At some point, most adult men and women will get infected with human papillomavirus or HPV. With over 100 types of HPV, most will be eliminated by our body’s immune response, but some strains can pose serious health risks down the line.
Knowing the facts of HPV and understanding the HPV vaccine can help you protect yourself and your family from HPV-related cancers.
We share with you some of the HPV Myths answered by some of the best doctors in the world today.
Even with nearly 20 million Americans contracting a sexually transmitted infection (STI) each year, many people continue to believe that only “someone else”—for example, people who have multiple partners, sex outside of marriage, or a different lifestyle—are at risk.A higher number of sexual partners throughout a lifetime does indeed correlate with a higher risk for STIs, including HPV. This is not because of any moral judgment concerning “casual” sex as compared with “committed” sex, but simply because the more sexual partners you have, the more likely you will have a partner who (knowingly or unknowingly) is carrying an STI.
However, STIs can be passed along as readily in a loving, long-term relationship as in a one-night stand. And HPV is the virus to prove it. At least one study of middle-class, middle-aged women, most of them married with children, found that 21% were infected with cervical HPV. In other studies, according to Nancy Kiviat, MD, a researcher at the University of Washington, about 80% of people who have had as few as four sexual partners have been infected with HPV.
This myth has been responsible for a great deal of anger, confusion, and heartache. It has led many people to tragically wrong conclusions because it fails to take into account one of the most mysterious aspects of genital HPV: its ability to lie latent.The virus can remain in the body for weeks, years, or even a lifetime, giving no sign of its presence. Or a genital HPV infection may produce warts, lesions, or cervical abnormalities after a latent period of months or even years.
As mentioned above, most people who are infected with genital HPV never know it. In most cases, a person is diagnosed with HPV only because some troubling symptom drove him or her to a healthcare professional, or some abnormality was revealed in the course of a routine exam.
But even after an HPV infection is diagnosed, there is simply no way to find out how long a particular infection has been in place, or to trace it back to a particular partner.
In a monogamous relationship, therefore, just as in an affair or even in an interval of no sexual relationships at all, an HPV diagnosis means only that the person contracted an HPV infection at some point in his or her life.
No one knows how many sleepless nights can be laid at the door of this myth. The truth, however, is that the fleshy growths we call genital warts are almost always benign. The Centers for Disease Control and Prevention states it clearly” “No evidence indicates that the presence of genital warts or their treatment is associated with the development of cervical cancer.”As for ordinary genital warts, says Doug Lowy, MD, chief of the Laboratory of Cellular Oncology at the National Cancer Institute, “These are caused by HPV types that are virtually never found in cancer.” These are the “low-risk” types, 6, 11, 42, 43, and 44. When not causing genital warts they may cause a transient abnormality in Pap test results, or most often produce no symptoms at all.
It is worth keeping in mind that both men and women may be infected with, and infectious for, high-risk HPV, regardless of whether or not they have genital warts.
First of all, an abnormal Pap test can be caused by factors other than the presence of a high-risk HPV type. When a Pap test comes back as “abnormal,” it means just that: Under the microscope, the appearance of a few cells in this sample differs in some way from the classic appearance of healthy, intact cervical cells. The difference could be due to local irritation, a non-HPV infection, a low-risk HPV type, or even a mistake in the preparation of the cell sample.To help sort out the various possibilities, a woman with an abnormal Pap test will likely have to follow up testing. A Pap is a screening test, not a diagnostic one, so a provider will help determine the next steps to take, which may include additional testing or procedures such as colposcopy and biopsy.
But this very effective system of protection can work only when each woman takes responsibility for the first step herself, by getting screened regular intervals. More than 50% of all new cervical cancers are in women who have never been screened or have not been screened in the past five years.
Warts and dysplasia do come back in some cases but by no means all. When they come back, they show varying persistence: Some people experience just one more episode, and others several. The good news for most people is that with time, the immune system seems to take charge of the virus, making recurrences less frequent and often eliminating them within about two years.The limiting factor here is the state of the immune system itself. According to Thomas Sedlacek, MD, adjunct professor of obstetrics and gynecology at Allegheny University, if an individual’s immune system is impaired—by the use of certain medications, by HIV infection, or by some temporary trauma such as excessive stress, serious illness, or surgery—it may be unable to prevent a recurrence. However, if the immune system is weakened only temporarily, most likely the recurrence will be short-lived.
The concern about life-long recurrences may be based on a misconception rather than a myth. It’s true that at present there is no known cure for genital HPV. Like a virus, it will remain in the infected person’s cells for an indefinite time–most often in a latent state but occasionally producing symptoms or disease, as we have discussed elsewhere. Recent studies from the Albert Einstein College of Medicine and the University of Washington suggest that HPV may eventually be cleared, or rooted out altogether, in most people with well-functioning immune systems. However, in at least some cases the virus does remain in the body indefinitely, able to produce symptoms if the immune system weakens.
This myth is based on an overly simple view of how HPV can be transmitted. Certainly, penile-vaginal sex can pass the virus along from one partner to another, but HPV can be passed through other forms of skin-to-skin contact as well.The most recent evidence for this comes from a study underway at the University of Washington, which has found several genital HPV infections among lesbian—even in some women who had never had sex with a man. Genital HPV in lesbians has not yet been extensively studied, but researchers suspect the prevalence rates will be lower than among heterosexuals. Even so, the rates will not be low enough to rule out the risk of cervical cancer altogether, so regular screening is a smart health measure for gay and straight women alike.
Based on our experience with other infections, this would seem like a good idea. However, thus far there is no diagnostic test that can accurately determine whether a man is carrying an HPV infection. And even if he does, there is no way to treat him for the virus.According to recent guidelines drafted by the CDC, “examination of sex partners is not necessary” as a follow-up to an abnormal Pap test. It’s certainly possible—even likely—that the partner is or has been infected with the virus, although highly unlikely that he will ever show any symptoms. Nor is it possible to determine whether he can spread HPV to a future partner.
However, if a woman has external genital warts, her partner may still consider scheduling a medical exam. It may be useful for a male partner to talk with a healthcare provider to gain more information. And of course, if a man starts to notice symptoms of his own, such as unexplained bumps or lesions in his genital area, he should get medical attention at once.
Unfortunately, this is not always the case. Used correctly, condoms are very effective against STIs such as chlamydia, gonorrhea, and HIV that are spread through bodily fluids. However, they are likely to be less protective against STIs that spread through skin-to-skin contacts, such as HPV and herpes. The reason is simply that condoms do not cover the entire genital area of either sex. They leave the vulva, anus, perineal area, base of the penis, and scrotum uncovered, and contact between these areas can transmit HPV.That is not to say condoms are useless. Studies have shown condom use can lower the risk of acquiring HPV infection and reduce the risk of HPV-related diseases, as well as help, prevent other STIs and unintended pregnancy. For these reasons, condoms should play an important part in any new or non-monogamous sexual relationship.
Adapted from “10 Myths About HPV” by Sandra Ackerman. Reprinted from HPV News (c) 1998 The American Sexual Health Association