HPV is one of the most common STD’s. Unlike other STD’s which can be prevented with condom use, HPV cannot. It can also take a dormant stage and surface weeks, months, or years after the initial exposure. Thus, a wife of someone for twenty years can suddenly develop genital warts from her husband’s exposure years before they were married. This is why HPV is tricky…a majority of those exposed will never display symptoms and their bodies will eventually fight off the virus, but all sexual partners in the meanwhile will be exposed. It is my hope in this article to spread awareness that this can still be contracted with perfect condom use, as well as address not only the physical but the emotional aspects of this virus.
Pathology: The virus lives on the skin in the genital areas, including areas that are not covered by condoms. This is what makes this STD unique- it is transmitted from skin to skin contact, not bodily fluid contact. There are about 30 strains of genital HPV. Of these, many are harmless- the person will never have symptoms, and the body will fight it off on its own. 10 of these strains are linked to the development of cervical cancer, although this is rare.
Symptoms: Most people who are exposed to HPV never develop symptoms. This is why it spreads so rampantly throughout the sexually active community. For those who do develop symptoms, they may appear either as genital warts or show up on tests as pre-cancerous changes in the genital areas. Genital warts may be flat or raised, small or large, few or many, and with different color variations. Warts can appear in as few as a couple of weeks to as long as years after initial exposure.
Pre-cancerous changes usually show up as abnormal results from Pap Smear tests. Depending on the level of cell dysplasia (changes), HPV tests may not be needed as nearly all cervical cell changes are from this virus. Women cannot feel these changes in their body, so it is important to get the recommended annual Pap Smear to catch any cell changes.
Treatment: Because most people who are exposed to HPV never show symptoms, treatment is not usually necessary. For those who have genital warts, treatment consists of procedures which removes the warts, whether through freezing or simple surgical procedures. There are also prescription medications which can be used to treat the warts.
For those who develop pre-cancerous changes, the patient may opt to have these cells removed. Should the patient develop cervical cancer, treatment would depend on the scope and nature of the disease.
Epidemiology: HPV infections affect people worldwide.
Morbidity (# of deaths): Although no one dies from the virus alone, this virus is the main cause of cervical cancer. About 10,000 American women and about 500,000 women worldwide will acquire this disease, and about 4,000 American women and 250,000 women worldwide will die from it.
Mortality (# of those affected): Approximately 20 million Americans are currently infected with HPV. At any given time, about 50% of sexually active Americans have been exposed to at least one strain of HPV.
Preventative Measures: Because this virus is transmitted sexually, the only way to ensure that you will not contract this disease is either to abstain from sexual contact or to have sexual contact with someone who has never had sexual contact with someone else.
The second best preventative measure is to stay in a long-term monogamous relationship, although if your partner is already infected this may make you infected as well.
The highest risk for contracting many strains of this virus is from having multiple sexual partners or from having one sexual partner who has had many sexual partners.
Gardasil, the new HPV vaccine, may help prevent 90% of the risk for developing cervical cancer. This consists of three injections over the course of 7 months. However, this vaccine is most effective before the person begins having sexual contact. Should the person be exposed to HPV before the three injections are complete, the person will likely still get infected.
Emotional Aspect: (as taken directly from the American Social Health Association): “Yes, it is normal [to feel upset about having HPV]. Some people feel very upset. They may feel ashamed, fearful, confused, less attractive, or less interested in sex. They feel angry at their sex partner(s), even though it is usually not possible to know exactly when or from whom the virus was spread. Some people are afraid they will get cancer, or that they will never be able to find a sexual partner again. It is normal to have all, some or none of these feelings. It may take some time, but it is important to know that it is still possible to have a normal, healthy life, even with HPV.”
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