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 Post subject: Sharing HPV history
PostPosted: Mon Dec 04, 2006 2:25 pm 

Joined: Mon Dec 04, 2006 2:14 pm
Posts: 1
I was diagnosed with HPV over 5 years ago. I only had one outbreak at that time and was treated. I have had one abnormal pap and was tested to find out the type of virus I had 3 years ago, which came back positive.

My question is: if it has been this long since detection of HPV, do I still need to share this information with new sexual partners? If I get retested for HPV and it comes back negative, is it like I never had it? I ask because I have shared this info with new partners and it's very stressful for me and I've actually had people say that they would have rather not known if there was a minimal risk; do I have a need to recall this history if the risk is so small of transmission?


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 Post subject:
PostPosted: Mon Dec 04, 2006 3:01 pm 
Site Admin

Joined: Wed Oct 04, 2006 4:08 pm
Posts: 2122
Location: North Carolina
Hello Maria,

Welcome to our HPV forum. We're glad you joined us!

The emotional toll of dealing with HPV is often as difficult as the medical aspects and can be more awkward to address, affecting people in the areas of heart and soul. This may be where we are most vulnerable, and the lack of clear counseling messages can make this even more stressful.

For example, the National HPV Resource Center (NHPVRC) often receives questions about what to tell either a current or future sex partner. The messages have to be tailored to each individual situation.

Still, there are some basics that are probably good to cover in a conversation with a partner about HPV. Many who have recently been diagnosed with HPV are worried that a current partner will assume there has been infidelity in the relationship, and they fear the partner’s reaction. It’s important to understand that one may have HPV for weeks, months, or even years before symptoms develop or the virus is detected. This is why it is usually impossible to determine when, or from whom, HPV may have been contracted. A diagnosis of genital warts or cervical cell changes in an established relationship does not automatically mean that anyone has been unfaithful, but this does not address the awkward questions that may be raised yet often are left unanswered.

Another common issue is what to say to a new partner about an HPV diagnosis that may have occurred years ago. Basic messages are hard to formulate as there is a great deal about the natural history and progression of HPV that science is still sorting out. An example is the question of whether or not the virus is always present. There is evidence, and some experts firmly believe, that HPV is transient in nature. Some research with DNA testing indicates that the majority of those testing positive for HPV will eventually test negative, often within a year or two (especially with younger patients). Still, there remains disagreement over just what this means. Is the virus still contagious? Will there be recurrences?

The answers to these questions may not be the same for every case, either. For someone who has not had new warts or cell changes detected for years, it seems reasonable to say that the risk of the virus remaining active is likely to be minimal, but this is another gray zone as indicated by qualifiers such as “likely to be.” The truth is, there is no way to determine these answers definitively. Still, long-term persistence of this virus does not seem to be typical.

The question naturally begged is whether or not it’s even necessary to bring HPV up years after the fact with a new partner? Good arguments may be made either way, and there is little consensus about this. ASHA does encourage open and honest communication between partners about matters of sexual health and, naturally, this includes HPV. Part of the difficulty in developing messages is that even if the virus is likely to become latent at some point, one cannot say for certain when this will occur. This may be one reason to discuss HPV. Another consideration is that sometimes by not talking about it, one may feel that they are harboring some kind of “secret,” and we’ve spoken with many over the years who tell us they feel a strong sense of regret in not speaking with their partners about this.

The other side of the discussion comes from those who, quite reasonably, point out the risks of rejection inherent in such a discussion about STDs and wonder if the apparent transience of HPV over time warrants even bringing it up years later. A number of experts would say this not necessary to do, while others would disagree.

I hope this helps, Maria, and I'm sorry there isn't a more definitive "yes or no" answer. If it's been years since your last abnormal Pap, it's probably fair to refer to HPV as a past infection that your immunity seems to have cleared. The lack of a test of cure is frustrating, though.

We encourage others to offer their thoughts on this topic, too.

Fredo
ASHA Moderator


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 Post subject: Research
PostPosted: Mon Dec 18, 2006 5:54 pm 

Joined: Mon Dec 18, 2006 5:12 pm
Posts: 3
Fredo:

Thank you for that great reply!

