I’m Married & Monogamous — So How Did I Get HPV?

Photographed by Jessica Nash.
Hi, this is Dr. ___’s office, calling about the results of your recent pap smear.

Uh oh, that’s not good. When it comes to medical tests, typically, no news is good news — and I’d received normal results on paps since I started getting them in college. Okay, let’s hear it.

It came back abnormal. The results were atypical squamous cells of undetermined significance with exposure to HPV.
Um, come again? What the hell does that mean? Atypical sounds bad! When it comes to my vagina, I definitely want to be typical. Don’t worry, it doesn’t mean you have cervical cancer. I haven’t seen cervical cancer in my office for 30 years. Good news, I guess? Okay, so make an appointment for a colposcopy in a week.

Record scratch/freeze frame/so, you’re probably wondering how I ended up here. Kidding, but that’s about where my mind was at this moment two years ago — how could I, a married 31-year-old woman who’d been monogamous for nearly six years, have HPV? And need a colposcopy, which thanks to Dr. Google, I learned was a super-fun procedure where your gyno biopsies tissue from your cervix to see if it’s cancerous, and sends you home wearing a giant menstrual pad? It felt like my body had betrayed me. Thankfully, it turned out my own cells were not precancerous, and I was given instructions to avoid smoking, take vitamins, and get another pap in six months to see if my body fought off the HPV. But I was still baffled about how I ended up with HPV (human papillomavirus) in the first place. Of course, I know being in your 30s and monogamous doesn’t necessarily safeguard you from sexually transmitted infections (STIs), but I really didn’t expect to be told I had one — even HPV. I thought I’d escaped my 20s in the clear. But in reality, I’m far from unique. There’s a running joke (if you can call it that) that "everyone has HPV." The real numbers aren’t quite that dramatic, but it’s still hugely common: In fact, 80 million (one in four) people in the U.S. are infected, according to the CDC. That’s why experts push vaccination so hard. The CDC recommends that all girls and boys get vaccinated at age 11 or 12, to get protection against the HPV types that are most likely to cause cervical cancer. But I was in college when the vaccine was just gaining steam. I didn’t know that much about it. The vaccine requires three doses, but I got one and never went back for the others. Too bad, too, because there’s evidence that even two shots may be just as good as three. The lesson is a retroactive schooling in STIs and sexual health — one that I learned way too late as a married lady. A few years back, I interviewed a well-known Ob/Gyn for a story I was writing, and she told me that when she tells married women that they have HPV, she also tells them not to go home and hit their spouses over the head with a pan for cheating on them. That’s because you could have been exposed to the virus long ago, and it can lay dormant in your system for years, emerging just as you’re experiencing something that’s weighing your immune function down, like stress.

Even if your sexual health is on point now, your past can still sneak up on you.

Which means that even if your sexual health is on point now, your past can still sneak up on you. If you met me now, you’d probably call me a “cerebral” person, a “thinker before she speaks,” or “reserved.” That’s what I’d call my "real personality," because that’s who I was before college, too. But during college, I spent a glorious year and a half exploring my party-loving alter ego. I drank a lot. And had unprotected sex sometimes. I chalk that up to a combo of feeling invincible, not having super great self-esteem, and, well, booze. Sure, I was on hormonal birth control, but when a guy — as they so often do in college — “forgot” to wear a condom or “didn’t feel like it,” I’d let it slide. And I totally got away with it, until, a decade later, the other shoe dropped. Yes, I know I am completely lucky to walk away with HPV and not something more. But if I could give my younger self the sex talk, it would definitely include this: Take advantage of the trifecta: Take hormonal birth control, use condoms, and get that HPV vaccine. Then, go have fun. Women are advised (and covered by insurance) to get the vaccine before age 26, since after that, it’s assumed you’ve been exposed to the disease. Plus, the younger you get it, the more effective it is. But recent research published in the journal The Lancet Infectious Diseases shows that vaccinating women older than 25 can help protect them from the most cancer-causing strains. So if you haven’t been vaccinated, it’s worth asking your doc about whether doing so would make sense for you. Right now, I can say that the fear and anxiety of being told I had HPV was worse than actually having it. I’d even call it no big deal in the end. But it could have been horrible. And anxiety (and letting your mind wander to what ifs, and googling “cervical cancer”) is a real thing with real consequences. New preliminary research shows that stress and depression can decrease a woman’s ability to fight off the virus. And, hell, I’d like to have another baby someday — not exactly a pain-free experience — but I do not ever want another colposcopy. Six months after that scary call (when I was pregnant, no less), the HPV was still present. My doctor told me that that was normal, particularly since I was expecting, as pregnancy suppresses your immune system a bit. But at my first postpartum appointment I was checked again, and all was well. Apparently, my immune system fought it off, as is what happens nine out of 10 times. Thank you, body: You were on my side after all.

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