Sex With HPV

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Dr. Kat answers the difficult question of what to when you're diagnosed with HPV.

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HPV Diagnosis

Ask the Sexpert

Sex with HPV

Dear Dr. Kat,

I just got diagnosed with HPV (genital warts) with a pap smear. I’ve been dating my boyfriend for six months and don’t know how to tell him. Also, I’m wondering if I got it from him possibly cheating on me. What do I do?


Dear Reader,

Most people have no idea that HPV (human papilloma virus aka genital warts) is the number one sexually transmitted disease (STI) not only in the United States but perhaps the world. It has well over sixty strains which can express themselves through lesions on the cervix or through warts on the vulva of a woman. It’s estimated that over 75% of the population carries at least one strain in their bodies. Many women go for years with no symptoms and men are much less likely to be symptomatic. It can be particularly difficult to diagnose men as they can pass it to their partners through virtually microscopic warts on their penis. It’s spread through skin to skin contact and therefore if the affected areas are outside of the range of a condom like the base or top of the penis or the outer lips of the vulva technically it can “rub off” on your partner.

Some people do have a natural resistance to some strains and not to others. The problem is that women have a much higher chance of developing cervical cancer from several strains of the virus. Men obviously don’t run this risk. Usually, when women develop HPV on the cervix the only way to tell is through a pap smear. But even so I’ve seen women who probably contracted the virus years prior and for one reason or another (either the pap didn’t detect it or the virus wasn’t active on the cervix) they had no idea. It’s almost impossible for most people to pin point when and who they picked it up from. Luckily, if caught early these cervical malignancies caused by HPV are highly treatable through a variety of procedures and topical ointments. But depending on the strain you have (new testing has finally been developed to tell us this), 80% of the time the malignancy cures it self. Which means you won’t have cancer but because HPV is a virus you will always have HPV. The virus is usually monitored through more frequent pap smears to make sure it’s reversing it self. This is a really good reason to get yourself in those stirrups every year or so.

So, what to do when it comes to having to tell your partner? Like any diagnosis of an STI you guys need to have a talk and you especially will need to educate him about the virus and its transmission. I’ve seen many couples get into the blame game about who got it from whom and there really seems no point to the route of discussion. Hopefully, both of you would be honest enough to discuss any sexual activity outside of your relationship in a mature manner. The important part is how to manage the relationship and this new variable that has been introduced to it. Because the risk to men is low many long term couples just assume the risk of HPV and decide to engage in unprotected sex when the female partner has already been diagnosed. However, if you’re a guy out there reading this column and either you’ve been diagnosed or a previous partner has been you should offer that information to any new partner. Although, cervical malignancies are treatable you are playing with some one else’s life and editing out important information they should have before you have sex is a no-no. Regardless, condoms are not fool proof in this instance, and the general rule is to assume that everyone has some form of this virus (or any STI for that matter) when you have sex with them. It’s a lot sexier to practice safer sex all of the time than having to worry about those microscopic lesions on your partner’s penis.

~ Dr. Kathleen Van Kirk