so, if you've had an abnormal pap and been told you have HPV, what do you tell your partners? I asked my doctor this question and she actually told me she wasn't sure what to say.... that it is so ubiquitous, and since condoms don't fully protect against it, you may just give it to a guy (who probably already has it) who may then pass it on to a woman (who probably already has it) and in the mean time, they will just freak out about it. When, statistically speaking, it isn't something to freak about. Basically, if you are sexually active with anyone who has ever had any previous sexual contact at all, you are likely to be exposed to it, so you might as well just not worry about it and, of course, be SURE to get your pap smears regularly. That's essentially what she told me.
I went ahead and told my current partner anyway, (weeks before we ever got close to being intimate), because it felt like the right thing to do. Everything seemed fine with this for awhile. His wife has since more clearly absorbed the fact that this could potentially lead to cancer (never mind how small the chances actually are), and is now completely freaking out about it. Freaking out to the extent that I may never be able to see him again and it is causing a rift in their relationship.
It's really making me wonder what the right thing is to say. I am so upset and feel so frustrated that trying to do the right thing has led to so much pain and confusion and upset. I am at a loss.
I'm curious to hear how other people handle this issue.
I went ahead and told my current partner anyway, (weeks before we ever got close to being intimate), because it felt like the right thing to do. Everything seemed fine with this for awhile. His wife has since more clearly absorbed the fact that this could potentially lead to cancer (never mind how small the chances actually are), and is now completely freaking out about it. Freaking out to the extent that I may never be able to see him again and it is causing a rift in their relationship.
It's really making me wonder what the right thing is to say. I am so upset and feel so frustrated that trying to do the right thing has led to so much pain and confusion and upset. I am at a loss.
I'm curious to hear how other people handle this issue.
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Unsu...
Re: talking about HPV
Mon, May 5, 2008 - 11:14 AMI haven't been in this situation but I have noticed in myself and in other people that freaking out about a medical issue is often a cover for something else--when trust breaks down or something else goes wrong, we'll focus on the medical stuff because society tells us it's a more legitimate concern that the emotional problems that are actually bothering us. Just a stab in the dark but if she is flipping out about (nearly ubiquitous) HPV, which I agree is non-impressive as a disease and not on my own top 10 list of worries (I'm sure I'll hear from people who disagree on this issue, but that's my view), the real problem might be she's having trust or jealousy issues. Is that possible? -
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Re: talking about HPV
Mon, May 5, 2008 - 11:30 AMWell I can tell you that for me I really don't want HPV and I ask that my partners be tested for it before we become intimate, but shit also happens and you just have to learn to roll with it.
You did the right thing by telling your possible partner, his wife's reaction is not your responsibility though you may suffer from her freak out. I my husband came home from a date to tell me the news that his possible love interest has HPV I would want to slow things down a touch and ask him if he's willing to take the small, but still possible, risk of bringing that home to me. If she seemed worth it to him I may propose that he and I use condoms for a while until it feels that the risk factor is lowered by repeated exposure with no infection. But I'm a rational person typing from the safety of my personal computer. If faced with the reality of her situation I reserve the right to freak out for a little while.
But rest assured that your conscious should be clean because you did the right thing by telling him about his possible risk. -
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Re: talking about HPV
Mon, May 5, 2008 - 2:33 PMJez, men can't be tested for HPV. So how to do handle that?
Diva, I think it's the kind of thing in which you bear the responsibility to tell, and then, for your own good, educate. I deal with the same thing in having HSV1, and it sucks, but people who are with it and up on their STI information are not too likely to be spooked by it. Those who are, oh well. -
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Re: talking about HPV
Mon, May 5, 2008 - 4:43 PMDitto that. I have the cold sore thing as well, and it's never really been a problem for my partners. But then, I am happy to use barriers for oral anyway.
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Re: talking about HPV
Mon, May 5, 2008 - 6:17 PM"Jez, men can't be tested for HPV. So how to do handle that?"
