How to Do It is Slate’s sex advice column. Send your questions for Stoya and Rich to firstname.lastname@example.org. Nothing’s too small (or big).
Every Thursday night, the crew responds to a bonus question in chat form.
Dear How to Do It,
I’m a heterosexual woman in my 30s not in a long-term relationship. I’ve had three to four partners in the past year with some overlap. (I’m honest with everyone.) At my most recent Pap, I was told I was HPV-positive. I know this is exceedingly common, that there’s no test for men, and that current recommendations typically have women my age—even those with multiple partners—only being tested every five years. That means there are a lot of people dating and having sex who unknowingly have HPV, even if they’re following recommended screening protocols.
I recently went out on a date with a married man. We hit it off and it seemed like sex was a date or two away. He’s looking for a longer-term girlfriend—his wife has a boyfriend, but he hasn’t found many women who would be interested in such an arrangement. I’m game! Then I told him I had HPV, and things came to a screeching halt. His wife said she didn’t feel comfortable taking a risk. This seems absurd to me since the man she’s sleeping with may well have HPV. If she hasn’t happened to get a Pap in the past year—likely, as she’s over 30—she may too!
I suspect they just aren’t terribly well-informed, which is surprising given their lifestyle. (This is new for them in the past year.) But it got me wondering, am I obliged to tell people if I use condoms? Eighty—80!—percent of people get some form in their lifetime, yet I’m surprised by how little people know about this. I feel like I was being unfairly stigmatized by their ignorance when they may be infected as well but remain blissfully unaware. Initially he told me they’d both been screened and found to be negative, which of course isn’t possible.
Stoya: According to the CDC, HPV can absolutely resolve and go away on its own. So our writer should check whether she even still has an HPV infection in the first place in a year or two.
Rich: My mind is blown. I guess I’ve bought into the stigma, figuring it was a mark for life. A manageable mark, but a mark nonetheless.
Stoya: I know this because I had an HPV infection that showed up on one Pap smear and never again. My health care professional said my body must have cleared it. I haven’t disclosed since the infection cleared, but I’m about to start disclosing again, because that’s a great sorting mechanism.
Rich: Everyone needs a filtration system.
Stoya: It’s a great test of how nuanced a person can be around sex. And—as our writer hints—how well-informed the potential partner is, or is willing to be. From the CDC’s website: “By age 50, at least 4 out of every 5 women will have been infected with HPV at one point in their lives.”
Rich: Because the couple the writer’s potential partner is in is relatively new to nonmonogamy, I do wonder if his wife was taking the excuse to veto. Whether she cares about HPV or not, maybe she just was looking for a reason to shut this down.
Stoya: There could definitely be a double standard afoot. But that last line about him telling her they’d both been tested for HPV makes me think they are at least also uneducated.
Rich: Right. I’ve talked to doctors who advise their HPV-positive patients NOT to disclose for the very reason of undue stigma, and that stigma certainly is a result of ignorance, as stigma tends to be. It’s interesting because in my reading HPV is the STI with the most controversy about disclosure.
Stoya: So I should probably avoid the internet the day this goes live, huh?
Rich: You know, avoiding the internet in general is a good idea. Where do you fall on the sort of hard-line issue here? Should people be disclosing their HPV diagnoses, given how prominent and misunderstood it is?
Stoya: If you have an active infection, you need to disclose. That’s my unilateral judgment.
Rich: I think that’s right.
Stoya: A cold? Disclose. HIV? Disclose. Meanwhile, even if you’ve had one strain of HPV, it’s worth seeing if your doctor will give you the vaccine, since there are a whole bunch of different strains. Although it’s not always recommended, women can get the vaccine until they’re 45 years old. I’m not sure about men.
Rich: It’s the same.
Stoya: I’m actually in the middle of getting a new round because they’ve added new strains in the past decade.
Rich: What complicates things is not only prevalence, but just how contagious HPV is; condoms don’t always work to suppress transmission. I mean, it can be transmitted skin to skin.
Stoya: And even if they did, condoms can break or fall off.
Rich: So HPV should be understood as a risk in any sexual encounter—even if it should be said, it goes without saying.
Rich: And I do think our writer has been unfairly stigmatized.
Rich: Regarding the sorting mechanism you mentioned, is there a way of looking at this scenario as our writer dodging a bullet?
Stoya: Oh, very much yes. This couple let her know that she’s of lesser value to them in a few ways. And have probably saved her at least a small amount of drama.
Rich: That’s what I’m thinking; if it weren’t this, it would probably have been something else. I mean, good on her for diving right into a poly situation.
Stoya: Bold of her, yes.
Rich: She may find, though, in less complicated configurations, that people are far less squeamish about her HPV.
Stoya: And even if the next few dates do recuse themselves, eventually she’ll meet someone she likes who can be chill about this.
More How to Do It
I am a woman in my mid-30s, and over the past year, I’ve gotten close to a 40-ish married man whom I met through a work colleague. For a variety of other reasons, this sexual relationship appeals to me at the moment. We’ve had conversations about discretion, but I’ve never explicitly asked what his wife knows or doesn’t. Should I? I can’t decide if it matters.