HPV Testing for Male Partners of Women with HPV
HPV testing is not recommended for male partners of women diagnosed with HPV infection. 1
Rationale for Not Testing Males
The CDC's Sexually Transmitted Diseases Treatment Guidelines clearly state that HPV tests should not be used to screen male partners of women with HPV 1. This recommendation is based on several important factors:
No FDA-approved test exists for men: Currently, there are no clinically validated tests to determine if men have HPV infection 1. All FDA-cleared HPV tests are only approved for use with cervical specimens, not for testing males 1.
High prevalence in sexually active population: HPV is extremely common, with most sexually active adults acquiring HPV at some point in their lives 1. The median duration of new HPV infections is approximately 8 months 2.
Natural clearance: Approximately 70% of new HPV infections clear within 1 year, and about 90% clear within 2 years 2, 3.
Shared infection status: Sexual partners in long-term relationships tend to share HPV status. If one partner has HPV, the other partner likely has it as well, even without symptoms 1.
What to Tell the Patient
When counseling this 45-year-old male patient whose wife has been diagnosed with HPV, the following key points should be discussed:
HPV is very common: Most sexually active adults will get HPV at some point, though most never know it because HPV usually has no signs or symptoms 1.
Not indicative of infidelity: A diagnosis of HPV in one partner does not indicate sexual infidelity in the other partner 1. HPV can remain dormant for years before detection.
No testing needed: HPV testing for men is not clinically useful and is not recommended 1.
Prevention measures: Consistent condom use might lower the chances of HPV transmission, but condoms aren't fully protective since HPV can infect areas not covered by condoms 1.
Vaccination consideration: For men up to age 26, HPV vaccination may be considered, though at age 45, the patient is outside the routine recommendation age range 1, 3.
Recommended Actions
Reassurance: Provide reassurance that no testing is needed for the male partner.
Education: Educate about the natural history of HPV infection and its high prevalence.
Prevention: Discuss prevention methods including condom use, though acknowledge its limitations for HPV prevention.
Partner support: Encourage the patient to support his wife in following recommended cervical cancer screening protocols.
Common Pitfalls to Avoid
Unnecessary testing: Ordering HPV tests for male partners provides no clinical benefit and is not recommended by guidelines 1.
Creating unwarranted anxiety: Emphasizing HPV infection can create unnecessary concern when most infections resolve spontaneously without causing health problems 1.
Misinterpreting relationship dynamics: Avoid implications about infidelity, as HPV can remain dormant for years before detection 1.
Neglecting female partner's follow-up: While the male doesn't need testing, ensure his wife follows appropriate cervical cancer screening recommendations based on her age and risk factors 1.
By following these evidence-based recommendations, clinicians can provide appropriate care while avoiding unnecessary testing and reducing patient anxiety about this common infection.