Scientifically of course. What is our chance for infection? How can we prevent it? Can it be treated or is it a virus? Is she worth putting your wife at risk? Weigh out the facts, the risks, and hopefully make a rational decision. What else can you do? -
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Re: talking about HPV
Wed, May 7, 2008 - 10:55 AMNothing, of course. I was just curious about your statement that you require testing of all partners, in an HPV context. Sounds like you do the same as I do.
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Re: talking about HPV
Mon, May 5, 2008 - 11:32 AMMy partner went through the same thing when she wanted to stop using condoms with her lover. Even after several sexually exclusive months and testing he was very reluctant. But when it came down to a choice of bare sex or no sex, it was not such a hard choice for him to make after all. Still it was a very tricky situation and it did not help that he was very clueless about sexual matters in general. I think he still does not understand that a IUD is a very effective form of birth control.
So fast forward a few months......... My partner and I are both 44. As always her pap smears have been coming back normal - or at least so we have been told. Yet for some unexplained reason the doctor wants to do a biopsy - next week. So we are trying not to freak out but it is unnerving. I'm sure it will be fine and as long as she keeps getting checked up she should be good. They say early detection of any abnormalities are essential. And as you mentioned the odds are very slim that it will turn into anything of real concern.
I hope your situation turns out well for all three of you. One possibility would be for your partner and his wife to get tested. Assuming they were not virgins when they married there is a very good chance that they already have HPV. If that is the case it should put the matter to rest. Unless of course this whole thing is not just a pretext being used by the wife to exclude you from her guy. If that is the case, as I suspect it probably is, then I might just suggest doing all you can to try and make yourself less 'threatening' to her.
I can speak from experience on that. I am okay with my partner having a lover. But when she stops being intimate with me or if I feel that they are becoming closer than we and I are then I am forced to tell her that she is crossing my boundaries.
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Unsu...
Re: talking about HPV
Mon, May 5, 2008 - 5:30 PMOne thing I found very helpful to know about HPV--and this is also true of HSV by the way--is that the vast majority of people who have it don't know they have it. So there's really no way to be "safe"--except to take the usual precautions; condoms don't eliminate transmission but they reduce the incidence of it--anyone could have it, and you'd never know. There is a vaccine for the types of HPV that cause cancer but it's only approved for women up to age 26--I'm not sure if that's because it's ineffective on older women or because older women are less likely to develop symptoms (abnormal pap smear). -
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Re: talking about HPV
Mon, May 5, 2008 - 10:02 PMOnly approved for women up to age 26 because that is the age range they used for clinical trials. At least that's what my doctor told me... -
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Unsu...
Re: talking about HPV
Tue, May 6, 2008 - 8:55 AMthis is true...but I was also told by my DR that women over the age of 26 (assuming she isnt a virgin) has most likely been exposed as well, being that statistically one out of every three sexually active women have been exposed to the virus...even if they have not contracted it.
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Re: talking about HPV
Tue, May 6, 2008 - 7:37 AMI told them "I've had an abnormal pap and been told I may have HPV but (in my case) don't know for sure or which kind. How would you like to proceed?" -
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addendum
Tue, May 6, 2008 - 7:40 AMDo you know which kind of HPV you have? There are over 100 and only four are real risks for cancer (which still only raises your risk from 4-6% to 6-8%). If you don't know which kind you have there is a test that can tell you. Then you can tell everybody exactly what their risks are or if you have one of the mostly harmless versions. -
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Re: addendum
Tue, May 6, 2008 - 1:39 PMI swear to god, I get different information every time I ever ask anyone about this... even doctors. <sigh>. I was told by doctors that A) they don't test for which strain and B) if the pap is abnormal they pretty much know it is a high-risk strain. So, no I don't know which strain but assume that it is likely a high-risk one. Though that percentage figure is very interesting -- can I ask where you got that from? That would be great to have.
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Re: addendum
Tue, May 6, 2008 - 3:11 PMI got this information from my Planned Parenthood doctor who also informed me that abnormal paps don't even always mean you have HPV. Sometimes all it means is that you have mutated squamous cells. Often that means HPV, and sometimes it means high risk HPV, but not always. Sometimes it just means you had a batch of cell mutations for a completely different reason or for no particular reason at all. I would suggest calling the Planned Parenthood line and asking to talk to one of their nurses so you can get a second opinion.
