Why Can’t Men Be Tested For HPV? An HPV Primer For People With Penises

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We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions will remain anonymous. Please send your questions to tips@bustle.com. This week’s topic: everything you wanted to know about HPV for people with penises.

Q: How can I tell if my boyfriend has HPV? I know that there are different strains of the virus, because my gyno told me that some give you genital warts and other types can give you cancer — this is why I get Pap smears every few years.

But she said that I can’t have my boyfriend get tested for this STD, which I think is pretty messed up — why is it our problem as women? Why don’t they test guys for this, particularly if you can get cancer from it?

A: This is a very good question, and one that confuses lots of people. If you have a vagina and you go to the gynecologist, you’re tested for HPV (which stands for human papillomavirus) routinely, through pap smears. This uncomfortable procedure is designed to make sure that if you have an HPV strain that has the capacity to cause cancer, you can monitor and deal with it.

Sounds totally reasonable right? So why don’t the penis-having people in our lives get the same medical attention when it comes to HPV? Let’s go through it— because there is a reason.

HPV 101

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HPV is actually the name for a ton of different viral strains, 40 of which are sexually transmitted. It’s super, super common — actually, it's the most common STD in the United States. If you are sexually active, it’s extremely likely that you’ll get at least one strain of HPV in your lifetime.

How do you get it? HPV is an STD, which means that you get it from sexual contact. However, it’s different than lots of other STDs, which are transmitted through sexual fluids (by which I mean semen or vaginal fluid). HPV is actually transmitted by skin-to-skin contact. Aka touching! So you get it by touching the infected area of someone who already has it.

The bad news is that there is currently no medical cure for HPV. If you have warts, your doctor can freeze or burn them off. If you have pre-cancerous cells, your doctor will work with you to remove the cells before they get dangerous. But there’s nothing we can do with medicine to get the virus out of your system.

That’s not as bad as it sounds, however, because your body can get the virus out all on its own! That’s right, your body is usually able to clear the HPV infection. And this happens pretty fast — the average life of an HPV infection is between four and twenty months, and most people get rid of it within two years. This is really important when it comes to testing procedures … stick with me, and I’ll explain in a minute!

How Can You Tell If You Have HPV?

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Since there are so many strains of HPV, the answer depends on the type you have. With some strains, you may get genital warts. If you have a penis, these can be found there or on the testicles, around or inside the butt, or even just in the general region, like on the upper thighs. They will look like mini-cauliflower, flat, or raised skin nodules and can be found solo or in groups. If you lay eyes on something that looks like this, chances are it’s HPV.

However, if you have a potentially cancerous strain, you will get no warts. None! Instead, you may get some pain, itching, bleeding, or discharge from the butt (for anal cancer), changes in the color or thickness of skin on the penis (for penile cancer), or a sore throat, pain in the ears, coughing, or trouble breathing or swallowing (for throat cancer).

And finally, it’s super possible you’ll get no symptoms whatsoever! In fact, this is the most likely outcome — most people never get symptoms from HPV (and don’t even know they have it in the first place).

Can You Get Tested To See If You Have It?

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So if you probably won’t get symptoms from an HPV infection … how can you tell you have it? Here’s where things get complicated. That’s because there is no clinically approved screening test for HPV in people with penises. That’s right — if you have a vagina (or, more specifically, a cervix) you’ll get pap smears to test for this virus. But if you don’t have that bit of anatomy, you won’t get routinely tested.

Luckily, there are some caveats to this. If you have what might be a wart, your doctor will definitely check that out and tell you if it’s a wart or not. And if you have anal sex, you can get an anal pap smear — this is usually only offered to people who tell their doctors they are gay or bisexual, so if you don’t identify that way but you do have anal sex with one or more penises, you should request an anal pap from your doctor.

Wait, Why Don’t They Regularly Screen For Cancerous Strains?

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Let’s get into this a bit more, because it does seem like a bit of an inequality in prevention — why would doctors screen cervixes for pre-cancer but not penises, and only butts when you explicitly ask for it? Basically, just because we have the technology to see if someone has HPV, that doesn’t necessarily mean that it makes medical sense to test everyone routinely. This comes back to the fact that in the vast majority of HPV cases, your body clears the infection before you get anywhere close to the cancer stage, as well as the reality that we don’t have a medical cure for HPV. This means that just because you know you have the virus doesn't mean you're able to do anything about it, medically speaking.

Wait, but why test cervixes but not other body parts? The research has definitively found that catching and treating pre-cancerous cells on the cervix can stop cancer before it becomes invasive. But just because that's true of one body part doesn't mean it is for all necessarily — for instance, doctors are currently doing research to see if anal pap smears actually result in anal cancer prevention. If it doesn’t, then putting everyone through expensive (and let’s be real, kinda invasive and definitely not comfortable) preventive screening may not make the most sense.

How Likely Is It That HPV Will Lead To Cancer?

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If there’s no screening, the risk better be super low for HPV turning into cancer, right? The good news is that yes, it is pretty rare that HPV will lead to cancer in male reproductive parts, even if you get a high-risk strain of the virus. In fact, penile cancer accounts for only around 0.2 percent of all cancers penis-havers get, and every year there’s only around 2,000 cases of anal cancer.

How Can You Protect Yourself and Your Partners?

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Okay, so if there is no way to know if you have HPV, and you get it by touching, but it can potentially cause cancer, WHAT DO YOU DO?!?!?! The first thing is to use condoms. While condoms can’t cover all your skin, they have been shown to help lower transmission rates. And you can get a vaccine that protects against the most medically serious HPV strains. Remember that there are 40 sexually transmitted strains of HPV, and the vaccine doesn’t protect against nearly that many — but it does protect against the main strains that can cause cancer and those that result in genital warts. While this vaccine is mostly given to young people who are less likely to have been exposed to HPV strains, if you get this vaccine after you've been exposed to some strains, you will be protected against any of the covered strains you haven’t already been exposed to.

The Bottom Line

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As accountable, mature sex-havers, we want to know our STD status — both so we can take care of our bodies if need be, and so we can do our best not to pass anything along to the other bodies we love (or at least think are sexy). So it can be difficult to hear that the medical community isn’t racing to the finish to find a screening test for HPV on penises and is just getting started when it comes to butts. The thing to remember about HPV is that pretty much everyone will get it at some point during their lives, and for the vast vast majority of those people, it will come and go before they even know it. So tell the penis-havers in your life that they should for sure tell their doctors if they notice any wart-like things in that vicinity and to speak to their doctors if they have any symptoms that could be indicative of cancer. But otherwise, tell them to chill and live their lives!