Help! My girlfriend has the Virus.

So your girlfriend went for a routine doctor’s appointment. And then you discovered it was an exam called a smear test, and they checked for HPV. Wtf – your girlfriend has an STD?!!!

You should read the sticky article here to educate yourself fully about STD tests, but to present a more concise primer, here are a few things in particular that you should know:

(NB: for ease, have written men and stressful impacts on women, but please assume people with penises and people with cervixes if you are trans, nb or other. I’ve also based this mainly on positive smear results rather than warts because this is a common incident on this board).

Having it is extremely normal:

– 80% of people will get genital HPV by the age of 45, and after a few sexual partners, your chance is close to 100%.

– Tests show that most infections for STDs happen within the first few years of sex life. So, the prevalence in the late teens to early 20s is very high. Almost half of women of this age will have an active high-risk infection right now. For all types of HPV, it may be as high as 70% for college-aged women. Note that the figures are probably similar for men.

Most people don’t know they have it:

– Most STD infections are symptomless,

– In most places, cervical smears are only done after a certain age and may only be tested for HPV after a certain age, too (e.g. 25+). This is because it’s assumed that younger people will have an STD, and it will probably go away with no problems. Cervical smears with HPV variant tests are designed to find those persistent cases that don’t clear up and can, therefore, pose a potential danger.

It can hang around for a while and recur later in life:

Most infections clear up within a few years, but some last longer.

– A small % can come back even after immune suppression

– Therefore, even if you’ve been in a monogamous relationship for some time, it’s still not weird for STDs to come up

Do I have the Virus, too?

If you’ve been having regular sex (genital or oral contact), even with condoms (which only mitigate but don’t prevent STD transmission), there’s a good chance you share the infection. Maybe it came from her, maybe it came from you. Where it came from is both impossible to know and not very important.

(I’ve not seen data on dental dams, but we know that female/female couples often share infections, too).

You should assume that you either have her strain now or may have already immune suppressed it.

How can I have an infection? I’ve never had one before

STD panels only test for a small number of possible infections, and even if you have been practising ‘safe’ sex, it’s still very possible and indeed probable to have something (look up the prevalence of HSV, for example). With HPV in the mix, there is a very high chance that you have had, have or will have ‘an STD’ in future.

In the modern world, because of the aftermath of the AIDs crisis and our increased scientific knowledge, mixed with toxic purity culture, there is so much stigma around STDs. But HPV is something that’s pretty much impossible to avoid – even virgins have a small chance of getting it, and with one-lifetime partner, the chance is somewhere between 20 and 70%.

If you are stigmatising your girlfriend and yourself, stop. HPV is not something you can ever fully prevent unless you were to live life in a polythene bubble. No sex is truly safe. But we take the risk because, when consensual, it’s a good, fun, natural part of a healthy adult life.

Also, Don’t use ‘clean’—nobody is ‘dirty’ for living their life, including you!

Should I get checked?

You don’t need to rush to get a test outside your regular smear schedule if you have a cervix. They may not allow you to do this. This is because smear tests are a cancer screening tool, not an STD test. Since there’s nothing one can do about an HPV infection and most infections go away on their own, constant testing for it is not considered clinically relevant. Cervical smears are scheduled to detect persistent infections for monitoring and potential treatment when necessary.

If you have a penis, in most places, testing is not commonly done. This is because it’s unreliable in commonly used methods and clinically useless.

Will I get warts?

If your girlfriend has been STD panel tested via a smear, her infection is likely high risk. This is because most smear tests don’t bother looking for the non-oncogenic strains. If you’re not sure, she should clarify with her doctor. Low-risk strains cause most warts. While high-risk strains can cause warts, this is not hugely common, so you should not expect to develop them (although it’s perfectly possible to have more than one kind at a time and in different parts of the genitals).

Can we still have sex?

Yes, regular partners can keep having sex because you will share the STD infection already. You may consider using condoms, as they reduce the viral load shared between you. And, therefore, make it easier for the body to deal with the infection.