And yes, you can be tested for what kind of HPV you have. Perhaps the doctors you spoke to can't or won't do it but it can be done. It's not the cheapest procedure in the world but I believe Planned Parenthood will also help you with the expense if you explain you've had abnormal results.
Here's some good info (it also states that even among women who HAVE abnormal paps doctors often don't recommend biopsy because "...the yield of a biopsy to find a moderate or severe dysplasia is fairly low (5-10%)..." It's a bit rough reading but there's stuff in there you'll want to know.
www.wdxcyber.com/npapvg13.htm
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Unsu...
Re: talking about HPV
Tue, May 6, 2008 - 8:57 AMAlso, just because you have had an abnormal pap does not mean that you have HPV...but that you may have been exposed to it. Normally repeat paps and a "just to be sure" biopsy are often ordered, then HPV could be dismissed. Good LUck
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Re: talking about HPV - an update
Tue, May 6, 2008 - 1:43 PMWell, the good news is, this seems to have blown over. I was able to give my boyfriend's wife enough good solid information, plus other information she got on her own, to make her feel more comfortable about all this. And to the people who thought this might be about things other than just the STD issue, there were a lot of other factors going on between the two of them. This just brought things to a head.
So, things appear to be back to normal, she is ok with me seeing him (and sleeping with him) and she even wants a date with my husband! Who would have expected such a quick turn-around.
Thanks for your comments. I will continue to take the tack of telling people and will actually give them even MORE information than I did this time and hope that they can process it well, even if they have an initial panic. I'm sure if I had been in exactly her shoes I would have reacted pretty much exactly the same way.
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Re: talking about HPV
Tue, May 6, 2008 - 1:57 PMI would tell if for no other reason than it's a good litmus test. Someone who FREAKS OUT or has another partner who FREAKS OUT about STDs isn't someone I want to be fucking. Questions are fine. Concerns are fine. Deciding some activities are off the table is fine. Freaking out is never okay with me, though.
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Re: talking about HPV
Tue, May 6, 2008 - 10:33 PMDiva,
These things have already been addressed a little bit, but I figure it's worth adding to the conversation. A few things:
It DOES look like HPV that's detected thorough an abnormal pap is at a higher risk of being something, you know, risky. The NIAID cites this in one of their brief overviews.
www3.niaid.nih.gov/healthsc...cause.htm
However, I HIGHLY recommend that you get your HPV typed to figure out which kind it is. Even though it was discovered through an abnormal pap, it's still totally possible that it's not a cancer- or wart-causing type. I'm sure you've done much of this research already, but there are over 100 types of HPV, and only about 30-40 types spread through sexual contact. Many forms of HPV are *not* harmful. (Check out stdresource.com/disease/index.php - which is sponsored by the British Columbia Centre for Disease control).
Even though you're over 26, you can still get the HPV vaccination, Guardasil. Some health care providers won't provide to women outside of the age range (12-26), but many will. The US CDC recommends those ages because they're within the range that the vaccine has been tested in. Additionally, there's a push to vaccinate younger women in hopes that they'll get vaccinated before possible exposure. The CDC says they're investigating the vaccination for women outside of the age range as well as for men. (www.cdc.gov/vaccines/vpd...ac-faqs.htm). If your health provider (or one you find) will give you the vaccine, I'd highly recommend it. Again, you may know this already, but it protects against 4 strains that cause 70% of cervical cancers and 90% of genital warts. (www.cdc.gov/std/Hpv/STDF...-vaccine.htm) Even if, heavens forbid, you DO have one of these four types you can still receive the vaccination without any adverse effects related to an existing strain, and it will protect you from any of the 4 strains it covers that you're not already infected with.
