Hello,

Recently, my monogamous partner had an abnormal pap smear which her gynecologist referred to as "high risk" We have both been perfectly monogamous with each other and with all previous partners. Although I am aware that it is nearly impossible to determine the origin of the potential infection, who gave it to whom, etc; we are still both worried about our mutual well being. I have a few questions which I hope can be answered concisely.

1. Assuming she is infected and we have been using the pill and withdrawal as birth control for many months, what are the chances that I have become infected?

2. Assuming I am infected and we have been using the pill and withdrawal as birth control for many months, what are the chances that I infected her?

3. Assuming that both of us have been infected, are there any negative repercussions to continued sexual intercourse?

4. I am aware that the majority of the population has HPV. How dangerous is it? I cannot find any conclusive data online. I am psychological neuroscientist in training so I am well aware of the resources available on the Internet.

5. If she is infected and it has been caught within one year: (she has an annual pap smear)

6. What are the specific procedures involved with the removal of the potential malignant cells?

7. Does it threaten her ability to have a natural birth, if so, would a seasecton be an option which would allow for an otherwise natural birth?
I am aware that a host mother can be used, please exclude that possibility.

8. If the cancer is removed, how often is a hysterectomy necessary to prevent the spread of cancer in a healthy 19 year old female?


Thank you for your time and in advance for through answers. Please do not use layman's terms in your reply. Any response copied and pasted will most likely be from a source I have previously exhausted.

Please help me. I am unaccustomed to such a high degree of mutual fear between myself and the woman I love.

Sincerely,

--Jason

Hi Jason,

Welcome to our message boards and thanks for your post.

The incubation period with HPV can vary greatly, from weeks to months or even years, making it impossible in most cases to sort out the "when" and "from whom" questions. Either/both of you could have had HPV from a prior relationship. HPV testing is limited in it's application to specific cervical cancer screening situations, and is neither designed nor approved as a general means of checking infection status, determining how long one may have been infected, or whether or not HPV infection can currently be transmitted.

There is no way to know for certain if you have contracted HPV from your partner, although couples are generally presumed to share HPV infection (some experts might take issue with such a general statement, although I suspect not too strongly). What follows in this specific section is what I posted to someone else who had a question similar to yours re: HPV in a relationship: Transmission studies among couples are lacking, but it doesn't appear likely that couples sharing an HPV infection will "ping pong" the virus back and forth. Some research suggests that couples who use condoms might be able to clear both HPV and associated lesions (like cervical cell abnormalities) a bit more quickly, but more studies are needed to fully understand this. Suffice to say reinfection with your current partner probably isn't an issue, but some couples choose to use condoms regardless. Condom use has also been associated with lower rates of HPV-related diseases, like cervical cancer.

In terms of how "dangerous" HPV is, I think the best answer anyone can offer is that cancer is an uncommon outcome of HPV infection and the malignancy most often associated with "high risk" HPV, cancer of the cervix, is essentially preventable through regular screening and, if needed, treatment and follow up exams. Because cervical cancer usually takes years to develop, the disease is most often observed in women who have either never had a Pap test, or have gone many years without one.

As for treatment of cervical cell changes, review the pertinent section of our Web site at http://www.ashastd.org/hpv/hpv_learn_dysplasia.cfm#6. Treatment options vary based on factors such as size, location, and distribution of lesions. Hysterectomy is not commonly indicated to treat cervical precancers, and even many cancers do not require this approach.

Re: pregnancy, go to http://www.ashastd.org/hpv/hpv_learn_dysplasia.cfm#7. C-section is not generally recommended solely due to the presence of HPV, as the risks of neonatal transmission are slight. The issue with cervical HPV during pregnancy is the health of the cervix, not the baby.

For all points we've discussed, your partner should ask her health care provider to address them given her specific case and medical history.

Hopefully this has offered some insight. Your questions are very specific and very excellent; I hope you'll continue to participate in this forum.

All the best,
Fredo

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ASHA Moderator