My thoughts on HPV

In a casual sex encounter it’s common sense to assume the other person is positive and take the necessary precautions against HIV and any number of STDs including HPV. That said, HPV is prevalent and hard to protect against. Most people who have had sex have HPV at some point in their lives. And most infections go away on their own. The CDC says that approximately 20 million Americans are currently infected with HPV. Another 6 million people become newly infected each year.

Why is HPV so prevalent and hard to protect against?

• There are over 40 different genital strains of HPV. Some cause genital warts and others can cause cellular changes that can turn into cancer.
• There is no HPV screening test for men. Only women with abnormal pap smears are tested for HPV.
• Condoms/barriers do not fully protect against HPV, because not all areas are covered by barriers.
• HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.
• HPV is spread through skin to skin contact- not through fluid transmission

I’ve had HPV “twice”. The first time I had an abnormal pap smear was in 2002. I was getting my first annual gynecological exam since my sexual assault. I had cellular changes on my cervix so they ran an HPV test and it was positive.

I had a colposcopy (think intense pap smear, with a microscope type tool called a colposcope) and a cervical biopsy done. (Yep, they took chunks of my cervix out. Yes, it hurt BADLY. You know to be worried when they tell you to take advil BEFORE the procedure!) The tests found I had “Low-grade Squamous Intraepithelial Lesions”. I followed up with pap smears every 6 months instead of every year. Within a year and a half or so, my cervix was back to “normal” (i.e. cellular changes no longer detected.) I was lucky. Had the changes gotten more serious I could have had to have a painful procedure to cut away the affected tissue from my cervix (Here is an article by Andrea Grimes on her experience)

Years later, 2009 to be exact- I received the HPV vaccine*. I was 25 and I’d been married for 5 years (though we’re non-monogamous) so my doctor didn’t recommend it, I was the one that brought it up to my doctor. My insurance covered it fully, and while it may not be “as effective” for someone who had HPV previously and was 25 years old….we decided the potential benefits were worth it. I went in like clockwork for my 3 shots, and boy, do I *HATE* shots.

Then in late 2010, I had another annual gynecological exam and round of STD testing. My pap smear came up as abnormal, AGAIN. (This time I had ASCUS-atypical squamous cells of undetermined significance”) ASCUS is a very common and slight abnormality, but I still followed up with my OB/GYN for a colposcopy. Luckily she didn’t even see enough abnormalities to do a biopsy this time, and I only need to have regular yearly exams for now, but I was still flabbergasted. How did I, a woman who’s had HPV before but “cleared it”,  had the HPV vaccine and who takes safer sex precautions very seriously-have HPV again? Well my doctor said that there is no real way of knowing. Since there is no test for men, we can’t know when or from whom I contracted it. (HPV also can have a long incubation period, lying dormant for years). Her best guess was that my body might not have “fully cleared” the virus from the first time, or that the strain(s) of HPV I had were ones NOT included in the vaccine.

*There are currently two HPV vaccines (Cervarix and Gardasil) on the market in the US. Currently Gardasil is approved for use in girls and women as well as boys and men age 9-26. Both vaccines are very effective against HPV types 16 and 18, which cause most cervical cancers. So both vaccines prevent cervical cancer and precancer in women. Only one of the vaccines (Gardasil) also protects against HPV types 6 and 11. These HPV types cause most genital warts in females and males. For more information on the HPV vaccines visit the CDC’s website here.

If you use condoms/barriers, get regular pap smears (women, obviously) and get an HPV vaccine and you’re as protected from HPV as you can be, bottom line.