I hope this is useful, and good luck with your partners and your own process. -
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Re: talking about HPV
Wed, May 7, 2008 - 11:21 AMI'm 33 and was able to get the Guardasil vaccine last year from my Dr at Kaiser. Initially my request was turned down but when I explained my sexual history and how its changed in the past couple of years (Was a virgin when I met my husband and until 2 years ago we were monogamous) my Dr agreed it was a good idea.
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Re: talking about HPV
Sat, May 10, 2008 - 10:08 PMStill--it's everyone's right--when they decide to share a sex partner to know what risks that might entail. If they are kind enough to share they have the right to say, "wrap those uglies up right!"
I've never had a cold sore (or tested positive for HPV) and I have no desire to have one, or have someone's simplex 1 become my simplex 2. AND--I'm very sorry to say, PRIMARIES of my partners have been much more forthcoming with their men's histories than even my mot trusted male partners have been...
Grrrls? Sit your man down and ask him twice: Were you safe EVERY SINGLE TIME. In my experience many will say "no".
Primary wives (they seem to be the most "off-into their-own-thing--husband, what husband?--who-don't-know-he's just getting "a taste". Ewwwww! Being the secondary for a long time, I find that EVERY SINGLE TIME I am the one who let's the prima ry know that her partner is taking a lot more risks than she signed off on....
HPV is bad, very abd, but there is worse, alot worse.
SB
lks: ASK. Please ask. -
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Re: talking about HPV
Sun, May 11, 2008 - 10:47 PMJust to be clear, HPV and herpes are not the same. Herpes Simplex Virus has two different types - I and II. Type I is typically oral and II is typically genital, but there's a great deal of crossover.
HPV (Human Papilloma Virus) has scores of types. While the herpes virus (it seems) is a 'forever' type of thing, HPV sometimes disappears. Also, it is HSV (herpes) that creates cold sores, and HPV that can create warts or cancer, but these two viruses are distinct and do NOT cause the same complications.
Trusting partners can be very difficult when negotiating safer sex, particularly as everyone has different definitions of "safe." Additionally, not everyone gets tested for the same infections (for example, it is not in a standard screening to test for herpes) so saying "I've been tested and I'm fine" can mean one thing for one person and another for another.
Really, this just emphasizes the importance of having really clear communication, particularly about something as emotional and body-related as sexual health. What have you been tested for? How long ago was that? When was the last time you had protected sex prior to that? Have you had sex after that? What does "protected" mean to you - does that include oral sex? What are the sexual practices of your current partners, and what are your safer sex practices with them? It can be a pretty in-depth and intense conversation, but it can be much better to go through that and get everyone on the same page than to risk disastrous miscommunication.
One last note on transmissibility: One can, in fact, have used latex barriers for every genital-genital and genital-oral contact and still become infected with either HPV or HSV. HPV is tricky because it can manifest outside of areas covered by condoms, as can HSV. Additionally, HSV most commonly infects the mouth, and how many people think to ask if someone has ever had a cold sore before kissing them? One must also note that someone can be infected with HSV or HPV and never ever have experienced symptoms (as is true with many sexually transmitted infections), so a partner might be entirely unaware of infection status, PARTICULARLY as these viruses are not typically tested for in a standard STI screening (which usually includes chlamydia, gonorrhea, HIV, and usually syphilis, though different communities have different trends and standards).
Bottom line: Talk with your partners, get all yerselves tested, and make sure everyone is on the same page regarding safer sex practices. If you feel you can't trust a partner (or a partner's partner) to keep to safer sex agreements, it might be a good indicator that you should reevaluate your relationships. -
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Re: talking about HPV
Mon, May 12, 2008 - 9:07 PMDon't know if anyone's still following this thread, but rereading your comment, Sugar, I realize that in no way were you mixing up HPV and herpes. Please forgive my misinterpretation. However, it is worth noting that Simplex I and Simplex II are distinct viruses that can infect someone in nearly any mucus membrane (think about it ...) though it appears that type I has a "preference" for oral infection and type II has a "preference" for genital infection.
Alright, 'nuff technical sex talk for today!
