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Your Questions Answered: 9 Things You Need to Know About HPV

In light of a recent CDC study reporting that 42 percent of U.S. adults have HPV, we sat down with one of our medical directors, Dr. Keith Falter, to get the facts on this prevalent disease.

How serious is the threat of getting cancer as a result of an HPV infection?
Cervical cancer is common in developing countries, but rare in developed countries like the United States. This is due to access to health care and cancer screening, routine PAP smears, and possibly due to HPV vaccinations. The risk of cervical cancer is 30% if a patient has a high grade pre-cancerous lesion left untreated for 30 years. This is why we encourage women to stick to routine screening. If a pre-cancerous lesion is found in the early stages, it is easier to treat with even greater regression rates.

Recent Washington Post articles on this subject focus on oral sex, but is HPV spread through intercourse as well?
Yes. HPV can be spread through touch, oral sex, intercourse, foreplay and rarely inanimate objects.
(To read the articles, see below.)

Are people really not supposed to have oral sex?
HPV can lead to oral cancers, more commonly in men than women. It's thought that women develop a better antibody response to vaginal exposure of HPV than men do to penile exposure. Men also have higher rates of smoking and alcohol use, which are two big risk factors for oral cancers. Any sexual activity has "some" risk to it. Some behaviors are riskier than others. You can minimize your risks by using condoms, being selective of partners, not smoking, and limiting yourself to light or moderate alcohol intake, which is 1 or fewer drinks per day for women and 1-2 or fewer drinks per day for men.

Can HPV be transmitted by kissing or by non-sexual contact?
Yes. The scary answer is it can be transmitted by touch.

If I’m too old to be vaccinated, what steps can I take to protect myself?
Practice safe sex. Condoms decrease risk but do not offer 100% protection, as foreplay can spread the virus as well. Additionally, select your intimate partners carefully.

Should my partner and I be tested for signs of HPV in the mouth and throat? 
I am not aware of any oral HPV tests, only oral cancer screening exams. I recommend that every patient get routine oral care with their dentist, including screening for oral cancers. Any throat masses or enlarged lymph nodes should be checked as well.

Can a man be tested for genital or oral HPV?
According to the CDC, there is currently no approved test for HPV in men. However, some healthcare providers do offer anal Pap tests to men who may be at increased risk for anal cancer, including men with HIV or men who receive anal sex.

If a woman has normal Pap smears, is she still in danger of transmitting HPV to her partner? 
Yes. A Pap smear for a woman under the age of 30 does not include a test for high risk HPV. So, that means a young woman may be positive, not know she is, and transmit the virus to her partner. A man may also unknowingly pass it to his partner, as there is no test available for HPV in men.

Should I tell my partner if I have HPV?
That is not an easy question to answer. I think it would be a more obvious answer if we were talking about chlamydia, herpes, HIV, gonorrhea or syphilis.  HPV is a more complicated issue for a few reasons. The main reason is that there is no test for males - so you don't know if he got it from you or you got it from him.  The other complicating factor is that many HPV infections are transiently positive and negative.

If you were infected and didn't know, and your body has long since cleared the infection, can you still pass it to a partner?
Probably, as the virus expression may wax and wane as outlined above. The CDC website actually includes the statement that nearly all sexually active people will get HPV at some point in their life. On one hand that is kind of terrifying. On the other the other hand, most infections will be transient and lead to no long term complications or problems. If you have any questions about HPV or HPV screening, don’t hesitate to reach out to your Women’s Health CT provider.

Read the Washington Post articles here:
More than 1 in 5 U.S. adults are infected with cancer-causing HPV, CDC report says
What men should know about cancer that spreads through oral sex
The startling rise in oral cancer in men, and what it says about our changing sexual habits

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