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Thursday, Sept. 24, 2009

HPV: Is Woman-to-Woman Transmission Possible?

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A friend of mine was recently diagnosed with HPV. Her previous long-term relationship was with a woman who had HPV, and her doctor told her that it is impossible for HPV to be spread through lesbian sex. I'm assuming that's not the case, since my friend didn't have it before she was with her ex, and has it now. I was hoping you could give me some information about HPV, how it can be spread, and ways my friend can protect her current partner from getting it. She's really freaking out because she feels like her doctor lied to her and her ex, and she doesn't want to put her current girlfriend at risk.

This is the second question I've received over the past few months about human papillomavirus (HPV), and as I said in my July 9 column, both the general public and the medical community are often misinformed about HPV because research about the virus is evolving so quickly. I don't think that your friend's doctor would deliberately lie to a patient, but I do think that he or she was wrong. Doctors are human just like the rest of us, and unless the doctors themselves are part of the LGBT community, they often have the same level of ignorance about lesbian sex that other people do. It's a common misconception that women who have sex with women are not at risk for sexually transmitted infections (STIs), and if you add confusion about HPV to those myths, you have a recipe for incorrect information.

In my previous column on HPV, I addressed a reader question about the risk of HPV transmission when performing oral sex on a woman, which you can read here. HPV can also be spread through skin-to-skin contact, which for lesbian couples might mean genital-to-genital rubbing, touching your own genitals with your fingers and then touching your partner's genitals immediately afterward, or possibly using a sex toy on your genitals and then using it on your partner's genitals immediately afterward. It's difficult to quantify the level of risk involved in these activities because most research about STI transmission isn't focused on, say, how likely it is that HPV will hang out on your dildo. So all we can really say is that it appears to be possible to transmit HPV in these ways, and if a woman knows that she has HPV, she may want to take extra precautions to avoid transmitting the virus to her partner(s). This means using latex or polyurethane dams during oral sex, avoiding direct genital-to-genital contact, putting condoms over shared sex toys and changing those condoms when switching the toy from one person to another, and/or wearing latex or nitrile gloves and changing those gloves when moving from touching your own genitals to touching your partner's.

With that said, most of the time HPV is not actually something to freak out about. The majority of people will be infected with HPV at some point in their lives. People are not usually "diagnosed with HPV"— either they are diagnosed with genital warts (annoying, but treatable and harmless) or they have an abnormal Pap smear that has detected precancerous cervical cell changes that are linked with HPV infection. Yes, "cancer" is a scary word, but the reason that women get regular Pap smears is to detect and treat precancerous cells before they evolve into something serious, and the treatments we have are very effective. So, HPV infection is very difficult to avoid if you're sexually active, and having HPV is not the end of the world. In addition, abnormal Pap smears usually show up years after someone is actually infected with HPV. So, I'm not sure what you mean when you say that your friend was diagnosed with HPV, and it's important to realize that just because she was recently told that she has an HPV infection, this does not necessarily mean that her most recent ex was the person who passed this infection along to her.

If that previous paragraph is confusing, I recommend reading more about HPV at the two Web sites I mentioned in my July column, the American Social Health Association (www.ashastd.org) and the National Cancer Institute (www.cancer.gov). Another site I like is Lesbianstd.com , which summarizes the often scarce and hard-to-find research or current thinking about STI transmission between women.

Want Laura to answer your questions in SEXpress? Send them to laura@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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