‘Hmm. I think it looks a bit like a wart.’
I knew this could be a possibility. It is why I asked the doctor to take a look at the weird, flesh-toned patch of rough skin on my pubic area in the first place. But I thought it would turn out to be another one of those you-were-worried-for-nothing kinds of things.
‘I’m going to grab another doctor to take a look, if you don’t mind,’ she said, and I nodded. Yes, more doctors! All the doctors! Another physician will surely correct your terrible mistake!
On entering, Doctor Number Two peered between my legs, squinting through a magnifying device. ‘Yep, that looks like a wart,’ he said, pulling off his gloves and taking his leave. I dissolved into tears. ‘So,’ my Doctor said, indicating that I could close my parted thighs, ‘do you want to treat it now or later?’
Human Papillomavirus, or HPV, is an extremely common sexually transmitted infection (STI). There are around 120 different strains of the virus, and over fifty of those affect the genitals. Some strains of the virus are high-risk, meaning they are carcinogenic and can cause various kinds of cancers, including cervical, vaginal, anal, penile, head and neck. Other strains are considered low-risk, and cause genital warts (Type 6 and 11 are responsible for up to 90% of genital warts).
The majority of those infected with HPV clear the infection within two years and have no symptoms. Indeed HPV is so common, sources say it ‘could be considered a normal part of being a sexually active person.’
This is not my first brush with HPV. At nineteen I had my first pap smear, and consequently, my first abnormal pap result. I had the abnormal cells removed via a loop electrosurgical excision procedure (LEEP) and my paps have been clear ever since.
When I was twenty-six my doctor told me I should get the HPV Vaccine as it was free for me for one more year, and I did. Half the girls I know have had abnormal paps, and most of those have had a LEEP or similar.
We just don’t really talk about it.
I informed a partner once about my brush with high-risk HPV all those years ago. ‘At least it wasn’t the warts kind, right? That was lucky,’ he said. I nodded and giggled, probably because I really wanted to have sex with him. At the time I thought, ‘Ew, warts!’ Now I remember his comment and think, ‘Why is potential cancer and the removal of a large portion of my cervix more lucky than a treatable skin condition?’
Is it because it’s invisible? Is it because there is less stigma on a cluster of hidden cells than a visible manifestation of the virus? Is it because a ‘wart’ is like a scarlet letter, a brand that betrays one’s status as one of ‘those’ people? Why is it that one strain of the virus is easily dismissed, while another forever marks you as a much-feared and derided person with an STI?
The doctor dabbed the offending bump with a cotton-tip dipped in Liquid Nitrogen. ‘I hope this doesn’t hurt too much.’
As the little sting zapped between my legs, the nasty part of my mind thought, ‘You deserved this. This is what you get for being a slut.’ Even as I thought it, I knew it wasn’t true, but I’ve been conditioned to believe that people who get STIs deserve it for their promiscuity, for their lax attitudes to protection, for their stupidity.
I’m not stupid and I’m pretty sensible about using protection, but I have been promiscuous in my time. I now know enough about HPV to know that none of it matters.
HPV is transmitted through skin-on-skin contact, through microscopic breaks in the dermis. Condoms offer some protection against the virus, but are not one hundred per cent effective as they don’t cover all of the genital area.
Contracting HPV shouldn’t start a blame game: the virus can be present for months to years and is often asymptomatic. A pap smear can detect the high-risk strains of the virus present on the cervix, but there are no other methods to test for the presence of HPV.
The good news is that the HPV vaccine, Gardasil, is effective at preventing the strains of HPV that cause cervical cancer, as well as the types responsible for genital warts. A study at the University of New South Wales showed that diagnoses of genital warts in young women dropped by 59 percent in the first two years of the national vaccination program. A noticeable decrease in the diagnoses of cervical cancer will take longer to see, as cancers can take some years to develop.
I went back for two more treatments before the wart was finally gone, both of which were as quick and relatively painless as the first. Cryotherapy is the simplest and most common method of treatment, though topical creams, paints and laser therapy are also used. In a third of cases, untreated warts clear up within two years. Treatment is not necessary, but is recommended to reduce the risk of transmission, and for aesthetics.
