Get Real! I Have HPV — Do I Have to Tell Him?

Heather Corinna

Knowingly putting someone at risk of a HPV infection -- an infection that isn't yet curable and for which men can't be tested accurately -- without giving them a choice about whether they want to take that risk isn't okay.

Gaby asks:

I
got HPV from my last sexual partner. I was wondering if I went to
donate blood would I still be able to? My new partner doesn’t know I
have this and I don’t want him to find out. By donating blood and
getting the results back will they be able to tell I have it?

Heather replies:

You
will need to tell new partners about a sexually transmitted infection
you have or have had, particularly one like human papillomavirus (HPV)
where condoms reduce the risks of transmission, but not as well as they
do for other kinds of infections.

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Putting someone knowingly at risk of an infection — one that isn’t
yet curable and which men also can’t be tested accurately for yet —
without giving them a choice about if they WANT to take that risk isn’t
okay as far as I’m concerned. If your previous partner had HPV and knew
(and it’s totally possible he didn’t) and didn’t give YOU that choice,
that is obviously very unfortunate, but it doesn’t mean it’s okay for
you to do that to someone else. I’d also consider how nondisclosure has
an impact over time. If he gets it, particularly given how tough it is
to detect in men, he may have it silently. So, he’s not going to
disclose possible HPV on his part, putting any future partners of his
at an unknown risk, and on and on it goes, particularly if he does give
it to partners who either don’t get visible warts or pap smears
regularly to find out about HPV, or who have it, but in whom it goes
undetected. While some strains of HPV are a hindrance, but are known to
be pretty harmless, others are not: some strains can cause cervical,
anal or penile cancers.

HPV is very contagious, which is why it is so common, with around
5.5 million new genital HPV transmissions occurring in the United
States each year, representing about one-third of all new STD
infections, and an estimated 20 million men and women are thought to
have genital HPV at any given time. According to a 1997 American
Journal of Medicine article, nearly three in four Americans between the
ages of 15 and 49 have been infected with genital HPV at some point in
their life (AGI, HPV in the United States and Developing Nations: A Problem of Public Health or Politics?).

If you were diagnosed recently you most likely still have it now.
While it’s understood that many people can and do shed or suppress the
virus in time, we don’t really have a sound way of finding out who has
and who hasn’t yet. So, anyone diagnosed with a type of HPV needs to
consider themselves as always having it when it comes to current or
future partners. Your partner is at a substantial risk of contracting
it from you if the two of you engage in any genital sex, such as
vaginal intercourse, especially unprotected. Using latex barriers is
known to reduce the risk of transmission by around 70%.

If you aren’t at all sexually active yet, and are just getting to
know this guy, it’s fine to wait to tell him until you get closer to
that point in your relationship, but if you are getting to that point
or already sexually active, you do need to tell him. Choosing FOR him
to take that risk — rather than affording him the basic respect of
making that choice for himself — isn’t fair, even if it’s completely
understandable that you wish you didn’t have to tell him. Part of
informed consent when it comes to sex is the informed part: one partner
purposefully and knowingly keeping information from the other which
puts their health at risk, and then having sex with that partner really
isn’t with a partner who can be giving full, informed consent.

So if you just can’t deal with telling him, then you need not to be
sexually involved with him yet. Wait for that until you feel
comfortable enough with him to fill him in. If you already have been
sexually active, not telling him ASAP just isn’t an option in my book.
I know those are hardly easy conversations, especially with the crappy
attitude a lot of people have about STIs, and with how ashamed a person
can feel for having one, even though there’s no more shame in having
HPV than there is in having a cold. I also recognize that it can feel
like an unfair burden for women: since we’re the ones it can be most
often soundly identified in, the burden of disclosing often lies with
us. But that’s just the way the cookie crumbles.

