From the Guidelines
Finding HPV on a Pap test when it wasn't present before doesn't necessarily indicate infidelity in your relationship. HPV infections can remain dormant for months or years before becoming detectable, so this could be from an exposure that occurred before your current relationship 1. The human papillomavirus is extremely common, with most sexually active people contracting at least one strain during their lifetime. Your immune system can suppress HPV for long periods, allowing it to remain undetectable on tests, and then it may become active later due to changes in immune function or other factors.
Key Points to Consider
- HPV infections often are shared between partners but it is often not possible to know the origin of an HPV infection; HPV tests might become positive many years after initial exposure due to reactivation of latent infections in both male and female partners 1.
- Having an HPV infection should not raise concerns about a male partner’s health 1.
- Providers should frame HPV positivity in a neutral, nonstigmatizing context and emphasize its common, asymptomatic, and transient nature 1.
Recommendations
- If you're concerned, have an open conversation with your healthcare provider who can provide personalized guidance based on your specific situation and testing history.
- They may recommend follow-up testing in 6-12 months to monitor the infection, as most HPV infections clear naturally within 1-2 years without treatment.
- Understanding HPV's dormancy patterns may help provide context for your test results, and it's essential to prioritize open communication with your partner and healthcare provider to address any concerns or questions you may have.
From the Research
Significance of New HPV Detection
- A new Human Papillomavirus (HPV) detection on a Papanicolaou (Pap) test in a patient with previously negative results may indicate a recent infection, as high-risk HPV is highly prevalent in the general population and usually transient 2.
- The detection of HPV does not necessarily imply infidelity in a monogamous relationship, as HPV can be transmitted through skin-to-skin contact and can remain dormant for years before being detected 2.
- A study found that providers who perform reflex HPV testing were more likely to recommend that patients with an ASCUS Pap inform their partners of test results if an HPV test was positive than if it was negative, highlighting the importance of HPV testing in cervical cancer screening 2.
Implications for Cervical Cancer Screening
- Women who consecutively test positive for high-risk HPV without significant changes on reflex cytology or dysplasia on cervical colposcopy-oriented biopsy are always referred to colposcopy, as the risk of cervical cancer is still present 3.
- A study found that all women testing positive for HPV, regardless of Pap smear result, should be referred to colposcopy to rule out high-grade squamous intraepithelial lesion (HSIL) 3.
- The detection of HPV can also indicate the presence of other sexually transmitted infections (STIs), such as trichomoniasis, which can be detected by Pap smear 4.
Management of HPV Infection
- Topical imiquimod treatment has been shown to be effective in treating persistent HPV infection in patients with or without cervical/vaginal intraepithelial neoplasia (CIN/VAIN) 5.
- A study found that HPV testing can be a valuable tool in diagnosing STIs, including asymptomatic infections, and can detect infections not detected by conventional methods 4.
- The management of women with abnormal Pap tests requires a proficient combination of diagnostic tools, including Pap test, colposcopy, and HPV testing, to result in the most satisfactory clinical practice 6.