HPV stands for Human Papilloma Virus (HPV). It’s the most commonly spread STD around. In fact, most experts believe that almost everyone who is sexually active will carry a strain of HPV at one point or another. Some strains of HPV can lead to cancer, and that’s why health experts want to spread the word and ensure women are observing regular checkups and screenings that can prevent HPV-related complications.
As testing methods improve, there’s a chance you could test positive for HPV, even if you’re over the age of 30 and in a completely monogamous relationship.
What does a positive HPV test mean?
First, let’s talk about the variety of HPV strains – there are more than 100 different types of HPV. Ultimately, they’re divided into two categories: high risk and low risk. The low-risk strains are the ones that cause noticeable side effects such as genital warts but aren’t associated with cancer. The high-risk strains of HPV are the ones that can cause changes in cervical cells that might eventually lead to cancer. A chronic case of HPV often shows up in the form of an abnormal pap smear, which will lead to further investigation and treatment. There is nothing different about your pap smear when we test for HPV – we use the same cell sample that we do to look for cervical cell abnormalities.
These days, most OB/GYNs will test for some of the most common, “high risk” HPV strains when you come in for your routine pap smear, and this can lead to a positive HPV test result.
If you do have a positive HPV test result, there is no cause for panic. Experts estimate that about 75% to 80% of all sexually active adults have had HPV at one point or another. And, we also know that while HPV is a common link in those that have cervical cancer, most cases of HPV DO NOT become cancerous.
In 90% to 95% of those cases, HPV runs its course, the immune system fights it off within one to two years, and that’s that. This is most common for women in their teens and in their 20s. For others, the virus is more persistent and it will continue to multiply and build in their system until it’s ultimately detectable via screening tools.
If you test positive for HPV your doctor will want to make sure you’re well informed about the situation, and will keep a close eye on you over time to see if it resolves itself or if it shows up in the form of abnormal cervical cells. It’s also important to note that HPV tests have high rates of false positives, another reason why we choose to investigate further, rather than rush into action.
Be diligent about well-woman checks and regular pap smears
In most cases, women are clear of HPV within about eight- to 24-months. So your positive test may mean nothing more than, “take care of yourself, eat well, exercise and get good sleep so your immune system can do its job well.” If you text positive for one of the more high-risk strains of HPV, your doctor may want to test you again, specifically for strains 16 and 18, which are associated most often with changes in cervical tissue that lead to cancer.
If you text negative for one of those two strains, we’ll ask you to come back the next year for a repeat pap smear. If you’re negative again, we say, “Congrats! You’ve cleared it!” and you are back on the every-three-year pap smear rotation.
If you text positive for Strains 16 or 18, we’ll use a procedure called a colposcopy so we can get a better look at your cervix and see whether there are any unusual signs or abnormal cells that warrant further examination or testing. Any tissue that looks abnormal will be removed and/or sent for biopsy, and your doctor will keep a close watch on your cervix, probably recommending a pap smear every year just to be safe. After a series of “clear” years, you’ll probably be put back on the three-year rotation again.
Could I have prevented HPV?
While HPV is a sexually transmitted disease, penetration is not necessary to contract it. It can also be spread through oral sex – as well as anal sex – or physical contact outside the surface area of the condom. So, while using a condom can help to prevent the spread, it’s not 100% effective in preventing the transmission of HPV.
There are vaccines out now that help the immune system develop immunity to some of the most common and high-risk strains of HPV. These are recommended for teens and women into their mid-20s. After that, the efficacy of the vaccine is questionable.
At this point, the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the CDC advise that all young women and men ages 11-26 get the HPV vaccine, and this is one of the first things we consider during a teen’s first OB/GYN appointment. The HPV vaccine is not approved for adults over the age of 26.
The good news is that pap smears have been amazingly effective at detecting – and stopping – the most dangerous strains of HPV in their tracks, preventing the development of cervical cancer. Developing a comfortable rapport with your OB/GYN and observing routine well-woman visits and pap smear schedules is the best way forward for women with – or without – HPV.