Picture it: Virginia, winter 2002. I’m home on college break when my mom calls me into her room and pats the bed for me to sit down. She’d read my mail while I was gone, including a letter from my gyno, and found out I had an STD—an incurable one. My annual Pap smear had abnormal cell changes on the cervix, and I’d been diagnosed with human papillomavirus, aka HPV. I wished I could’ve pounded a beer to dull the mental pain, but at 20, I wasn’t even legal to drink yet.
Hearing that my snatch wasn’t squeaky-clean instantly turned me into an emotional hot mess. How could this be possible? I’d only had sex with three people, and two were virgins. My boyfriend at the time (the non-virgin) had taken a general STD test before we stopped using condoms, and everything was shipshape—or so we thought. I called my best friend in tears, thinking my boyfriend had cheated on me. But after flipping out, I talked to my mom and did some research. What I found blew my mind. For one thing, while my boyfriend’s tests covered chlamydia and gonorrhea, they didn’t cover HPV, because there is no HPV test for men (meaning my boyfriend hadn’t necessarily cheated, because he wasn’t clear to begin with).
Then I found out how widespread HPV is: it’s actually the most common STD in the U.S. The Center for Disease Control (cdc.gov) states that “50 percent of sexually active people will have genital HPV at some point in their lives.” I’d considered myself very responsible when it came to safe sex, so how did I not know all about this ultraprevalent infection? After my boyfriend and I broke up, I put HPV out of my mind. But at that point, I still didn’t know much about this sneaky STD, and my friends were similarly in the dark. How is the virus contracted? Can it be prevented? Can it be cured? What are the side effects of an infection? If you had trouble answering any of those questions, read on—I’m gonna take you to school.
The American Social Health Association (ashastd.org) defines HPV as a group of viruses that infect the skin; it’s not actually an STD but rather an STI (a sexually transmitted infection). There are more than 100 types of HPV, and most are harmless—some are responsible for things as innocuous as warts on your hands. But the HPV that everyone’s afraid of is spread sexually, and there are two types: high and low risk, the latter of which can cause genital warts. I had high risk, which can cause cervical cancer as well as rarer forms of genital and oral cancer. To be clear: high risk doesn’t cause warts, and low risk doesn’t cause cancer.
Right after I was diagnosed, I was instructed to get a colposcopy, a procedure in which your doctor looks at your cervix and vagina with a magnifying device; any abnormal cells found are biopsied, to screen for cancer. Mine came back sans cancer—in fact, according to the CDC, “most” women with high-risk HPV will not develop the disease. Still, the ASHA reports that 11,000 cases of cervical cancer are diagnosed a year, almost all of which are attributed to HPV, and more than 4,000 women die from the disease annually. Men, on the other hand, aren’t likely to have any nasty HPV side effects at all; while it’s possible for them to get penile or anal cancer from it, those outcomes are super-rare.
How do you get this virus in the first place? Turns out that it’s generally passed from skin-to-skin contact. That means even a virgin can have it, since you can obviously bump uglies without penetration, and HPV can also be passed through oral sex. Carol Queen, Good Vibrations Staff Sexologist and BUST sex columnist, explained that it’s typically contracted “if one of those skins is mucosal, like the vagina, cervix, anus, mouth, or throat.” The CDC states that there’s no way to know when or from whom you contracted HPV, because the majority of people who have it don’t know it (making the virus like some sort of unseen genital ghost). Some people never experience any visible signs, and warts can pop up years after exposure.
Apparently I’d flipped out on my boo for no reason. I could’ve gotten the virus from one of the virgins I’d been with, who could have contracted it years before me. Since there’s no way to test men for the infection, there’s no way of knowing if a guy has high-risk HPV, unless he develops abnormal cells in the anus or mouth, which is very rare. Plus, anyone can have high- and/or low-risk HPV without showing any symptoms.