You refer to the fact that their is some research that indicates that after a year or two the majority of those who have tested positive for HPV will test negative. I would like to learn more about what this might mean. You mention in your post to Maria that since she has not had an abnormal Pap for years, that its probably a past infection that her immunity has cleared.

This is certainly cause for hope, but unfortunately, I don't have access to a test. The FDA, in their infinite wisdom, has not released a test for men.

I am trying to find information that could help me determine the likelihood of a person's immunity overcoming the disease if he hasn't had an outbreak of warts for 4 years.

Do you know where I can find any more information on the research about those testing negative after testing positive?

Thank you for this wonderful place to access vital information.

Chris


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 Post subject:
PostPosted: Wed Dec 20, 2006 9:29 am 
Site Admin

Joined: Wed Oct 04, 2006 4:08 pm
Posts: 2122
Location: North Carolina
Hello Chris,

Good to hear from you and we appreciate your posts on these message boards.

HPV DNA testing, as you correctly state, is not currently approved for clinical (that is, routine diagnostic) use for men. This is primarily because 1) the sampling methods to obtain good specimens with male genital skin have historically been tricky and 2) it isn't clear just what the best use of these tests are with men; there is no "male equivalent" (there has to be a better way to say that...) to cervical cancer screening.

The other consideration is that with both men and women, HPV DNA tests are not best used as a general means of checking infection status. In other words, they don't answer questions such as "Do I still have HPV, is it active, will it ever be active, does this mean it can be transmitted" and so on.

Medical research studies have shown time and again that most of those who test positive for HPV DNA do evenutally test negative, often within a year or two (often less than that) but there aren't studies we're aware of that address transmission of the virus with these subjects to new partners. Many experts do think HPV is simply not likely to persist and the risks of transmission do diminish greatly after one has gone awhile with no additional signs of warts or cervical cell changes. The hard part is there is no means of proving that an individual is no longer able to transmit the virus.

Hope this helps.

Best,
Fredo
HPV Board Moderator

_________________
ASHA Moderator


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 Post subject:
PostPosted: Thu Mar 22, 2007 8:23 am 
Site Admin

Joined: Wed Oct 04, 2006 4:08 pm
Posts: 2122
Location: North Carolina
Since this has been such a popular thread with many views, I thought I'd put it near the top of the board.

Fredo

_________________
ASHA Moderator


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 Post subject:
PostPosted: Wed Mar 28, 2007 5:19 pm 

Joined: Wed Mar 28, 2007 4:55 pm
Posts: 2
I had an abnormal pap years ago and was told I had genital warts, but have never had a break out. I'm almost in denial about it, but know they wouldn't lie. I know there are several types. I'm not sure what they all are though or what type I have. I just went today for my exam and asked a few questions, but I'm not satified or I wouldn't be on this board. I haven't had a sexual partner in 5 years and I'm talking with someone now. I haven't brought this up to him because I'm scared/worried that he'll not want anything to do with me.

Here are a couple of questions:

How can I tell which one I have, is that through the HVP DNA?

Are there types of HPV that you can't spread?

I will also call my doctor back and talk to a nurse or someone with other questions. I just hope they'll have the time.

I know using protection is the best answer for anyone whos been told they've had an abnormal pap.


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 Post subject:
PostPosted: Wed Mar 28, 2007 5:30 pm 

Joined: Wed Mar 28, 2007 4:55 pm
Posts: 2
I think I'm rehashing the second question so you don't have to answer it.


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 Post subject:
PostPosted: Thu Mar 29, 2007 8:34 am 
Site Admin

Joined: Wed Oct 04, 2006 4:08 pm
Posts: 2122
Location: North Carolina
Hi Candice,

I note you mention you plan on speaking about your situation with a healthcare provider, which is always the best thing to do. When women with no visible symptoms have an abnormal Pap test that is found to be related to HPV, most often they are dealing with cervical cell changes rather than genital warts. This isn't always the case, as cervical warts are sometimes found, so have your provider help you sort out the specifics of your diagnosis.

All types of HPV that are associated with the genital area can be transmitted to new partners, although as discussed above the risks of this may diminish over time as natural immunity clears the virus. No way to know when this natural suppression might occur and some HPV infections do persist, of course, but the immune system seems able to gain control of HPV in most cases at some point.

Hope this helps but post again if you have more questions.

