There’s an age-old question when it comes to relationships. It’s a question that’s seen couples everywhere manically texting their friends for advice, Googling into the small hours and tossing and turning throughout the night: do you need to tell your partner absolutely everything? Some would say yes: that honesty is unfailingly the surest policy, and that relationships are built on transparency and a total lack of secrets. Others would say no: that it’s not always necessary for your partner to know something that won’t make any difference to their lives and that could bring about pointless anxiety. Others still would say it simply depends on the situation and the couple in question. Often, there’s no right answer; and deciding whether or not to share a particular confidence with your partner remains a matter of personal choice. A prime example? Talking to your partner about HPV.
says Mr John Butler, Consultant Gynaecologist at The Royal Marsden Hospital and the London Clinic and Medical Director at the Lady Garden Foundation. “There are over 100 types of HPV. Around 13 of these are ‘high risk’ and may increase the risk of developing some cancers. Other types may cause warts; but for most people, [HPV] causes no problems.”
Dr. Louise Rix is Chief Medical Officer at Béa Fertility. “HPV is contracted through oral, vaginal or anal sex with someone that has the virus,” she explains. “It can also be spread through genital to genital contact and [through] sharing sex toys. You can have HPV even if you haven’t been sexually active or had a new partner [for a long time], because the virus can be dormant in the body for many years.”
As far as HPV symptoms go, they can be non-existent.
“Most people don’t know they have HPV; and in most cases, it gets better on its own,” says Rix. “However, some people may develop genital warts; and for some, the virus may not be cleared by the body which can lead to problems over time.” The risk factors are low; Rix points out that, in most people, HPV will be cleared by the immune system within two years and will not cause any health problems. “For the small number of people who have persistent HPV infection, there is a higher chance of developing certain cancers; however, this is usually many years or even decades after initial exposure to the virus,” she says.
“For women and people assigned female at birth who have a long-lasting HPV infection, there is a greater risk of cervical cancer and vaginal cancer,” Rix continues (it’s worth noting here that HPV is generally diagnosed via a routine smear test for cervical cancer). “In men and people assigned male at birth there is an increased risk of penile cancer; and HPV can be associated with anal cancer and mouth and throat cancer in all genders.”
So, back to the big question: if you receive an HPV diagnosis, what do you need to know about telling your partner?
Well, the first thing to bear in mind is that there’s absolutely no obligation to do so. Butler points out that it’s a “very personal decision, as most people carry HPV without being aware of it”; and both Butler and Rix emphasise that the majority of people will contract HPV at some point during their lifetime.
Sarah, 30, from Manchester, was diagnosed with HPV following a smear test when she was “around 23”; and she’s opted for both privacy and honesty with her sexual partners over the years. She doesn’t think she ever told any partners about her diagnosis during her twenties. “But this wasn’t really a conscious decision of not telling them, more that I just generally forgot about it myself until it was time for my next smear [test] as it didn’t affect me in my day-to-day life,” she tells me. “I was single [for] most of my twenties, with few long-term partners; and to be honest, having HPV seemed like a non-event as I was told it’s very common. I’m not sure most of my partners would have even had a clue what it was."
In short: it’s completely your call whether or not you talk to your partner about an HPV diagnosis.
If you identify as female and are in a relationship with someone who identifies as male, it’s worth bearing in mind that, as Rix says, there are currently “no recommended tests to check for genital HPV in men.”
Now, though, Sarah is in a long-term relationship; and she’s opted to disclose her HPV diagnosis to her current partner. “We’re very open with each other about everything, so it was bound to come up,” she says. Sarah felt more concerned about her diagnosis when she was asked to attend a colposcopy about a year ago, but she emphasises how supportive her partner has been throughout: “We did a little test drive to the hospital outpatient ward together on the weekend before my appointment.”
So let’s say you’ve decided that talking to your partner about HPV is the best thing for you, for your partner and for your relationship. In this instance, it’s normal to wonder how to go about starting the conversation, what information to share and how to manage any concerns or fears your partner might have. “It’s totally understandable that a woman may feel apprehensive about about telling her partner about an HPV diagnosis,” says Sex and Relationship Expert Rhian Kivits. “She may feel concerned that he’d jump to the conclusion that she’d been unfaithful and catastrophise about the implications of the diagnosis.”
Luckily, there is some valuable guidance that might prove useful. The conversation may feel daunting; but it doesn’t have to be difficult.
First, it’s best to make sure you’ve got your facts straight.
“It’s important to explain that [HPV] is a virus that around 80% of people will contract, and very occasionally will need further checks for pre-cancerous changes,” says Butler.
Rix emphasises that there is no need for a partner to jump to conclusions regarding infidelity. “You can have HPV for many years without knowing it, and finding out you have HPV doesn’t mean you or your partner have been unfaithful. It’s very difficult to know who you got HPV from, both because the virus is so common and because it can remain dormant in cells for more than 10 years before becoming active,” she explains.
In terms of practical advice, Rix suggests being upfront with your partner if you have visible genital warts, and that you “avoid any skin to skin contact with the infected area until you’ve completed treatment.”
When it comes to beginning the conversation, Kivits has some useful advice on how to go about this. “Since it’s a sensitive conversation, you’ll want to pick a time when you have some space and privacy,” she says. “You could ask your partner whether they’ve heard of HPV, and explain a bit about it and how it’s diagnosed before explaining what’s happened in your situation. It can be reassuring for your partner if you have some information on hand for them to read.”
There’s no need to blame yourself or anyone else for the diagnosis, and it’s always better to be informed than to remain in the dark.
Kivits has some pointers for the opposite perspective, too; namely, when it comes to the support that partners can offer when they’re told of an HPV diagnosis. “There’s no need to blame yourself or anyone else for the diagnosis, and it’s always better to be informed than to remain in the dark,” she points out. “The most supportive thing partners can do is to be reassuring and take a positive, pragmatic perspective. The biggest worries, [such as] the link between HPV and cancer, are a rare occurence; and, usually, the immune system takes care of the infection.”
As with any health condition — and especially conditions that particularly impact women and AFAB individuals' health — greater awareness is paramount.
“Having HPV is so common that it should be regarded as an almost unavoidable part of being sexually active,” Rix maintains. “The more we normalise HPV, the less shame and anxiety [people will feel] about having the virus. With that in mind, I think being frank with your partner about HPV is useful and creates a greater level of honesty between you.”
Butler agrees. “Increasing HPV awareness will help people ensure they have their cervical screening tests regularly and promote HPV vaccination: which will help to reduce HPV and cancer rates,” he says.
The parting message, when it comes to HPV, is that we need to remove the stigma around the virus. “Having HPV doesn’t mean you’re ‘dirty’, promiscuous or in any way different to anyone else,” Rix emphasises. “Just please make sure you keep your smear test up to date.”
This was Sarah’s concluding sentence, too. “If you’ve put it off: go and get your smear test regularly!”, she implores. Amen to that.