The physical symptoms were gone pretty rapidly; the mental symptoms took a lot longer to disappear. A sense of shame hounded me for weeks; I felt a profound disgust at myself and wondered how on earth I’d ever be able to have another relationship. I kept it to myself at first, confusing everyone with my dire mood and deep despair.
Slowly, I started to feel better: I read as much as I could about HPV and sought out personal experiences online. I confided in a few friends, and even though I thought I might drop dead if I said the words, I didn’t. All I received was loving support, as well as a few admissions of similar experiences. More than you’d think. HPV is very common; we just don’t talk really about it.
Newly diagnosed and single, my first thought was that relationships were going to be, if not off-limits, then difficult and fraught. After all, who would want to risk contracting an STI? Catastrophic thinking plagued me for those first few weeks and I even caught myself thinking once or twice, ‘No one will ever love me again!’ I read a lot about people’s experiences informing new partners, and while some stories didn’t go so well, the majority were positive.
My doctor suggested that any prospective partners could take advantage of the HPV vaccine, though expensive for those not covered by the national vaccination program (Gardasil is free for 12-13 year olds, and all three doses cost $450 for everyone else).
But an emotional side-effect of my diagnosis and treatment was that for a good long while I stopped feeling sexy. I didn’t masturbate, I didn’t fantasise, and every time a sexy thought came into my head I would banish it. It’s like I was punishing myself for the shame I felt about being diagnosed with warts. I’d see a cute guy or girl and they’d give me a smile, but I’d turn away thinking, ‘If they knew…’
It took a long time for me to start feeling like I deserved to feel sexy again, but it came back. The more open I was about my predicament and the more acceptance I received, the better I felt about myself.
I mourned that I could no longer engage in casual sex. I was speaking with a similarly-minded, sexually-liberated friend, and when I told her that my casual sex days were over she paused, then said: ‘I am so sorry,’ with a sincere and deep sympathy. Me too, babe, me too.
I commiserated for a while until a thought occurred to me: while I can’t just meet a beautiful stranger and fall into bed with them, sex isn’t the be-all and end-all of sexuality. There are many more parts than just my private ones. I can kiss! I can make out! I can run my fingers over skin without fear of transmitting the virus to anyone.
Deep down, that was my main fear: I didn’t want to be responsible for giving this to anyone else. While it wasn’t a big deal in the long run, I still couldn’t shoulder the burden of passing it along.
Not too long ago, I met a nice guy. We had a lot in common, a shared group of friends and a similar outlook on life, sex, and happiness. After a few drinks we fell into bed together. As we kissed feverishly, I could feel his hands creeping towards the waistband of my pants. ‘Um, I’m sorry. I have this rule: nothing below the belt. Is that okay?’’ He said it was fine. I pressed him. ‘Aren’t you curious as to why?’ He smiled and said I could tell him when I was ready. There are a bunch of sexy things you can do with your pants on! We did them all, and it was actually pretty fun.
Disclosing your sexual health status is a stressful, upsetting and difficult thing to do. The stigma surrounding STIs is fierce. The fear of judgement and rejection prevents a lot of people from opening up about it to their sexual partners.
But a diagnosis of genital warts doesn’t mean you will spend the rest of your life loveless and sexually barren. A recent study from the University of London found that the majority of questioned subjects had relatively positive outcomes after disclosing their history of genital warts to prospective and current partners.
I disclosed when I felt ready (or as ready as I was able). Seeing that the relationship had potential, I sat in front of my computer and wrote it all out. Putting it down in words allowed me to be completely honest and to get out all the necessary facts and details. I even had links ready in case he had questions! (The CDC’s page on HPV is very informative if you are looking for a good comprehensive explanation of the Human Papillomavirus to send to a potential partner.)
Looking over the words filled me with fear, but also resolve. I sent him an instant message saying I wanted to tell him about my no-below-the-belt-rule and how difficult it was to talk about it. ‘If you are ready,’ he responded. ‘Take all the time you need.’ I copy/pasted my letter, and sat back, nervously clenching my hands together.
‘Is that it?’ he said after a tense few minutes. ‘I thought it was going to be something bad!’