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I have HPV, and I don't want him to know.

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Gaby asks:

I got HPV from my last sexual partner. I was wondering if I went to donate blood would I still be able to? My new partner doesn't know I have this and I don't want him to find out. By donating blood and getting the results back will they be able to tell I have it?

Heather Corinna replies:

You will need to tell new partners about a sexually transmitted infection you have or have had, particularly one like human papillomavirus (HPV) where condoms reduce the risks of transmission, but not as well as they do for other kinds of infections.

Putting someone knowingly at risk of an infection -- one that isn't yet curable and which men also can't be tested accurately for yet -- without giving them a choice about if they WANT to take that risk isn't okay as far as I'm concerned. If your previous partner had HPV and knew (and it's totally possible he didn't) and didn't give YOU that choice, that is obviously very unfortunate, but it doesn't mean it's okay for you to do that to someone else. I'd also consider how nondisclosure has an impact over time. If he gets it, particularly given how tough it is to detect in men, he may have it silently. So, he's not going to disclose possible HPV on his part, putting any future partners of his at an unknown risk, and on and on it goes, particularly if he does give it to partners who either don't get visible warts or pap smears regularly to find out about HPV, or who have it, but in whom it goes undetected. While some strains of HPV are a hindrance, but are known to be pretty harmless, others are not: some strains can cause cervical, anal or penile cancers.

HPV is very contagious, which is why it is so common, with around 5.5 million new genital HPV transmissions occurring in the United States each year, representing about one-third of all new STD infections, and an estimated 20 million men and women are thought to have genital HPV at any given time. According to a 1997 American Journal of Medicine article, nearly three in four Americans between the ages of 15 and 49 have been infected with genital HPV at some point in their life (AGI, HPV in the United States and Developing Nations: A Problem of Public Health or Politics?).

If you were diagnosed recently you most likely still have it now. While it's understood that many people can and do shed or suppress the virus in time, we don't really have a sound way of finding out who has and who hasn't yet. So, anyone diagnosed with a type of HPV needs to consider themselves as always having it when it comes to current or future partners. Your partner is at a substantial risk of contracting it from you if the two of you engage in any genital sex, such as vaginal intercourse, especially unprotected. Using latex barriers is known to reduce the risk of transmission by around 70%.

If you aren't at all sexually active yet, and are just getting to know this guy, it's fine to wait to tell him until you get closer to that point in your relationship, but if you are getting to that point or already sexually active, you do need to tell him. Choosing FOR him to take that risk -- rather than affording him the basic respect of making that choice for himself -- isn't fair, even if it's completely understandable that you wish you didn't have to tell him. Part of informed consent when it comes to sex is the informed part: one partner purposefully and knowingly keeping information from the other which puts their health at risk, and then having sex with that partner really isn't with a partner who can be giving full, informed consent.

So if you just can't deal with telling him, then you need not to be sexually involved with him yet. Wait for that until you feel comfortable enough with him to fill him in. If you already have been sexually active, not telling him ASAP just isn't an option in my book. I know those are hardly easy conversations, especially with the crappy attitude a lot of people have about STIs, and with how ashamed a person can feel for having one, even though there's no more shame in having HPV than there is in having a cold. I also recognize that it can feel like an unfair burden for women: since we're the ones it can be most often soundly identified in, the burden of disclosing often lies with us. But that's just the way the cookie crumbles.

It's also one of the kinds of tough conversations we simply need to have if we're going to be sexually active -- of which there are usually more than one -- and when it comes to partners who we care for, and who we know care for and respect us, that conversation also really isn't likely to be awful. What it may result in is simply your new partner wanting to do some research before he makes up his mind about sex with you, including seeing what the two of you can do to reduce your risks if he does decide he's okay with that risk and a sexual relationship. No matter what he decides, if he's a good guy who cares for you, he's not going to make you feel like a pariah about this: he's going to be supportive, even if he's nervous or scared. If he handles it like a big jerk...well, then you can say buh-bye and know you've dodged a bullet. If he's a jerk about this, he probably was going to be a jerk in other respects in the future. Most of us are going to have an illness of some kind at some point, and many are communicable: if we're going to be in contact with other people, we just need to accept that. As well, someone who is sexually active but who doesn't accept that STIs are something everyone is at risk of, and which many people do or will have -- including them -- isn't being particularly realistic about sexual partnership. Obviously, everyone would like to think and hope that it won't even happen to us (and for many people, it won't, and for people practicing safer sex, it's much less likely), but if we're going to be sexually active we've got to recognize that it might and have some level of preparation for dealing with STIs.

As far as your questions about blood, HPV isn't transmitted through blood, it's transmitted by skin-to-skin contact. So, people with HPV can and do still donate blood. Too, people doing blood drives are not going to be testing your blood for HPV, since your blood doesn't present a problem per donation if you have HPV. If you haven't had a recent full STI screen (and if you've been sexually active, which it sounds like you have, that's something you need to do every year), you need to get those screens from your gynecologist, general doctor and/or sexual healthcare provider. Too, it's particularly important when you have HPV to get your yearly pap smears without fail, because HPV can cause cervical cancer, so it's vital to have your doctor keep an eye on your cervix to be sure it has not for you.

Here are a couple of links for you with more information about HPV, as well as another link or two that I think will help you sort this all out.

Gaby wrote back and asked...

Thanks for that information. I don't know how to tell him yet but I do want to. I do have or had genital warts but I got treatment and my doctor told me unless I had another outbreak it would be a slight chance of me transmitting it to someone. I haven't gotten sexually active with this person yet and for a long while I don't want to for the same reason. I do feel ashamed of having HPV. I cant help it, I feel dirty and I know that its not fair for me not to tell him later on I just don't know how to? How do you tell someone you have HPV without scaring them away?

