HPV Testing: Common Concerns and Recommendations

Questions about HPV testing?

Hello, Doctor Huang: I had my first sexual experience about 4 months ago with my ex-boyfriend, who is not a virgin.
Since I cannot determine whether my ex-boyfriend had any previous sexual partners who were HPV carriers, I have some questions that I hope you can clarify.
Thank you.
1.
Since I had oral sex without a condom, should I also get tested for oral HPV? What clinic should I visit for oral HPV diagnosis?
2.
Regarding the first question, do you think I am being overly concerned? Because even if I test positive, I learned online that HPV can only be cleared by the body's immune system, but I am worried that if I have HPV, I might transmit it to my next partner.
3.
It has only been 4 months since my first sexual experience, and I used condoms throughout.
How long do you recommend I wait before getting a Pap smear or HPV testing?
4.
I completed the quadrivalent HPV vaccine 5 years ago.
Would you recommend that I receive the nine-valent vaccine as a booster?

Z, 20~29 year old female. Ask Date: 2021/09/05

Dr. Huang Zifei reply Obstetrics and Gynecology

Dear Z,
1.
Oral HPV can also be screened using a swab test, which can be performed by both obstetricians and infectious disease specialists.
2.
If you are concerned, you can certainly get tested (this is an out-of-pocket expense).
About 90% of those infected with this virus can clear it through their immune system, so there is no need to be overly anxious even if you are infected.
3.
Since you are approaching 30 years old, you can use the annual Pap smear provided by the National Health Administration in the year you turn 30, along with an HPV test.
4.
Generally, the nine-valent HPV vaccine covers a broader range of viral strains, and if there are no financial constraints, it is recommended to get vaccinated.

If you have any other questions, please consult with an obstetrician.
Dr.
Huang Zifei, Department of Obstetrics and Gynecology, Nantou Hospital

Reply Date: 2021/09/05

More Info

Understanding HPV Testing: Common Concerns and Recommendations
Human Papillomavirus (HPV) is a common sexually transmitted infection that can lead to various health issues, including genital warts and certain types of cancer, such as cervical cancer. Given your concerns about HPV after your first sexual experience, it's important to address your questions with accurate information and guidance.

1. Oral HPV Testing: Since you mentioned engaging in oral sex without a condom, it is reasonable to consider the possibility of oral HPV. While HPV primarily affects the genital area, it can also infect the oral cavity. Currently, there are no standardized screening tests for oral HPV in the general population. If you have specific concerns, you should consult an ear, nose, and throat (ENT) specialist or a dentist experienced in oral health related to HPV. They can perform an examination and discuss the need for any further testing.

2. Concerns About Transmission: It’s natural to worry about the implications of an HPV diagnosis, especially regarding future partners. However, it’s important to remember that many people with HPV do not develop any health issues, as the immune system often clears the virus naturally. If you were to test positive for HPV, it does not necessarily mean you would transmit it to future partners, especially if you maintain a healthy immune system. Open communication with future partners about sexual health is crucial, and practicing safe sex can significantly reduce the risk of transmission.

3. Timing for Pap Smear and HPV Testing: The general recommendation for cervical cancer screening (Pap smear) begins at age 21, regardless of sexual history. Since you are 21, you should have your first Pap smear. If you are concerned about HPV, you can discuss with your healthcare provider about getting an HPV test at the same time. If you have had a Pap smear and HPV test done, follow-up screenings are typically recommended every three years if both results are normal. However, given your recent sexual activity, it may be prudent to discuss with your healthcare provider the best timing for your next screening.

4. HPV Vaccination: You mentioned receiving the quadrivalent HPV vaccine five years ago. The quadrivalent vaccine protects against HPV types 6, 11, 16, and 18, which are associated with genital warts and cervical cancer. The nine-valent vaccine offers protection against additional high-risk HPV types (31, 33, 45, 52, and 58). If you are within the recommended age range (up to 26 years old) and have not completed the full vaccination series, it may be beneficial to receive the nine-valent vaccine for broader protection. Discuss this with your healthcare provider, who can provide personalized advice based on your health history and risk factors.

In summary, while your concerns about HPV are valid, it’s essential to approach them with accurate information and a proactive mindset. Regular screenings, vaccination, and safe sexual practices are key components in managing your sexual health. Always feel free to discuss any concerns with your healthcare provider, who can guide you through the process and help alleviate your worries. Remember, you are not alone in this, and many individuals share similar concerns about HPV and sexual health.

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