Sexually Transmitted Diseases/HPV Scare

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Question
Hi Mark,

My name is Kristin, I'm 30, and I live in Canada. I have some concerns about HPV. A little over a year ago, I found a wart on my partner's penis. The wart was refractory to treatment and my partner and I abstained from sex from then on. Him and I have since broken up and I've been talking to someone new and haven't had any sexual contact whatsoever. I have no warts that I can see. I've done the vinegar test multiple times. I haven't found any outward symptoms of HPV. I've always assumed that my ex got his HPV infection from me - He is a strong proponent of condom use and initially told me that he never has unprotected sex. Several months into our relationship, for reasons unclear to me, he changed his mind about that. Several months later I found a wart on his penis. I understand that condoms never would have protected him completely and I'm not necessarily the source of his infection but if I am, that means I was exposed at least 6 months prior...and that would put me at around the magical 2 year mark for 'clearance', whatever that really means. I have an appointment with a nurse practitioner to get a pap test done in about a month. I have a good feeling the result of that test will be normal and if it is, how cautious should I be moving forward? Is it worth discussing the fact that I might have had an HPV infection with a future partner, or would it only serve to pass on to them the same kind of anxiety and paranoia that I've experienced and cause unnecessary strain on the relationship? Do I now need to worry about getting warts in the future, like if I become pregnant? Sorry if this was a bit long-winded. I really appreciate any advice you can give.

Answer
Hello Kirstin,
Almost all people who are sexually active are thought to be infected with HPV.  Therefore, aside from usual precautions such as proper wearing of condoms, nothing else need be done.  A 2 year "clearance" is hypothetical, but no one really knows what this means!! Be forever vigilant, but if no warts show up after two years following infection, it is probably not likely to show up.  Yes, that vigilance includes becoming pregnant, and getting necessary pelvic exams to make sure that warts do not appear.

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. 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 “pre-screen” 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 consequences 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; answered 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.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), 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) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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