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Re: talking about HPV
Tue, May 20, 2008 - 3:39 AMThere is a blood test for herpes, but it is not commonly given to people unless they are in high risk categories. Like, you have a partner with herpes who has had outbreaks while with you. I suppose you can probably get the test if you are willing to pay for it, regardless of the risk category you are in, but I hear it is quite expensive. If someone says they have been tested for everything the likelihood is that they have not been blood tested for herpes, since it is very rare that STD clinics and whatnot do that test (cause it is costly for them, too).
I got lucky cause I had a partner who had herpes, so I got given the test and was able to find out I have neither strain. -
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Re: talking about HPV
Tue, May 20, 2008 - 5:04 AMYeah, when I wanted to have a completely clean bill of health the herpes test cost me $50, and that was WITH some school insurance.
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Re: talking about HPV
Wed, May 21, 2008 - 2:12 AMThe herpes blood test exists, but is not necessarily meaningful. I heard from my doctor that it is possible to be positive for either strain and yet not have outbreaks - which means it's extremely unlikely to give it to a partner. -
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Re: talking about HPV
Wed, May 21, 2008 - 9:19 PMPeople who don't have outbreaks they notice are just as likely to pass it on as those who don't. Outbreaks that are subclinical (not the sort of thing most people see as "outbreaks") are the norm, not the exception, and shed enough virus to transmit it.
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Re: talking about HPV
Sat, May 31, 2008 - 2:33 AMMore and more doctors believe that you can be a "carrier" for herpes, never have anything you ever identify as an outbreak, and yet still transmit the virus to others.
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Re: talking about HPV
Sat, May 31, 2008 - 3:30 PMI've read that both HPV and HSV will eventually infect 75% of the regular population, most of whom won't know they have it. If that's the case, how much higher is that percentage among those of us that are more sexually prolific; ie swingers, serial monogamists, etc?
Also, I believe there's a false of security about using condoms for intercourse but not barriers for oral. My understanding is that those viral STDs (and a few others) can be transmitted just as easily through oral sex as they can with intercourse, so it's a little like locking the front door but not the side door to your home - an unwanted intruder can still get in!
This is not a suggestion to use more barriers - for some of us, using less barriers is a risk that consenting adults are willing to take for what we perceive to be a more intimate experience. Making an informed decision about the acceptable level of risks with all affected parties, and getting tested regularly so one knows their "riskiness" to others, is the only admonition I'm willing to make.
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Re: talking about HPV
Tue, May 13, 2008 - 8:58 AMOn "HPV is bad, very bad"--this is untrue from a medical standpoint (though maybe you're thinking of it from a social stigma standpoint...). HPV is no big deal for the vast majority of people who contract it. Some people who get it have symptoms, most don't. Of those who have symptoms, most have fairly quick and painless treatment. So, really, when compared to a cold that I caught that dragged on for 3 months and turned out to be whooping cough, I'd rather get HPV. -
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Re: talking about HPV
Tue, May 13, 2008 - 6:04 PMI'll second the "rather have HPV than whooping cough." I've had both. Whooping cough is WAY worse. Yeah, coughing so hard you vomit and/or knock the wind out of yourself (which is what causes the "Whooping" part of the cough as you make this horrid sound trying to drag air back into your lungs) is pretty damned wretched. That doesn't mean HPV is a walk in the park. It all comes down to which kind you have. Some you need to worry about as much as the average pimple. Some you need to be VERY cautious not to pass it on to others. Get the DNA test. -
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Re: talking about HPV
Wed, May 14, 2008 - 10:35 AMTypes 16 and 18, the two strains that cause 80% of all cervical cancer, still don't cause symptoms in most people who have them. My ex-girlfriend had 16, and I was really worried about getting it and having to have a chunk of my cervix removed, but every doc I talked to said it goes away without causing problems in over 90% of people who contract it. I believe them. The issue to worry about is less transmission and more keeping one's immune system strong--take folic acid if you're worried about getting it. -
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Re: talking about HPV
Wed, May 14, 2008 - 5:00 PMI'd still worry about transmission. Just because most people are a-symptomatic does NOT mean it's OK to be passing a potentially life-threatening microbe on to new people. Yes, for self-care keep your immune system strong, but also don't spread the damn thing around. -
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Re: talking about HPV
Thu, May 15, 2008 - 9:03 AMI don't know about "ok", but there's little one can do about it after having treated it other than telling potential partners and practicing safer sex (condoms and washing up--the step most people skip). I'd suggest disclosure and safer sex measures as the middle ground between passing it willy-nilly, and abstinence, because I'm of the opinion (along with many in the medical profession) that it's a low-risk virus that is more likely to be contracted from someone who doesn't know they have it than someone who's been treated for it.