Can we still have oral sex?

If you’re both unvaccinated, there is a risk that you share HPV16. This is the riskiest strain for oral cancer, so you might want to use protection or abstain from oral to lower the viral load in the mouth. However, if you weigh up the risk and feel that it is low enough to feel comfortable proceeding (e.g. she is vaccinated, or you know she has a strain other than 16), then sure, go ahead.

Should I get vaccinated?

Imo, yes. Gardasil 9 protects you against 9 of the most prevalent and riskiest strains, including 7 cancer-causing types and the 2 that cause 90% of genital warts. While it’s not proven to aid a current infection, limited evidence suggests it *may* help regress more advanced abnormalities and stimulate male bodies to produce antibodies against the included STD strains. Additionally, it gives you future protection against the included types (and you’re unlikely to have had all 9).

Men can also get vaccinated, licensed up to age 45. You should search for ways to get it in your location. It may be free in some cases (e.g., in the UK if you have sex with men or in countries with health insurance if covered by your provider), or you may need to pay.

Am I going to get tumours and more?

Although high-risk strains of HPV can cause cancer, that doesn’t mean they will. Relative to the number of cases, cancer is not a likely outcome.

Cervical cancer remains the greatest risk of persistent HPV (those infections that hang around for a long time). But keeping up with screening means that anything dangerous is likely to be caught in time and can be treated.

Oral cancer rates are rising, and it’s the greatest risk for men. That said, only 1% of oral HPV infections become cancerous. Currently, there’s no screening programme because it’s not a useful way to identify those infections that could persist and become dangerous.

The best thing to do now is to visit the dentist regularly and ask them to check you out.

Penile, anal, vulval and vaginal cancers are not very common. You may be able to get an anal smear test, but it’s not available everywhere. Otherwise, you should try not to think about this obsessively. Many, many things in life give us a risk of cancer. And we tend not to worry about them. Just keep a gentle eye on your health and do everything you know you should be doing to live a happy and healthy life.

Do I need to go on a crazy healthcare programme?

No. There is some evidence that stopping smoking can help prevent HPV cancers. But you already know that smoking kills, so why are you still doing it?! There’s currently no data out there on weed or vaping, so you can make your call on those.

Exercise, sleep, and vegetables are all good for your health and life. But most people’s bodies deal with HPV naturally anyway, and there needs to be a proven routine or single thing you can do to guarantee anything.

If doing something makes you feel better and you feel like changing your life. However, this may be your wake-up call.

What about my future in dating?

As mentioned above, most HPV infections go within a few months to a couple of years, and almost everyone will have a past or current infection. Suppose you are seeking new partners imminently (i.e. in the next few months). In that case, you may want to discuss it with them (e.g. check if they’re vaccinated). But beyond this, unless you have a cervix and get a positive test result at your next smear, there’s no obligation. It’s really up to you (there are a lot of nuances here, and different people will have different strong feelings on the matter).

What can I do to support my girlfriend?

Thanks for asking the most important question.

Your girlfriend might feel worried, confused, or upset. Many doctors are pretty rubbish at dealing with HPV-related stuff. Share any information you learn, and make sure you approach HPV together in a non-judgmental way.

Ask if she wants you to accompany her to appointments, and afterwards, make her a nice hot drink, get her a blanket, bring her cookies, kiss the top of her head—all the lovely partner things you can do to make her feel safe and loved.

Some people might feel weird about sex after diagnosis, so please be understanding and keep communicating how you both feel. Acting entitled and pissy because someone won’t do XYZ thing with you is jerk behaviour. And if that’s your attitude, fuck right off.

Sex is not the only part of a relationship. And if you need to pause on some things for a short while, nobody will die. Sex toys and masturbation are a thing.

If you are privileged enough to have a partner and a healthy, happy relationship, that is more important than an infection almost everyone will get. Lots of us with HPV don’t have this luxury, so don’t be a fool about this – thanks.