During recent years there have been many alarming and sensational media reports linking the human papilloma virus (HPV) with cancer of the cervix and calling it a new epidemic and a sexually transmissible disease. None of these claims have been proved, but they have caused much anguish among people (both women and men) whose lives are affected when HPV is reported in a Pap smear. What does it all mean?
The wart virus is all around us. There are many different types: almost 50 have been identified and there are probably more. Some types cause skin warts; others cause genital warts; others live in the vagina and on the cervix, some types causing typical warty outgrowths, and some just causing a change in the microscopic appearance of the cells covering the ectocervix.
HPV isn’t new. It has probably always been around, but modem technology has now produced tests that demonstrate its presence more sensitively. These tests have even shown evidence of HPV in Egyptian mummies. What is now described as HPV effect in Pap smears used to be called something else (so common that it was considered a normal variation) 30 years ago before we knew much as we now do about viruses.
If the wart viruses are so widespread, why aren’t we all affected? We probably all carry many types of HPV on our skin and some lining membranes (it only lives in stratified squamous epithelium) but t is not known why the virus invades cells and causes changes in only some people. It’s suspected that there must be a change in our immune state plus one or more other factors (still not known) before the virus can invade and express its presence by causing cell changes. Studies using the new sensitive tests have found evidence of HPV on the cervix of up to 80 per cent of women, most of whom have normal Pap smears.
The suggestion that HPV changes in the cervix are due to sexual transmission of the virus has caused great anxiety and un-happiness. It makes women feel tainted, diseased and often judged as being promiscuous. A woman wonders who gave her the infection. She may have her suspicions, but if she has had only one partner she may doubt his sexual fidelity. A man whose only sexual partner develops HPV in a Pap smear may have similar doubts about her sexual behaviour. All the misery and distrust that arises because HPV changes in Pap smears are branded as a ‘sexually transmissible disease’ is, I believe, unjustified and unnecessary. HPV can certainly be transmitted through sex (and the more partners, the more likely the transmission), but is probably more often picked up in other ways, as suggested by the following facts.
• The virus can be demonstrated in newborn babies. Perhaps we all pick it up from our mothers during birth.
• A recent Sydney study of 1000 men, the only-ever sexual partners of women with HPV changes in their Pap smears, found evidence of wart virus in less than 10 of the men.
I’m not suggesting that HPV should be disregarded: we know that it can
cause disease in animals and plants. But there’s heaps that we don’t know about it, and until we learn more it is wrong for women to feel bad and for relationships to be damaged by unproven assumptions. So if your Pap smear shows HPV changes, don’t feel tainted don’t blame yourself or your partner.
*245/31/5*
