Daniela

Men, people with penises and – some myth-busting – Part I

I wanted to put together a myth-busting post to address some of the common comments, queries, fears and complaints we get at HPV tests on a weekly, if not daily, basis. This post is about both men and people with penises who don’t identify as men, but for brevity, I have just used the word men throughout the post. Please assume ‘…and people with penises’ wherever you see this word. Same for the use of women – please assume ‘…and people with cervixes’ wherever you see this word.

As a bit of context to the post, there is a huge education gap when it comes to HPV. Especially when it comes to men. Although this is a virus that can and does infect everybody, it’s often seen as a women’s issue or something that only women/people with cervixes need to care about. This STD post serves to dispel this myth but also to address some of the doom-mongering that can lead some men with STD infections to feel afraid, depressed and broken. I also want to briefly confront the question of stigma and ‘who has it worst’.

Disclaimer: not a doctor, scientist, or someone who spends too much time reading about this and likes to be informed. Open to correction if you’ve got evidence to back it up.

Myth 1: Men are just carriers 

I think well-meaning nurses or doctors sometimes say this to women who receive an HPV diagnosis and may understandably feel distressed about potentially transmitting something to a partner or vice versa. Additionally, as we’ll discuss later, the lack of routine testing for men may contribute to the perception that they could unknowingly spread the disease.

Men are not ‘just carriers’ of HPV, and men are also not ‘the source’ of the STD.

Almost all men and women have HPV infections that, in most cases, cause no symptoms and no harmful problems to arise. These infections are temporary, and while they may pass to sexual partners, likely, neither party will ever know.

Health Implications for Men

In a small number of cases, infections can cause visible symptoms for both men and women. Low-risk STD infections usually cause warts, but high-risk strains can also cause them. High-risk strains can also (rarely) cause other skin lesions like Bowenoid Papulosis.

Infections can also persist and cause cell abnormalities that, in a small number of cases, can develop into cancers. The biggest risk is to those with cervixes because the cervix is more susceptible to these changes. However, STD cancers can also affect the oral region and, less commonly, the penis, anus, scrotum, vagina and vulva.

When we say something like ‘men are carriers‘ for HPV, it implies that men are not affected by STD, when, although the risk is statistically lower in terms of cancer, they are still vulnerable to STD-related health issues, and warts can be a huge source of mental distress. It also implies that men are somehow responsible for ‘spreading’ infection when the reality is that HPV is pretty much inescapable unless you decide to be fully celibate for life. Thirdly, it erases the importance of STD awareness for MSM.

Men, women and those of different identities deserve to enjoy and explore sex and love, and we must recognise that although this will never be ‘safe’, it’s also nobody’s fault that rubbing our skin together can transmit viruses!

Men can’t get checked.

The myth: ‘There is no test for men for HPV.’

The reality is that clinicians can certainly test men for STDs; they don’t do it in most clinical settings.

This is said with the acknowledgement that in some healthcare systems, testing for men is available and sometimes done fairly routinely. From posts on this forum, this seems to be in certain Eastern European and Asian countries.

Private or niche clinics in other healthcare systems may offer such testing where it is not usually available.

Of course, scientific studies also make use of testing to examine the prevalence and duration of STDs in male populations.

But is this something that the ordinary person should pursue? And why is testing not offered as a routine part of sexual health STD screening?

Compared to Other infections

Let’s consider a sexually transmitted infection like chlamydia. It is widespread, especially among young people. Still, you can reasonably avoid infection by doing two simple things: 1) testing before you get a new sexual partner, which is quick and easy for the most part with a swab or urine test, and 2) using a condom or dental dam during sex to prevent the exchange of fluids. If you do have an infection, you can usually pop an antibiotic, send an anonymous message to anyone you had unprotected sex with recently so they can pop an antibiotic, and Bob’s your uncle. No more chlamydia.

Now, let’s consider HPV. Firstly, if you go to get a urethral swab done, it’s testing a tiny, tiny area of your genitals (your urethra). It doesn’t tell you about your shaft, balls, anus, inner thighs…all places where HPV could be hanging out, just waiting to hitch a ride onto your next date.

Implications of a Positive Result

Secondly, let’s say your swab test comes back positive. Uh…what now? There’s no treatment for an HPV infection, so the only thing you can do is sit back and wait for it to go. But that might take years. And in the meantime, a condom won’t fully protect your sexual partners. Are you happy to be fully (and I mean FULLY, like NO TOUCHING) celibate for up to a few years?

HPV testing for women is relatively new. For example, in the UK, where I live, they introduced it alongside cervical smear tests only about five years ago. The purpose of HPV exams in this instance is not the same as a chlamydia STD test—i.e., to treat, treat partners, and prevent onward transmission. It’s a cancer screening tool that helps doctors identify people who need more monitoring. Preventing it from spreading would be like getting the sand off a beach.