All the best,
Fredo

_________________
ASHA Moderator


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 Post subject: To tell or not to tell
PostPosted: Thu Aug 09, 2007 1:30 pm 

Joined: Thu Aug 09, 2007 12:41 pm
Posts: 22
As a man, I would appreciate knowing about my partner's history, and in all likelihood move past the HPV issue if I truly cared about the person. Speaking from the perspective as someone who had sex with at person and didn't tell her, I would say that the resulting feelings of guilt and shame are not worth the price of starting any relationship under false pretenses. There is no way that I can put the "horse back in the bar," so to speak and I would give anything to do so. I forgot that the most important relationship is to ourselves and but not telling my partner, I betrayed not only her, but myself as well.

It is simply not worth it to go ahead with being totally honest.

In addition, I realized this after the fact, that if I had been honest with her she could have gotten vaccinated and during the six months we could have really taken the time to get to know one another. Then if we progressed to the physical stage there would be no issue. As it stands I am afraid that there is too much damage done to a relationship too new to handle it and I have ruined her life needlessly.


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 Post subject: How Do You Handle It
PostPosted: Mon Aug 27, 2007 10:27 am 

Joined: Mon Aug 27, 2007 8:19 am
Posts: 5
I've had HPV for 2 years now. I can't take the rejection anymore. I've tried being honest but it hurts so bad when I have to tell someone I like that I have this STD. I know it isn't a bad one, but people hear STD and tuck tail and run. I'm so young and so hurt. I have a guy that I like so much, and I've tried to refrain from having intercourse until I could get up the nerve to tell him. Unfortunately I was stupid and gave into temptation with him and didn't wait to tell him. We were smart and used a condom, but still, I hate myself. What kind of horrible person am I? I know once I tell him, he will be like every other guy I have told and run as far away from me as possible. And right now, I wouldn't blame him. But I don't think emotionally, I can handle this anymore. I don't know what to do. I don't know how to sit down with him, or anyone in the future and tell them. How do you do it? How do you take constantly being rejected, people saying your dirty? I was in a relationship for 2.5 years and got it from that guy, its not like I slept with 50 guys. I was so hurt that he didn't tell me until I got it, and now I'm out doing the same thing. How do I stop this? How do I become okay with what I have? How do I just tell people, and brush aside them rejecting me? Wow, I sound like I should just go to a therapist huh? We definitely need more support groups around the world for this stuff. Start an HPV dating site then you know what your getting into. :wink:


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 Post subject:
PostPosted: Mon Aug 27, 2007 11:41 am 

Joined: Wed Aug 01, 2007 11:09 am
Posts: 251
Saray,

See this link: http://www.ashastd.org/phpBB/viewtopic.php?t=1601. It is a great string on telling partners. majormajor who posted the initial question is in a similiar situation to you. I hope this is helpful.

Have you considered compiling a quick reference fact sheet for your future partners, and urging them to research it on their own? A nice starting point could be referring to the media storm about Gardasil vaccinations for young girls. For example, "I really wish I had that option when I was 11 because HPV can strike anyone, even when you have only had one sexual partner - that is what happened to me."

When people realize that anywhere from 75-90% of sexually active adults will come in contact with the HPV virus in their lifetime, and anywhere from 1-4% of sexually active adults have genital warts at any one time (which may be underreported as these self-clear, people may not realize what they are, and it is not a reportable STD), it may dawn on them that they are going to encounter this virus at one point or another. In addition, you could suggest that they research the Gardasil vaccine, and if they are comfortable with it, get it before you are sexually active. The vaccine can cost up to $450 for the 3 shots, but it would be beneficial for your partners not only if they have sex with you but if they are having sex at all. It would be an off-label prescription for men, but some doctors will prescribe it. Clinical trials are underway to assess its effectiveness in men, but certain articles (April 07 in American Vogue) discuss prescribing it for men now.

You are NOT dirty. I am 36, was sexually active for 11 years, abstinent for 6 years and as soon as I became sexually active again 9 months ago, went on the pill, and stopped using condoms - bam, I have HPV. When I told two members of my family who were in long term monogamous MARRIED relationships, and urged them to get HPV testing, they BOTH had already had bouts with HPV, never told me, plus they knew many other people who had had it - smart, university educated people who knew to be tested for STI/STD, but who never knew much about HPV or genital warts because there really has not been a dialogue about HPV in society. Basically, if you are sexually active, you will be exposed to this virus at some point in your life. Our mothers, grandmothers, sisters, aunts, cousins all probably have had this infection - not to mention all the men in our lives.

