Feature Article: DYK Why HPV Doesn’t Mean Cheating? Take Our Quiz.

February is the month for love. People are thinking about flowers, chocolates and moments with their special someone. But at the Vaccine Education Center, we often get questions about something less carefree that couples deal with — human papillomavirus, or HPV, and the questions don’t arrive only in February. Couples deal with HPV diagnoses throughout the year.

HPV is one of the most common sexually transmitted diseases (STD). In fact, most people will be exposed to HPV at some point in their lives. For most, the infection resolves, and they don’t know they were even infected. But for those who develop genital warts or an HPV-associated cancer, the finding can come with not only the emotions of such a diagnosis but also accusations of being unfaithful.

So, during this month for love, see what you know about HPV and find out why an HPV diagnosis should not be considered evidence of cheating.

Q. 1: How does HPV spread?

1. Penetrative sex (oral, anal or vaginal)
2. Genital-to-genital exposure
3. French kissing
4. Two of these
5. All of these

The answer is E, all of these. While most people realize that penetrative sex can spread HPV, they may not realize that genital-to-genital exposure can also spread the virus from one person to another. French kissing may also spread the virus, but this occurs less commonly. Regular kissing, including kissing one’s children, would not be likely to spread the virus.

Because this virus replicates in cells that line the surface of our oral (e.g., throat) and genital areas (e.g., anus, cervix, vagina), these cells can be physically disrupted, leaving viral particles on surfaces that may touch susceptible areas of the other person during intimacy.

Q. 2: Does a condom prevent spread of HPV?

1. Yes
2. No
3. Maybe

The answer is C, maybe. Condoms can decrease your chance of being infected with HPV, but they are not foolproof. First, they do not cover all areas that may be infected with HPV. Second, the virus can be transmitted without intercourse.

Q. 3: What kind of infection does HPV cause?

1. Dormant infection that lives silently in cells and only replicates at certain times
2. Persistent infection that replicates in cells continuously
3. Short-lived infection that the immune system clears
4. Two of these

The answer is D, two of these. Both B and C can occur. Most people experience a relatively short-lived infection (months), but some people experience a persistent infection in which the virus replicates for years, or even decades, in their cells. Over time, persistent infections can cause cellular changes that lead to cancer.

Q. 4: Which of these individuals can be diagnosed with an HPV-associated cancer?

1. Someone who has never had sexual intercourse.
2. Someone who has been with multiple partners in the last 5 years.
3. Someone who recently started a new relationship.
4. Someone who has been in a monogamous relationship for 15 years.
5. Any of these people.

The answer is E, any of these people. People can be infected with HPV without having sexual intercourse. The likelihood of exposure increases with the number of partners a person has, and HPV will often spread early in a relationship as the person is newly exposed to the virus. While cancer doesn’t typically develop until years later, the infection is typically spread early during the relationship. Likewise, even during a new relationship, someone could be diagnosed with cancer resulting from a persistent infection introduced during a previous relationship. Finally, even if someone has been in a long-term, exclusive relationship, they or their partner could have a persistent infection that leads to cellular changes resulting in cancer. This is why an HPV-associated cancer diagnosis should not be viewed as evidence of cheating.

Q. 5: If a person is exposed to HPV while performing oral sex, which of their cells may the virus infect?

1. Cells in their mouth or throat
2. Cells in their anus
3. Cells in their reproductive organs
4. All of these

The answer is A, cells in their mouth or throat. If the only intimacy was oral sex, the virus would likely only be found in their oral cavity as the HPV virus does not spread through the bloodstream. However, if there was other intimacy (e.g., genital-to-genital), even without intercourse, additional areas, like the anus or reproductive tract, could be exposed.

Q. 6: Which of these people could benefit from getting the HPV vaccine? (Choose all that apply.)

1. An 11-year-old who is not yet sexually active
2. An 18-year-old who is starting college
3. A 25-year-old who has been in several intimate relationships
4. A 44-year-old who is in a long-term monogamous relationship

All of the answers apply (A-D). Any of these individuals could benefit from the HPV vaccine. The HPV vaccine protects against 9 types of HPV; however, it does not protect against types to which one was previously exposed. For this reason, HPV vaccine is of most benefit prior to initiation of intimate relationships, which is why it’s recommended for all 11- to 12-year-olds. In fact, the vaccine can be given as early as 9 years of age. Those younger than 15 years of age also only need 2 doses instead of 3 doses. The second dose should be given at least 6 months after the first dose to build a robust immunologic memory.

Those 15 years and older require 3 doses. The second dose should be given 1 to 2 months after the first dose, and the third dose should be at least 6 months after the first dose. The vaccine cannot treat an ongoing infection, but even after someone has been intimate, it is unlikely that they were exposed to all 9 types of HPV that the vaccine protects against.

People younger than 27 years of age are recommended to get the HPV vaccine if they did not get all recommended dose or if they missed getting it at a younger age.

Those 27 to 45 years of age are recommended to discuss vaccination with their healthcare provider. In the answer provided here, a 44-year-old in a long-term monogamous relationship may decide not to pursue vaccination; however, it is important for adults younger than 45 years of age to be aware that the vaccine is not approved for use in those older than 45. Since people are living longer and may be intimate with new partners later in life, this group could still potentially benefit from vaccination.

Get more info

If you want to learn more about HPV infection or vaccination, check out the VEC’s dedicated page, prevent-HPV.org, which has answers to almost 100 HPV-related questions. These questions have been submitted to our team over time and have been de-identified and added to sections of the page related to HPV infection, pregnancy, testing and treatment, and vaccination. If you don’t find your question, simply email us by using the form on the webpage.

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