The information your doctor gave you, based on everything I understand about HPV, was questionable. According to most reliable health sources, treating warts may reduce the risk of transmission, but we really just can't say for sure yet nor do we know how much that can reduce risks. Removal of warts now is done mostly for the comfort of the person with warts. While having warts -- which are not always somewhere you can see, so you may have another outbreak and not even know -- does make it more likely to transmit the virus, it can still be transmitted when they have been treated and are no longer present or visible. When it comes to determining how likely any kind of infection is to be spread, it's also a larger issue than just the virus itself: we have to take the health and the immune system of the people we may transmit it to into account, and that usually is an X-factor.

However, even if your doctor is correct and there is only a slight chance of transmission... there's still a chance of transmission.

Whether the risk is high or low, it still is something you will need to tell partners about if you are going to be a partner who is considerate about their health. As I mentioned in my previous response to you, wart strains are not known to present the cancer risks which other strains do, but it still is something we want to tell partners about, and still is a virus which could impact their health or quality of life, something I likely don't have to tell you.

I totally understand that disclosing this is scary and daunting. I also understand feelings dirty, not because you are dirty -- no more than someone with a cold, flu or diabetes is, anyway -- but because the culture we live in still often attaches a stigma to sexually transmitted or genital infections. But you aren't dirty, and you don't have anything to be ashamed of: you've just been sick. People get sick. A sexually transmitted infection, genital infection or reproductive infection is really no different from any other kinds of illness. The only reason our culture stigmatizes those particularly is because our culture often still considers sex and genitals, period, as dirty. Me, I think that's pretty juvenile and something everyone should have grown the heck up and gotten over by know, particularly when it's so clear how it negatively impacts people's health, body image, sexuality and overall well-being. However, while I'm certainly not the only one who feels that way, some people do still feel or think otherwise, and we appear to make pretty slow cultural progress in this regard. If I could wave my magic wand and change that, I would.

Let's be realistic: you might scare him away. It could happen. Some people do panic in the face of sexually transmitted infections, even though around one in every four people your age do have one, have had one or will have one. However, any number of things might scare a partner off, and for the most part, that's just not something we can control. If we want to have a healthy relationship, we've got to aim for openness and honesty and accept that how another person reacts to whatever it is we're being honest about is out of our hands. That's a risk with intimate relationships, when HPV is an issue or not. But if we're not open and honest, we risk something bigger, which is having a relationship whose our closeness and the quality of that relationship is limited: where what's supposed to be an intimate relationship is only so intimate.

He might also choose -- and that's his right, as it would be yours -- to nix a sexual relationship with you because he doesn't want to take a know risk of contracting HPV. I know that would suck, and could also likely leave you feeling rejected and pretty low, and there's nothing I can say about that which wouldn't come off as glib or trite: rejection always hurts, particularly when it's about things we cannot change and which are out of our control. Just know that if he does reject you on this basis, there are plenty of other people -- whether they have HPV or not -- who won't.

He also might handle this fantastically and be very caring and supportive. (Heck, he might also have HPV himself.) I think we have to be just as open to and prepared for acceptance from people as we are with rejection. Sure, he may be bummed out in some way, but there are people in the wold who can manage being disappointed, and people who choose to be with partners where some known level of risk exists, whether that's about HPV or whether it's about a partner needing to be away at school for a couple of years, a partner being uncertain about if they want to have children, a partner having a terminal disease, a partner having some kind of challenge in their lives or history which may impact the relationship. When we choose to take some level of known risk, it's usually because the possible benefits -- like being close to someone we love -- outweigh those risks.

Given the time lapse between your questions, I presume this relationship is going well, which is why YOU are looking at taking risks yourself. By now, you probably have some idea of how he's going to respond to this and if he's someone who cares a lot for you. If he's not, you have more reasons than HPV to reconsider pursuing a relationship with him further, including a sexual one where you'd be disclosing this. If he is someone you know as caring and sensitive, I'd suggest giving him the benefit of the doubt, and considering that he might not only handle it well, but might also be someone who could give you some of the support and acceptance you need right now.

Again, how soon you bring this up is up to you, particularly since you're not yet putting him at any risk right now. I'd base that on if and when you two start talking about sex, and based on how close you two are at this point in time. Per the how-to when you do bring it up, I'd suggest starting by just being very plain: you were diagnosed with a genital wart strain of HPV which you acquired from a previous partner. You have been treated, and know this kind of strain to present inconveniences, but not major health risks for most people. You can share some of the information I have shared here with you with him: the facts about HPV, how to reduce the risk of transmitting HPV, how common it is. I'd voice your worries and feelings about sharing the information, and make clear that while you certainly understand if he feels worried about this himself, or has some troubles dealing with it, that no matter what choices he decides he wants to make, you need him to be caring and supportive in talking about and dealing with this with you. And then I'd just talk it all out together.

Mostly, I'd implore you not to let HPV ruin your life, your self-image or your relationships. It doesn't have that capacity all by itself: it can only do that if you approach it in a way which limits your quality of life. It's always going to be scary in some respect to get close to people, no matter what we're bringing to the table, so that's not going to change, nor is that part even really about HPV. We will always have flaws or difficulties a partner will eventually discover and which they may or may not accept. And if you have HPV, and do want sexual relationships in your life, as most people do, you'll have to get to this point eventually. Try not to project your own feelings about all of this unto other people who may not feel like you do: not everyone thinks it makes someone dirty.

Only you know if this disclosure and a sexual relationship is something you're ready for right now, and it's up to you when you are. Just don't let HPV keep you from the good stuff and become something that is a much bigger problem than it actually is.

written 21 Nov 2007 . updated 17 Jan 2014

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