It’s a question I’m often asked by my patients after they learn that they not only have an abnormal Pap, but a sexually transmitted infection – Human Papilloma Virus.  Are they obligated to tell their current or future potential sexual partners that they have HPV?

I believe the answer is a qualified no. And here is why -

HPV is ubiquitous.

Did you know that close to three quarters of adults have had HPV at some point in their lives? Ninety five percent of the time, that infection will clear within 1-2 years with no long term consequences to themselves or their partners. Although we can offer treatment or removal for genital warts, there is no medical treatment to clear HPV itself. That’s the job of the immune system, which can be helped along in this regard by using condoms, avoiding tobacco and eating a diet rich in fruits and vegetables.

Unlike women, most men with HPV have no way of knowing they are infected.

Unless they have a visible genital wart, most men who have HPV have no idea they are infected. That’s because there is no FDA-approved HPV test for men. 

Women, on the other hand, if they happen to get a pap smear while infected, may very well find out that they have HPV. Lucky us.

Why then, should a woman be obligated to tell her partner that she has HPV? Given the ubiquitous nature of HPV infection, unless her partner is a virgin, the odds are pretty darned high that he already has had HPV. He may actually have the infection right now and be the one who gave it to her! On the other hand, he may have had it in the past and already be immune to the strain of HPV she has. Or be infected with another strain she does not have, so that she may actually be the one taking the risk by sleeping with him!

She’ll never know, and he’ll never know. Because he cannot be tested. Or treated.

HPV is not like chlamydia.

There is no role for partner notification and  treatment in preventing the spread of HPV. The only thing that partner notification accomplishes is to turn women with abnormal paps into pariahs, while the rest of the HPV infected men and women out there who have no idea they are infected continue to copulate in blissful ignorance.

And that’s why I don’t believe that every abnormal pap needs to turn into an STD confessional.

You’re not off the hook, however.

Just because I don’t think they’re obligated to disclose does not mean that women who have been diagnosed with HPV have no obligation to their partners(s), present or future.

I believe that they and all sexually active adults have an obligation to prevent the spread of HPV and other STD’s by using condoms and limiting their number of sexual partners. It’s not a moral message, unless morality means acting responsibly and maturely, and respecting one’s own health and that of those we love. By limiting one’s partners, I mean confining intimate physical relationships to those who we really care about. (Dare I use the word love?…)  If that means a few less one night stands, well, is that such a bad thing?

Genital warts are with discussing with your partner.

I do think it’s worth discussing with your partner if you currently have genital warts.More often that you’d think, the male partner may have  small, previously undetected genital warts that are amenable to treatment. He can visit his doc for a careful exam and get treated if warts are present. That in turn may help you clear the infection faster yourself, since your immune system won’t be under constant barrage with high viral loads from your partner.

Condoms are also worth discussing.

If you have an abnormal pap due to HPV, and you are not using condoms, it’s worth discussing the matter with your partner and asking him to use protection when you have sex. Women with HPV whose partners use condoms will clear the virus and return to normal paps faster than those who have unprotected sex.

There is a role for HPV vaccination.

I also support the use of HPV vaccination. Despite my objections to how it has been priced, marketed, marketed and legislated, the vaccine is safe and effective. Getting vaccinated after you’re infected won’t help you clear the infection faster, but can prevent new infections with the 4 strains that the vaccine targets.
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• More posts about HPV from the Blog that Ate Manhattan
• HPV info from the CDC