What my docs and nurse practitioners (I've talked to several) told me when I was worried about having a partner with a high-risk type of HPV was this:
Because of the high rate of asymptomatic carriers, anyone worried about becoming sick from high-risk HPV would be better protected by boosting their immune system, using condoms (which do protect against about 50% of transmission, as well as shorten the time it takes to clear the virus once contracted), and having yearly pap smears than by avoiding partners who know they have it. The vaccine (which I have received) is great if you get it early enough, but it only provides something like a 14% reduction in HPV symptoms in women over 26, which is why it isn't recommended for them. By that age, most women have contracted one or more of the viruses included in the vaccine.
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Re: talking about HPV
Thu, May 15, 2008 - 9:53 AMI've recently had 2 surgeries for cervical cancer (I didn't have health insurance for many years, so didn't get pap smears that would've allowed me to have caught it earlier.), and all of my medical reports, since I was diagnosed last year, state that there is no evidence of HPV infection or displasia.
In other words, an abnormal diagnosis doesn't necessarily connote the presence of active HPV. -
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Re: talking about HPV
Thu, May 15, 2008 - 9:52 PMTwice I found out after a sexual encounter with someone that she did not disclose that she had an STD. Once was herpes and the other was HPV. The HPV had also caused serious health problems for this person years before so it was a well known issue for her. I felt distrust of these people for not saying something before we became intimate. It certainly made me more cautious and I make sure to ask those questions beforehand. Its my responsibility to make sure I protect myself from exposure but it is also the responsibility of the infected person to disclose the risk up front so their partner can make an informed decision. It doesn't matter how low the risk might be, or which strain you have. Secrets like that suck. -
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Re: talking about HPV
Sat, May 31, 2008 - 2:53 AMHPV can cause cancer, so if you are part of the minority who get cancer from it, that is worse than a cold or whooping cough.
HPV is very common, but the high risk strains that the doctors worry about is a little less common. Im not exactly sure how they test for it or how they know if its a high risk strain. A lot of people carry HPV and never have any symptoms. Not telling your partners however is unethical, especially if you have the high risk strain. A friend of mine keeps it a secret and just sleeps with lots of people, and now there are a number of people who know he gave it to them who will never forgive him for it. Chances are they wont get cancer or have any serious complications because of it, but there is a chance they might, and they deserve to know.
If you have HPV the good news is that you will *most likely* be ok. However, you are obligated to tell any potential partners of any STDs you may carry, even if its just herpes or HPV. -
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Re: talking about HPV
Sat, May 31, 2008 - 12:37 PMSentience wrote, "Im not exactly sure how they test for it or how they know if its a high risk strain."
Check out Kastania's posts on this thread. I was about to launch into an HPV education post when I saw hers and got all happy. She's right on the mark and gave a thorough and accurate summary of what is known about HPV, including great links for further reading.
Thank you Kastania!!
Regarding the original post, gotta say that if I had a doctor who didn't know how to answer my questions about what I should tell people regarding a virus that is within their supposed area of medical expertise, I would promptly find a new doctor.
I'm glad to see that the consensus here is to be forthright and honest. Talking about these things can of course feel uncomfortable but I'm told it gets easier with practice and I would think the best way to make it easier is to be very well educated so we can be prepared to respond to visceral reactions rooted in often uninformed fear with facts and logical realities. But ultimately, I believe people get to determine their own risk tolerance and ought to be given the information they need to make those choices for themselves.
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