAN be performed in men it just ISN’T because it is completely unnecessary and medically irrelevant. You will not find many doctors who will perform a test for the sole purpose of figuring out who gave what to whom.
Paging Dr. Kate! Here is her eminently wise — and replete with actual medical knowledge — response:
The writer has some facts, but takes most of them out of the proper context. It is estimated that 80% of sexually active adults will be infected with HPV at some point, but they don’t all have it now. While not all infections with HPV cause clinical disease, it is still accurate to call HPV a sexually transmitted infection (STI). As for the focus on the strains, there are many more strains of HPV that cause both warts and cancer — these four listed are simply the most common ones, but they’re far from the only ones.
Yes, most women under 30 who are tested for HPV have an abnormal pap…but screening for HPV in all women over age 30 is becoming routine (and is already recommended). Yes, most men will not develop penile cancer from strains 16 and 18, but they will still infect their partners until they clear the virus (not forever). The sentence starting “For a clue” is awfully misleading — just because past partners haven’t had an abnormal pap or cervical dysplasia (that they know of), doesn’t mean a gentleman is free of the infection.
Finally, the HPV test has been designed for women, at the time of pap smear collection — the paddle may scrape cells of the penis that will show HPV infection, but since it wasn’t designed for men, it is not an accurate test in most cases.