Human papillomavirus (HPV) is a common infection affecting sexually active individuals. A misunderstanding persists that HPV cannot affect those in monogamous relationships. This article clarifies how HPV spreads and why a diagnosis within a monogamous partnership does not necessarily indicate infidelity.
How HPV Spreads
HPV primarily spreads through intimate skin-to-skin contact, including vaginal, anal, or oral sex. Penetrative intercourse is not required for transmission; even close genital skin contact can spread the virus. HPV is not transmitted through casual contact like hugging, sharing food, or using toilet seats.
HPV can also transmit through nonsexual means, such as hand-to-genital contact, though this is less common. HPV is a highly common infection, with an estimated 80% of sexually active adults contracting some form of HPV during their lives.
Why Monogamy Doesn’t Prevent HPV
HPV can appear in monogamous relationships because it remains dormant within the body for extended periods without causing noticeable symptoms. An infection acquired from a previous partner could lie latent for months, years, or even decades before becoming active. This means a new HPV diagnosis does not inherently imply recent sexual activity outside the current relationship.
The asymptomatic nature of HPV contributes to its silent transmission. Most infected individuals do not know they have the virus and can unknowingly pass it on. Approximately 70-90% of HPV infections are asymptomatic. While many infections clear on their own, the virus can persist, leading to later health issues. The development of visible warts or abnormal cell changes during a long-term relationship does not necessarily indicate new sexual contacts.
HPV Testing and Detection
Detecting HPV varies significantly between sexes, and there is no routine HPV test for men. For women, HPV testing is typically incorporated into cervical cancer screening protocols, often alongside or as part of a Pap test. A Pap test identifies abnormal cell changes in the cervix, while an HPV test specifically looks for the presence of high-risk HPV types linked to cervical cancer.
For women aged 30 and older, an HPV test may be recommended alone or as a co-test with a Pap test, usually performed every five years. Visible genital warts, if present, can be diagnosed by a healthcare provider through visual examination. Current HPV tests primarily detect high-risk strains associated with cancer or those causing visible warts, rather than detecting all HPV types.
Preventing and Managing HPV
The HPV vaccine, particularly Gardasil 9, serves as a highly effective preventive measure against several high-risk HPV types that cause cancer and low-risk types that cause genital warts. It is generally recommended for both males and females, ideally before they become sexually active, though it can be administered up to age 45. The vaccine offers long-lasting protection and has significantly reduced HPV infections and related cancers.
While condoms can reduce the risk of HPV transmission by about 70%, they do not offer complete protection because the virus can infect areas not covered by a condom. Consistent and correct use of condoms remains important for reducing the risk of HPV and other sexually transmitted infections. For women, regular cervical cancer screenings, including Pap tests and HPV tests, are crucial for early detection of precancerous changes.
If visible genital warts develop, various treatment options are available, such as topical medications, cryotherapy (freezing), or surgical removal. Treating warts removes the visible growths but does not eliminate the underlying virus itself. The immune system often clears the HPV infection over time, even if warts are present.