Dear Alice,

How can having multiple sex partners be a risk factor for cervical cancer? What is the difference between having sex with one man one thousand times and sex with one thousand men (not that I'm planning to!) one time?

— Curious

Dear Curious,

Whether someone’s in a strictly monogamous relationship or exploring their sexuality with multiple partners, the most common cause of cervical cancer is human papillomavirus (HPV). This virus, which has many strains, has been linked to a number of cancers, including cervical cancer. The reason the risk of getting HPV increases along with the number of sexual partners a person has is as follows: having sex with many different partners increases the chance of coming into contact with a person who is carrying the HPV virus. In other words, the probability of encountering an infected partner increases as the number of partners someone has increases. On the other hand, having fewer sexual partners means there are simply fewer chances to come into contact with someone who has HPV (or any other infection). Taking steps such as practicing safer sex and limiting the number of sexual partners may reduce the risk of transmitting HPV. It’s also critical that people with cervixes get screened regularly to check for precancerous or cancerous cells.  

For those who choose to have multiple sexual partners, barrier methods help to reduce the risk of infection HPV and other sexually transmitted infections (STIs). HPV is transmitted by skin-to-skin contact, so correct and consistent use of internal (female) and external (male) condoms and dental dams is one of the best ways to reduce the risk of getting HPV and other STIs. While the chances of HPV infection are drastically reduced, it’s worth noting that there may be some areas of the body these barrier methods don’t cover and therefore doesn’t guarantee protection against HPV.

It’s also worth pointing out that even those who are in a monogamous relationship can be at risk of contracting HPV. Some people are carriers of HPV, yet don’t show any symptoms; they may unknowingly be transmitting the virus to their sexual partners. It’s also possible that, in healthy individuals, the virus will clear from the body on its own. Screening for HPV is not considered routine for people with cervixes under 30, but it may be recommended for those over 30. To screen for cervical cancer, a Pap smear may be performed on those with a cervix to detect any atypical or precancerous cervical cells. It’s recommended that people with cervixes get a Pap smear every three years after age 21. If atypical or precancerous cells are found, then a follow up HPV test may be administered to see if the virus is the cause for the cellular changes. Unfortunately, there is no equivalent screening for people with a penis.

There are also vaccines available to protect against the strains of HPV most likely to cause cervical cancer. Speaking with a health care provider about the vaccine is a good first step to getting protected against HPV. They can explain more about the vaccine, for whom it is most appropriate, and any potential side effects. Check out HPV vaccine for genital warts and cervical cancer in the Go Ask Alice! archives to learn more about the HPV vaccine.

When it comes to reducing risk, knowing what may increase the likelihood of infections and cervical cancer is key to determining effective prevention strategies. Kudos to you for asking for more information and here’s hoping your knowledge increased by the numbers.

Alice!

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