AboutMark Behar Expertise Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything.
Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!).
There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!
Experience Family Practice PA since 1981;
Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site.
Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.
Organizations Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP); Board of Directors, National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)
Publications Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology;
Distinguished Fellow, American Academy of Physician Assistants;
Fellow, Wisconsin Academy of Physician Assistants
Past/Present Clients Brady East STD Clinic, Milwaukee, WI
Question dear Sir.
i do have maybe a bit specific question about hpv.
but i hope you can help me with the answer.
i have been diagnosed with hpv 16 and 18 some four yrs ago.
i also had a conisation. now my CIN is II and i am pregnant, h
oping i will never have to cope with it again.
my question is, what is the risk of having hpv in other parts of my body;
i read quite much about problems with cancer in mouth, anal etc..
i am afraid, that while practising for example oral sex with my husband, it is possible to transmit the virus to the mouth. especially when any of us is having some small wounds on tongue for example. i dont know much about the transmission of the virus, and the reactions of other parts of my body to the virus, ...
should i care about that in some way? what should i do as a prevention of these other problems hpv can cause? i am a little bit scared especially because the types of virus we are infected are so dangerous.
thank you very much for your answers...! my doctor is just not able to answer questions about specific other problems realted to hpv, and as i am "clear" for him according to my pap tests, he has nothing more to say to me...
thank you very much!
Answer Hello Zdenka,
If I understand you correctly, you were diagnosed with HPV types 16 and 18 (which are high risk HPV types that may progress to cancer) four years ago, and had an abnormal Pap smear that your doctor chose to treat with a conization. You are now pregnant, and have had another abnormal Pap, with the grade of abnormality rated as CIN 2 (cervical intraepithelial neoplasia, grade 2), also known as "moderate dysplasia"). You are concerned about HPV induced lesions on other parts of your body, such as the mouth or tongue, anal canal, etc.
First, you should know that your body's immune system is dampened during your pregnancy, so that the baby's health and growth will not be adversely affected. This may permit cervical dysplasia to temporarily worsen. Your Ob/Gyn should plan on a repeat Pap smear, perhaps with a colposcopy, after you deliver, when your immune system is back to top efficiency. So you should be taking prenatal vitamins, and folic acid (folate), and if you are in northern latitudes, a vitamin D supplement, as well as quitting smoking/tobacco use. All of these have been found to affect your heath and well being as well as the baby's health.
The HPV strains that you have are what we call "epitheliotropic" to the genitals. Meaning, that the virus prefers infecting other genital tissues. They can infect the mouth and throat and anus, but they require direct contact ("innoculation") to those areas. So your having an infected cervix may cause the virus to spread to your partner's penis, and if you have oral sex, back to your mouth and throat (although the virus prefers the penis and vulvovagina/cervix and anus). But your partner's mouth and throat are not at risk.
If you have any other specific questions, please ask. A very excellent web site for your doctor to visit, and you too, if you think you can handle the medical jargon, is: www.asccp.org (American Society for Colposcopy and Cervical Pathology).
