Treatment of Male Partners When Female Partner Has HPV-Related Cervical Findings
Men should not be treated for HPV when their partner has cervical findings related to HPV, as there is no clinically validated test for HPV in men and no treatment exists for the virus itself—only for visible manifestations like genital warts. 1, 2
Why Treatment Is Not Indicated
No diagnostic testing exists for asymptomatic HPV in men. The CDC explicitly states that no clinically validated test exists for men to determine if they have HPV infection, and HPV tests should not be used to screen men or partners of women with HPV. 1, 2
Partners in long-term relationships already share HPV. Sexual partners of HPV-infected patients likely already have HPV, even though they may have no signs or symptoms of infection. 1, 3 By the time one partner is diagnosed, both are typically already infected. 2, 3
No treatment exists for the virus itself. Treatments are available only for conditions caused by HPV (such as genital warts), but not for the underlying viral infection. 1 The immune system clears HPV infection most of the time without intervention. 1
What Should Be Done Instead
Clinical Examination
Examine for visible genital warts only. Men should be examined for visible genital warts if present, but routine screening for asymptomatic HPV is not indicated. 2 If genital warts are identified, they can be treated with appropriate modalities, but this does not eradicate the underlying HPV infection. 1
STD Screening
Screen both partners for other STDs. If one partner has genital warts or HPV-related conditions, both partners should be screened for other sexually transmitted diseases. 1, 2
Prevention Strategies
Recommend consistent condom use. Consistent condom use by male partners can reduce the risk for cervical and vulvovaginal HPV infection and might decrease the time required to clear HPV in the infected woman. 1, 3 However, counsel that condoms are not fully protective because HPV can infect areas not covered by a condom. 1, 2, 3
Offer HPV vaccination. Male partners can be vaccinated with the quadrivalent vaccine (Gardasil) to prevent genital warts, though this does not treat existing infection. 1, 2, 3 The vaccine is approved for males aged 9-26 years. 1, 2
Critical Counseling Points
Normalize the diagnosis and prevent stigmatization. Detection of high-risk HPV infection in a woman does not mean that the woman or her partner is engaging in sexual activity outside of a relationship. 1, 3 HPV infection can be present for many years before it is detected, and no method can accurately confirm when HPV infection was acquired. 1, 3
Emphasize how common HPV is. Most sexually active persons get HPV at some time in their lives, though most will never know it. 1, 3 Even persons with only one lifetime sex partner can get HPV if their partner was infected. 1
Reassure about partner cancer risk. The absolute risk of the male partner developing HPV-related cancer is extremely low, even for partners of patients with HPV-related disease. 1 No specific follow-up is required for male partners in the absence of any standard HPV screening test. 1
Common Pitfalls to Avoid
Do not order HPV testing in men. HPV testing is unnecessary in sexual partners of persons with HPV or genital warts. 1, 2 Testing for low-risk HPV types (6 and 11) provides no clinical benefit and should be avoided. 2
Do not recommend unnecessary clinical evaluation. Partner notification has a limited role in the control of HPV transmission or in preventing adverse health outcomes in the male partner. 4 Referring asymptomatic male partners to clinicians for HPV evaluation is not evidence-based. 4