Should I tell new partner about my STI?

I’m a 50-year old woman, recently single and I’ve started dating. I’ve used condoms, but somehow I have contracted HPV. 

How has it happened? I’ve just met someone and I think I should tell him, but worry it will ruin everything as he won’t want to sleep with me.

Human papilloma virus (HPV) is a sexually transmitted infection, so my guess is that you acquired it through having sex.

The question is when. More than 75% of sexually active women contract the virus at some stage, but because most people never have symptoms, they find out only when it is picked up during a cervical screening.

Although it is tempting to blame your most recent sexual partner, you may have acquired the infection months, years, or even decades ago.

In the past it was thought that the immune system naturally cleared the HPV infection within two years, but scientists are questioning whether this is true or not.

Research by Patti Gravitt, who developed the gold standard method for detecting and genotyping HPV, now suggests the virus is controlled rather than cleared, and that it can reactivate in women when they are in their late 40s and early 50s.

Gravitt found latent but undetectable HPV was reactivated in menopausal women who had been monogamous or sexually abstinent for decades.

There is a positive correlation between HPV and higher numbers of sexual partners because promiscuity increases the likelihood of exposure. However, when Gravitt looked at newly detected HPV in a cohort of menopausal women, she found that only 13% of infection was attributed to new sex partners, whereas 72% was said to be due to a higher number of lifetime partners.

In her subsequent paper, published in the Journal of Infectious Diseases in 2012, Gravitt concludes that these instances were not new infections but a reactivation of existing HPV.

She suggests that menopause and ageing might make women immunologically vulnerable, but she stresses that more research is required.

You’re doing the right thing by using condoms: barrier methods are still the best way to protect against all STIs, but they only limit the risk of transmission; they don’t fully protect.

Research by the University of Washington in 2006 found using condoms reduces a woman’s risk of acquiring the HPV virus by up to 70%, but because HPV affects the skin and the moist membranes of the cervix, anus and mouth, it can be spread by non-penetrative contact.

Containing HPV transmission is complicated by the fact that there are about 100 strains of the virus. About 60 of these cause common skin warts and verrucas on the hands or feet and the other 40 strains are sexually transmitted.

Although HPV is most commonly associated with genital warts, CervicalCheck provides free smear tests to women aged 25 to 60, because high-risk strains of HPV (such as HPV 16 and 18) are implicated in about 70% of cervical cancers.

HPV16 is also strongly associated with oropharyngeal cancer, affecting the throat. In a study at the Johns Hopkins Oncology Center, a quarter of 253 patients diagnosed with head and neck cancers had HPV-positive tumours and 90% of them were HPV16 — so it seems that Michael Douglas could have been right when he said that the virus, transmitted through oral sex, was responsible for his throat cancer.

A vaccine against HPV is offered free of charge from the HSE to all for all girls in 1st year of second level school, but since you already have the virus, that won’t do you any good. For you, the most important thing to protect yourself is to keep attending your cervical screening appointments.

The sooner abnormal cells are picked up, the easier it is to get rid of them, and thanks to screening, cervical cancer survival rates are almost 95% if the cancer is picked up while still in the cervix.

Limiting the number of men with whom you have sex is routinely advised as a prevention strategy, but since you have the virus already, your biggest dilemma is working out whether to tell your new beau about your HPV status.

Although HPV is so ubiquitous that it doesn’t seem to merit the same level of disclosure as more serious STIs, what goes around tends to come around. Men carry the HPV virus, too, so if you wouldn’t want your partner to keep an HPV diagnosis from you, then you probably shouldn’t hide your diagnosis from him, either.

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