He told you he loves you. He told you he wants to spend the rest of his life with you.
In you, he says, he’s found his soul mate. And one year into the relationship, you’ve never had any reason to doubt. Until now.
“You’ve tested positive for HPV.”
The sentence your doctor spoke only seconds ago echoed in your head when it hit you: He cheated on me.
Or did he?
Human papillomavirus, or HPV, is not only one of the most-common sexually transmitted diseases but also almost impossible to prevent. Roughly 65 percent of HIV-negative men and 95 percent of HIV-positive gay men carry HPV.
And, important to this story, it can remain asymptomatic after exposure. That means either man in the relationship (or both) could’ve contracted HPV before any sexual intimacy took place between the two of them.
Most often, as in this case, people don’t even know they have it until it’s discovered during a routine exam at their doctor’s office. So, if it’s undetectable, is there any reason someone should care whether they carry HPV?
Without a doubt, yes.
Just ask any woman. Prior to the introduction of pap smears, the incidence of cervical cancer was 40-50 per 100,000 women. But after regular screening began, that number dropped to 8 per 100,000.
As for men, sufficient data exists linking infection with the development of anal cancer. The incidence of anal cancer in men who have sex with men is at the same rate as cervical cancer in women prior to the introduction of routine pap smears.
So what women have known for years is equally important for gay men to realize: A regular pap smear test is a must.
HIV-positive men should make it part of their annual physical, and HIV-negative men should get tested every one to three years, depending on your doctor’s recommendation.
But the onset of symptoms of HPV – such as a hard spot or lump outside or just inside the anus or itching, bleeding, pain or pressure from the anus – also should lead someone to get tested, as earlier detection makes treatment easier.
Guidelines for screening are still evolving, but current procedures are relatively simple: One, The pap smear is performed by inserting a cotton swab about one inch into the anus to obtain cells for lab evaluation. Two, during the exam, a doctor likely will apply vinegar to a patient’s anus, as tissue infected with HPV turns white, which helps in locating lesions.
The most-common treatment a doctor employs for warts around and outside a patient’s anus is application of liquid nitrogen, an acid solution, or another solution called podophyllotoxin. He or she may also prescribe Aldara, a cream that stimulates the immune system at the area of application, for use at home.
For internal warts and precancerous lesions, he or she will likely use an acid solution and/or podophyllotoxin. It usually requires several treatments to resolve HPV lesions and occasionally surgery is required.
Though HPV may sound to some like scary stuff, it shouldn’t be, and worrying won’t prevent someone from contracting it. For the most part, only total abstinence will.
The chances of contracting HPV may be diminished if condoms are used from the point of initial physical activity. But since HPV can be harbored on the penis, scrotum and perineum, despite the absence of warts, it can be transmitted by almost any contact during sex.
The good news is that just because a person tests positive doesn’t mean they will develop warts or anal cancer. Frequently the immune system will take care of the virus.
So, if you’ve found the love of your life but also found something below the waistline that’s given you cause for concern, don’t jump to any conclusions before you know the facts. Get tested and get informed.