It’s also one of the kinds of tough conversations we simply need to
have if we’re going to be sexually active — of which there are usually
more than one — and when it comes to partners who we care for, and who
we know care for and respect us, that conversation also really isn’t
likely to be awful. What it may result in is simply your new partner
wanting to do some research before he makes up his mind about sex with
you, including seeing what the two of you can do to reduce your risks
if he does decide he’s okay with that risk and a sexual relationship.
No matter what he decides, if he’s a good guy who cares for you, he’s
not going to make you feel like a pariah about this: he’s going to be
supportive, even if he’s nervous or scared. If he handles it like a big
jerk…well, then you can say buh-bye and know you’ve dodged a bullet.
If he’s a jerk about this, he probably was going to be a jerk in other
respects in the future. Most of us are going to have an illness of some
kind at some point, and many are communicable: if we’re going to be in
contact with other people, we just need to accept that. As well,
someone who is sexually active but who doesn’t accept that STIs are
something everyone is at risk of, and which many people do or will have
— including them — isn’t being particularly realistic about sexual
partnership. Obviously, everyone would like to think and hope that it
won’t even happen to us (and for many people, it won’t, and for people
practicing safer sex, it’s much less likely), but if we’re going to be
sexually active we’ve got to recognize that it might and have some
level of preparation for dealing with STIs.

As far as your questions about blood, HPV isn’t transmitted through
blood, it’s transmitted by skin-to-skin contact. So, people with HPV
can and do still donate blood. Too, people doing blood drives are not
going to be testing your blood for HPV, since your blood doesn’t
present a problem per donation if you have HPV. If you haven’t had a
recent full STI screen (and if you’ve been sexually active, which it
sounds like you have, that’s something you need to do every year), you
need to get those screens from your gynecologist, general doctor and/or
sexual healthcare provider. Too, it’s particularly important when you
have HPV to get your yearly pap smears without fail, because HPV can
cause cervical cancer, so it’s vital to have your doctor keep an eye on
your cervix to be sure it has not for you.

Here are a couple of links for you with more information about HPV,
as well as another link or two that I think will help you sort this all
out.

Gaby wrote back and asked…

Thanks for that information. I don’t know how to tell
him yet but I do want to. I do have or had genital warts but I got
treatment and my doctor told me unless I had another outbreak it would
be a slight chance of me transmitting it to someone. I haven’t gotten
sexually active with this person yet and for a long while I don’t want
to for the same reason. I do feel ashamed of having HPV. I cant help
it, I feel dirty and I know that its not fair for me not to tell him
later on I just don’t know how to? How do you tell someone you have HPV
without scaring them away?

The information your doctor gave you, based on everything I understand about HPV, was questionable. According to most reliable health sources, treating warts may
reduce the risk of transmission, but we really just can’t say for sure
yet nor do we know how much that can reduce risks. Removal of warts now
is done mostly for the comfort of the person with warts. While having
warts — which are not always somewhere you can see, so you may have
another outbreak and not even know — does make it more likely to
transmit the virus, it can still be transmitted when they have been
treated and are no longer present or visible. When it comes to
determining how likely any kind of infection is to be spread, it’s also
a larger issue than just the virus itself: we have to take the health
and the immune system of the people we may transmit it to into account,
and that usually is an X-factor.

However, even if your doctor is correct and there is only a slight chance of transmission… there’s still a chance of transmission.

Whether the risk is high or low, it still is something you will need
to tell partners about if you are going to be a partner who is
considerate about their health. As I mentioned in my previous response
to you, wart strains are not known to present the cancer risks which
other strains do, but it still is something we want to tell partners
about, and still is a virus which could impact their health or quality
of life, something I likely don’t have to tell you.

I totally understand that disclosing this is scary and daunting. I
also understand feelings dirty, not because you are dirty — no more
than someone with a cold, flu or diabetes is, anyway — but because the
culture we live in still often attaches a stigma to sexually
transmitted or genital infections. But you aren’t dirty, and you don’t
have anything to be ashamed of: you’ve just been sick. People get sick.
A sexually transmitted infection, genital infection or reproductive
infection is really no different from any other kinds of illness. The
only reason our culture stigmatizes those particularly is because our
culture often still considers sex and genitals, period, as dirty. Me, I
think that’s pretty juvenile and something everyone should have grown
the heck up and gotten over by know, particularly when it’s so clear
how it negatively impacts people’s health, body image, sexuality and
overall well-being. However, while I’m certainly not the only one who
feels that way, some people do still feel or think otherwise, and we
appear to make pretty slow cultural progress in this regard. If I could
wave my magic wand and change that, I would.

