You're three cups of coffee and 72 Google Chrome tabs into researching the human papillomavirus (HPV). You've learned everything you can about colposcopies, cervixes, and the GARDASIL 9 vaccine. But you still have one question — can I have sex if I have HPV? (Spoiler alert: Yes, you can.)
According to the Guttmacher Institute, only 17 states require sex education to be medically accurate. The lack of accurate medical information mixed with STIs' societal stigma can make navigating HPV feel difficult, even scary. But Dr. Alyssa Dweck MD, OB/GYN, tells Bustle that testing positive for HPV doesn't mean putting your sex life on pause.
"The answer is common sense," Dr. Dweck says. "If you have an active lesion or growth, it should be addressed, but just because you have a history of HPV, or tested positive for it, doesn't mean that you can't have sex."
According to Dr. Dweck, you can still have sex when you have HPV. In fact, the majority of people who test positive for the virus will never encounter symptoms or complications.
"Most people have a strong enough immune system that even if they're exposed to HPV, it doesn't cause an actual problem," Dr. Dweck says. "Once you're exposed to one of the strains of the virus, you always have it in your system, but it lays dormant."
Dr. Dweck shares that once the virus is dormant, it's unlikely that you can transmit it to a partner. However, because HPV is transmitted via skin-to-skin contact, it can be easily spread during sex or foreplay.
"Even if you don't have intercourse or penetration, you can still be exposed," Dr. Dweck says. "HPV can be transmitted through oral-genital contact, anal-genital contact, and any skin on skin contact."
If your partner is a woman or person assigned female at birth (AFAB), getting a routine pap smear and STI test will screen for the virus. However, if your partner is a man or person assigned male at birth (AMAB), they likely won't get tested for HPV (even if you test positive) unless there is a physical symptom on their genitals, like a growth or bump.
Dr. Sherry A. Ross, OB/GYN and women’s health expert, adds that your best chance at limiting the transmission of HPV during sex is to use barrier methods of protection like condoms and dental dams.
"You can prevent contracting HPV by limiting exposure," Dr. Ross tells Bustle. "The best way to limit transmission is to practice safe sex."
If you're actively developing genital warts or notice skin changes, like discoloration, bumps, or sores, you should check in with your doctor before getting frisky. Though genital warts or growths caused by HPV often go away on their own, your doctor may be able to relieve them with different creams or treatments.
There are more than 150 strains of HPV, and the majority considered "low-risk," which may cause genital warts or growths. The lesser common, "high-risk" strains can potentially cause pre-cancer or cancer of the cervix, penis, anus, or throat. While there is currently no "cure" for the virus, Dr. Dweck says that there are treatments to deal with any problems the virus caused and prevent it from being active.
"If you have an actual outcome because of HPV, like precancerous cells on your cervix, we can remove those precancerous cells," Dr. Dweck says. "We can't get rid of the virus; we can get rid of what the virus caused."
According to Dr. Dweck, anywhere from 70 to 80% of sexually active people have been exposed to HPV. Describing the virus as "ubiquitous," she adds that most sexually active people will test positive for HPV at some point in their lives.
"Patients will have had normal HPV testing and pap smears for years and years, and then all of a sudden, they find out they're positive on one of their routine tests," Dr. Dweck says. "It may be a re-activation of a strain of the virus they were exposed to a while back, but now they're stressed out, sick, or something in their immune system isn't keeping the virus in a dormant state."
For those who have tested positive for HPV or who are worried about the virus re-activating, Dr. Dweck suggests boosting your immune system and using barrier methods during sex.
"Get enough sleep, reduce your stress, take anti-oxidants or a multivitamin, minimize alcohol, and other things that put your immune system on stress," Dr. Dweck says. "Condoms are recommended to cut down the chance of transmission, but they don't completely eliminate it."
Finally, Dr. Dweck says the GARDASIL 9 HPV vaccine has been proven to be very successful and can help suppress the virus's spread. "The Gardasil 9 vaccination is typically framed as an 'anti-cancer vaccine because it prevents nine most common strains of HPV, two low-risk and seven high-risk," she says. "With enough adoption of this vaccine, HPV can hopefully go by the wayside."
Dr. Alyssa Dweck MD, OB/GYN
Dr. Sherry A. Ross, OB/GYN and women’s health expert