I know the rejection is hard and it is extremely difficult to tell people about this infection. I am sorry that you have to go through this. I do hope that it gets easier for you as you get older, and I think it might, because as people get older, statistically the chances they have already come in contact with this virus (or another STI/STD) are higher - and they would then likely be more understanding.

Good luck, Saray and don't lose hope.


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 Post subject:
PostPosted: Wed Aug 29, 2007 5:40 pm 

Joined: Mon Mar 05, 2007 6:12 pm
Posts: 3
I've been in your shoes, it's horrible and I can't give you the answers because I don't have them myself. I lost someone with whom I had a connection like no other when I told him. My best advice to you is to relax (which I know is a joke, but have a glass of wine or two) as much as you can and just present him with the information you have (although most of it is not just black and white). And be careful, my doctor told me that HPV can be transmitted even if the guy is wearing a condom. It's the contact that counts not necessarily the bodily fluid. What I have found to be ridiculously frustrating is that there is no test for men! All this fuss about us when chances are they have it too! GRRRR! I feel your pain!!! I have dated a few people who ok with it, so don't give up hope!


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 Post subject: Doing the right thing
PostPosted: Sun Nov 11, 2007 11:36 pm 

Joined: Sun Nov 11, 2007 9:21 pm
Posts: 7
I just recently had sex with a man (after being celibate for 3 years) but I made the mistake of not telling him about my HPV history. I was given varying advice--some people told me NOT to tell him (because of the fact that I haven't had issues with my paps). Although, I made the mistake of telling him after the fact (we did use condoms but I know that doesn't completely take away the risk factor). I actually just dug out my medical files and have all my cytopathology reports. I went for years without having any issues. Although, I did forget that I had to get cyro done when I was 21 but I remember it was a very miniscule spot (I also remember the area she biopsied--which she showed me--very tiny) (I forgot about this when I was first diagnosed)--she did it as a precaution because of the cellular changes. I remember it was not fun.

Anyway, the two things that kept coming up were the following in my pap results: Atypical Squamous Cells of Undetermined Significance , Favor reactive but cannot rule out LGSIL. Last year my HPV decided to pay a vist after all these years (blah!) and had the Low Grade Squamous Intraepithelial lesion--cellular changes associated with HPV. So I guess it was lying dormant in my body for all this time :(. I went for about 6- 7 years with normal paps. I had slept with one person during that time (but that was in between my routine paps and everything was normal--I had used a condom with him as well).

I'm curious (I guess I could ask my sis who's a MD)--but are these considered "high risk" HPV strains? I don't know the exact numbers associated with my HPV??

I'm curious.


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 Post subject: Some good information
PostPosted: Sun Nov 11, 2007 11:53 pm 

Joined: Sun Nov 11, 2007 9:21 pm
Posts: 7
I used to work for this health organization. I actually know a lot about my HPV because of the fact that I worked for them and they were always coming up with the latest stats on HPV and cancer. I just wish they had had the vaccination when I was in college :( I'm 35.

I just wanted to share this information. Even if you are vaccinated, you still should be using a condom.

http://www.cancer.org/docroot/NWS/conte ... th_HPV.asp


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 Post subject:
PostPosted: Sat Feb 02, 2008 1:08 am 

Joined: Sat Feb 02, 2008 12:51 am
Posts: 2
Location: Miami, Florida
Hello...I"m new to this forum and am quite overwhelmed by all the info here and on the web.
I was diagnosed with HPV 16/18 about 8 years ago. I subsequently had further testing and ultimately a LEEP procedure. I followed up with a PAP test every 3 months for the following two years and all tests came back negative. I continue to receive yearly PAPs, thankfully all negative to date (my next PAP is scheduled in 2 weeks).
My question is, does this 'qualify' under what was previously stated in a post
"the immune system seems able to gain control of HPV in most cases at some point" or am I still infected with HPV? Is the strain dormant? Should I have an HPV/DNA test and/or coloscopy to answer these questions even though my PAPs are negative all this time?
Any and all info would be GREAT!!!
Thanks in advance!

_________________
Ocean&sun Cross


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