Let’s be realistic: you might scare him away. It could happen. Some
people do panic in the face of sexually transmitted infections, even
though around one in every four people your age do have one, have had
one or will have one. However, any number of things might scare a
partner off, and for the most part, that’s just not something we can
control. If we want to have a healthy relationship, we’ve got to aim
for openness and honesty and accept that how another person reacts to
whatever it is we’re being honest about is out of our hands. That’s a
risk with intimate relationships, when HPV is an issue or not. But if
we’re not open and honest, we risk something bigger, which is having a
relationship whose our closeness and the quality of that relationship
is limited: where what’s supposed to be an intimate relationship is
only so intimate.

He might also choose — and that’s his right, as it would be yours
— to nix a sexual relationship with you because he doesn’t want to
take a know risk of contracting HPV. I know that would suck, and could
also likely leave you feeling rejected and pretty low, and there’s
nothing I can say about that which wouldn’t come off as glib or trite:
rejection always hurts, particularly when it’s about things we cannot
change and which are out of our control. Just know that if he does
reject you on this basis, there are plenty of other people — whether
they have HPV or not — who won’t.

He also might handle this fantastically and be very caring and
supportive. (Heck, he might also have HPV himself.) I think we have to
be just as open to and prepared for acceptance from people as we are
with rejection. Sure, he may be bummed out in some way, but there are
people in the wold who can manage being disappointed, and people who
choose to be with partners where some known level of risk exists,
whether that’s about HPV or whether it’s about a partner needing to be
away at school for a couple of years, a partner being uncertain about
if they want to have children, a partner having a terminal disease, a
partner having some kind of challenge in their lives or history which
may impact the relationship. When we choose to take some level of known
risk, it’s usually because the possible benefits — like being close to
someone we love — outweigh those risks.

Given the time lapse between your questions, I presume this
relationship is going well, which is why YOU are looking at taking
risks yourself. By now, you probably have some idea of how he’s going
to respond to this and if he’s someone who cares a lot for you. If he’s
not, you have more reasons than HPV to reconsider pursuing a
relationship with him further, including a sexual one where you’d be
disclosing this. If he is someone you know as caring and sensitive, I’d
suggest giving him the benefit of the doubt, and considering that he
might not only handle it well, but might also be someone who could give
you some of the support and acceptance you need right now.

Again, how soon you bring this up is up to you, particularly since
you’re not yet putting him at any risk right now. I’d base that on if
and when you two start talking about sex, and based on how close you
two are at this point in time. Per the how-to when you do bring it up,
I’d suggest starting by just being very plain: you were diagnosed with
a genital wart strain of HOV which you acquired from a previous
partner. You have been treated, and know this kind of strain to present
inconveniences, but not major health risks for most people. You can
share some of the information I have shared here with you with him: the
facts about HPV, how to reduce the risk of transmitting HPV, how common
it is. I’d voice your worries and feelings about sharing the
information, and make clear that while you certainly understand if he
feels worried about this himself, or has some troubles dealing with it,
that no matter what choices he decides he wants to make, you need him
to be caring and supportive in talking about and dealing with this with
you. And then I’d just talk it all out together.

Mostly, I’d implore you not to let HPV ruin your life, your
self-image or your relationships. It doesn’t have that capacity all by
itself: it can only do that if you approach it in a way which limits
your quality of life. It’s always going to be scary in some respect to
get close to people, no matter what we’re bringing to the table, so
that’s not going to change, nor is that part even really about HPV. We
will always have flaws or difficulties a partner will eventually
discover and which they may or may not accept. And if you have HPV, and
do want sexual relationships in your life, as most people do, you’ll
have to get to this point eventually. Try not to project your own
feelings about all of this unto other people who may not feel like you
do: not everyone thinks it makes someone dirty.

Only you know if this disclosure and a sexual relationship is
something you’re ready for right now, and it’s up to you when you are.
Just don’t let HPV keep you from the good stuff and become something
that is a much bigger problem than it actually is.

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