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Thursday, Sept. 9, 2010

How to Tell a Partner About HPV

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I'm over 65 and starting to date. I became aware that I have HPV in 2006 when my gynecologist suggested I have a colposcopy after a Pap smear procedure. I did, and when she later suggested I have a LEEP procedure for this problem, I had that done as well. After my last Pap smear in June, my new gynecologist suggested I have another colposcopy, which was done last week.

My question is: How do I explain this situation to my new friend before we engage intimately without causing too much anxiety on his part? Please advise.

As I've mentioned in previous columns, HPV (human papillomavirus) is one of the topics I receive the most questions about. HPV is frustrating both because our knowledge about it is changing rapidly and because testing and treatment for the virus are not as cut-and-dried as they are for other sexually transmitted infections.

The key to discussing an HPV with a new sexual partner hinges on the fact that for most people HPV infection is completely benign. The majority of the population will be infected with HPV at some point in their lives—it's estimated that about 75% of people between the ages of 15 and 49 have had an HPV infection. So, it's likely that your new friend has already been exposed to HPV, whether he knows it or not. While some forms of HPV can cause genital warts and others may lead to cervical cancer, most people will naturally clear the virus from their bodies over time without any harmful effects.

Men, especially, are often silent carriers of the virus—so much so that there are no standard HPV tests that are performed for men the way Pap smears are performed for women. Although HPV has been linked to cancers of the throat, anus and penis, these cancers are very rare in men, far less common than cervical cancer (also linked to HPV) is in women.

Doctors carefully watch for women over 30 who show signs of HPV infection, because these women fall into the small group of people whose body's defenses have not naturally eliminated the virus over the course of a few years. This group of women is at higher risk for cervical cancer, which is why your gynecologists have been so diligent in recommending colposcopies (examination of the cervix with a high-powered microscope) and LEEP (loop electrosurgical excision procedure, which removes abnormal cells from the cervix). They want to make sure that the abnormal cell changes caused by HPV do not lead to cervical cancer.

However, just because HPV infection has caused abnormal cell changes in your body does not mean that a sexual partner of yours who became infected with the same virus would experience any ill effects from HPV. It's difficult to predict who will and who won't eventually have abnormal cell changes.

Many young people are familiar with HPV, since HPV vaccines are heavily marketed to adolescents and their parents. However, it's not a guarantee that older people will know much about the virus. So, you may want to begin a conversation with your friend by asking how aware he is of safer sex and sexually transmitted infections. This is best done outside the bedroom in a non-sexual context. You could even begin by comparing notes about the sex education you received in school and how different it is today, which can be a humorous way to break the ice on this topic (check out the American Social Health Association blog entry "Sex and the Senior Set"  for an example of this).

If he's not familiar with HPV, explain that it's a very common virus that is usually harmless, but that in some people it can cause genital warts or cancer. You can even say that he's probably been exposed to it already, even if he's never had any symptoms. Refer him to the American Social Health Association website for more information. There's even a one-page fact sheet about HPV for men that you can download and give to him if you want.

Let him know that you have an HPV infection that is being monitored by your doctor. At age 65, most people have some chronic health issues that they're dealing with, and this is really no different. If you are not ashamed to discuss it, then your partner too will have less anxiety and worry about it.

It is then up to the two of you to discuss what you want to do. Using condoms can reduce, but not eliminate, the risk of transmitting HPV to a partner. This is a good time to talk about other STIs as well, and see if he has had a sexual health checkup of his own recently. There are many other sexual health issues that come up as we get older, such as erectile dysfunction or vaginal lubrication, so this can be a good time to talk about those as well.

Finally, be sure to check with your gynecologist about sex, especially before or after an exam or surgical procedure. Your doctor may have specific recommendations about limiting sexual activity based on your particular situation.

Want Laura to answer your questions in SEXpress? Send them tolaura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.

Laura Anne Stuart has a master’s degree in public health and has worked as a sexuality educator for more than a decade. She owns the Tool Shed, an erotic boutique on Milwaukee’s East Side.

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