—Optimistic in Chicago

Dear Optimistic,

Your conscientiousness about protecting your partner's health is laudable. It's unfortunate there's such stigma associated with sexually transmitted infections (STIs) — fear and shame are less helpful than open communication and informed choices in preventing the spread of STIs.

Unfortunately, a simple yes or no answer to whether you can pass warts to your partner isn't in the cards; there's no way to know for sure whether your system has cleared the virus, or if the virus is simply lying dormant but may become active again at some point. Genital warts are caused by the human papillomavirus (HPV), which can be treated with medication but may become intermittently active and inactive for reasons that still aren't clearly understood. Often the virus is asymptomatic, so people don't know they have it, and it often goes away (or becomes inactive) on its own. Unfortunately, the virus's activity level can't always be determined by the human eye, especially because it can affect you internally as well as externally.

To make things more confusing, there are multiple strains of HPV. Even if your partner already has HPV, you may have a different strain of the virus, and therefore could infect her with a form she doesn't have. This is important because certain strains of HPV are associated with cervical cancer. The strains that cause warts aren't associated with cancer; other strains (that often have no external symptoms) are more closely linked with pre-cancerous and cancerous growths on the cervix.

In 2006, a vaccine was released that protects women against the two main strains of HPV that cause genital warts and the two strains that most often cause cervical cancer. For more information see HPV vaccine. The vaccine doesn't cure HPV, and it won't work if someone has already been exposed to the strains of the virus in the vaccine, but your partner could ask her health care provider to see if it might be appropriate for her (currently the vaccine is only approved for women). If she a Columbia student, she can schedule an appointment by calling x4-2284 or by logging into Open Communicator.

If you have visible warts, the safest way to prevent transmission is to avoid sexual contact around the areas with warts. Using latex barriers (condoms and dental dams) can reduce the risk of transmitting infection, but doesn't eliminate it entirely because HPV can be present on parts of skin not covered by a condom or dam. Given the uncertainty around whether HPV has cleared from your system or is simply inactive, you and your partner will have to come to an agreement about what kind of risk you are comfortable with. As part of this process, you could experiment with different kinds of condoms — textures, colors, flavors — and make it a fun experience each time you put one on. HPV can be dangerous, but often goes away on its own without causing any damage. Again, compliments to you for your concern about your own health and your partner's.

Alice

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