I was still pretty much clueless about this shifty virus when, three years after my initial diagnosis, I got a new steady boyfriend. I was honest with him about my STI status, and we were using condoms most of the time when we got busy. But after a couple of years together, he developed anal warts and they spread with a quickness. I felt terrible—was it my fault? Since I had high-risk HPV, though, warts weren’t supposed to be involved. And how did they get in his bunghole? He went to the doctor with a ton of questions and was told that he must have gotten my pussy drippings on his anus, and that his body had “morphed” the virus from high to low risk. It sounded fishy to me, and it turns out I was right to be suspicious. Queen explained recently that my boyfriend had probably had low-risk HPV (the wart kind) for several years, but it took a while to show its warty face. He could’ve picked up low-risk HPV from anybody he’d knocked boots with in the years prior. And as for the morphing, the CDC debunked his doctor’s theory, saying that “while there are many types of HPV, one does not morph into another type.”
So you can’t really be sure who’s carrying HPV, and once you have it, you may not even know. But providing you’re aware you have it, you should tell your sexy-times partner, right? Not so fast. The CDC’s site states that “it’s not clear if there is any health benefit to telling future sex partners about a past diagnosis of genital warts (once warts have been treated), because it’s not known for how long you remain contagious after treatment.” I emailed the agency asking for clarification: were they really suggesting that you don’t tell your partner you have HPV? They replied, “There is no known health benefit to discussing a past diagnosis because it is not clear if this past history results in ongoing health risk. The risk of partner violence should also be considered.” As if potential health risks weren’t enough, those with HPV have to worry about being physically punished for having it.
As a sexologist, Queen’s well aware of the stigma surrounding HPV. “Many of us are predisposed to think of having or getting an STI as different (and somehow worse) than catching any other kind of disease. This is illogical, really—STIs are just microbes that pass from person to person, like colds; they don’t require that a person be promiscuous or have low standards or any of the things we often assume. These ideas are really just cultural baggage.” On the part of the infected party, she says, “There’s very frequently a sense of excess vulnerability and guilt, even if the partner didn’t know they had an STI that they could transmit.”
To stay safe, I made sure to get regular Pap smears. And in 2006, after four consecutive years of smearing, my test came back clean and my doctor told me it was safe to assume I was free of the virus. What kind of Hogwarts (ahem) magic was this? I assumed that since there wasn’t a cure for HPV, I would be a carrier for life. But according to the CDC, the immune system fights off 90 percent of HPV infections naturally within two years. As soon as I heard I was clear, I hustled to get the HPV vaccine Gardasil, since my doctor said I could still be reinfected with a different strain of the virus. There are now two vaccines on the market: Cervarix (which is available only for women) and Gardasil (for women and men), both of which are administered in a series of three shots for people ages 11 to 26. Luckily, I was just under the age cutoff. Both vaccines protect against high-risk HPV, but Gardasil also protects against most low-risk wart strains.
Getting vaccinated is important for several reasons. Says Queen, “Over time, if enough people get it, it will not only cut back the amount of transmitted HPV in the population—a really good thing, especially given HPV’s link with cancer—it will also normalize this discussion further. A vaccine is a more neutral medical event than a diagnosis of an STI, culturally, except in those conservative communities where a vaccine is seen as abetting (immoral) sexual conduct.”
But just because I’m vaccinated now doesn’t guarantee I’ll be HPV-free for life. Gardasil only protects against most major types of HPV, and there are other preventive steps to take. Even if you think it’s all good under the clit hood, you really can’t be sure, so get regular Paps (every one to three years), and always use a rubber with new partners. And if you’re within the age range to get vaccinated, do that thing. Fortunately, even though you can’t quickly cure HPV, the symptoms are treatable: warts can be removed easily, and if you catch high-risk HPV early enough, you can prevent any associated cancers. Plus, as I said, the majority of cases are cleared in two years with no symptoms. So while you may not be able to completely avoid HPV, at least you don’t have to freak the fuck out about it.
By Callie Watts
Illustrations by Paige Vickers
This review appears in the Feb/Mar 2013 issue of BUST Magazine with Jason Schwartzman. Subscribe now.