HPV

HPV stands for human papillomavirus. It is really a family of viruses rather than a single entity. There are over 100 different strains of HPV and new ones are being discovered all the time. It is estimated that up to 85% of adults in the United States will be infected with HPV in their lifetime. Most strains of HPV do not cause any problems, however, occasionally problems do occur. The strains that cause problems are known as the “high risk” strains of HPV. It is these high risk strains that are tested for when HPV testing is done. These are also the strains the vaccine protects against.

HPV is one of the most misunderstood issues in all of medicine. Many people don’t know HPV exists, but even more have an exaggerated fear of HPV. HPV can cause genital warts in both men and women. These warts are certainly obnoxious, but they are rarely dangerous and almost always easily treatable. HPV can cause cervical dysplasia in women. Cervical dysplasia can be easily diagnosed with a colposcopy and treated with a LEEP cone biopsy, a simple office procedure. It is almost unheard of for a women to develop cervical cancer if she is compliant with treatment. HPV can lead to penile cancer in men, but this is an incredibly rare cancer. Ramifications of HPV can be inconvenient and obnoxious, but they are almost never life threatening.

It is common to have HPV yet have no symptoms. When HPV is diagnosed, it is impossible to tell how long it has been present; it could have been recently acquired, or it could have been present for years.  In most people, HPV infection never causes problems. This can be understood by simple logic. The majority of adults in the US have HPV, yet genital warts and cervical dysplasia are relatively uncommon. This argues the point that most people with HPV remain asymptomatic.

There are vaccines for HPV, Gardasil being the most popular. It is my opinion that everyone should receive the HPV vaccine before they become sexually active, both boys and girls. Even though it is rare for HPV to cause life threatening problems, it is not uncommon for the virus to cause issues that require treatment. This treatment can be time consuming and expensive. Furthermore it can cause significant stress for people that develop problems. The vaccine can help reduce these issues. The reason boys should be vaccinated is the concept of “herd immunity”. If everyone in a population is vaccinated against a given disease, that disease becomes very rare, and may even become non-existent. Vaccines are not 100% effective. Herd immunity protects those in the population in which the vaccine does not work.

People seem devastated when I tell them that the HPV test came back positive. If you have HPV it really just means that you are part of the majority of adults. It does not mean that you are dirty, bad, or immoral. It simply means that you have probably had sex some time in your life. If you are  a nun and have HPV that may be surprising; for everyone else it is sort of expected. It is my opinion, and I recognize this is controversial, this is not necessarily something that needs to be disclosed to a new partner. If for no other reason than it is so prevalent that there is an 85% chance the new partner also has HPV even if they do not know it. If both partners choose to have unprotected sex, I recommend that both be tested for STIs beforehand. If only one of the partners has HPV, this may be a reason to discuss the ramifications with your partner. This is my opinion and I certainly respect that others will disagree with it.

If you are diagnosed with HPV remember up to 85% of the population also has HPV. It will likely never cause any significant problems. Even if you develop cervical dysplasia, this can be cured with a simple office procedure. So follow your doctors advice regarding follow up and treatment, but try not to get too upset by the diagnosis. After all, the vast majority of adults share this diagnosis as well.