Do STI tests include HPV?

[ButteryLightHouse]

Following on from the strange thread about vaccinating against HPV...

For those of us who are older and were not vaccinated against HPV, if you and a new partner were to pop down to the sexual health clinic to be tested, does the panel of tests include HPV as standard?

No, generally not. It would be for the usual bacterial ones in a swab (chlamydia etc) and bloods for HIV, syphillis and hepatitis. 80% of sexually active adults have been infected with HPV (obviously the ones who haven’t been vaccinated), so there is no point testing everyone for it. If you have a lesion you’re concerned about, it can be tested.

No, but it's tested on your smear test.

I thought that although the majority of adults (80% as you say) have had the infection at some point in their life, but most clear it within 2 years. So it's not 80% of adults at any one time?

But if I had a negative test from a recent smear, and was entering into a new relationship, would it not be sensible to check to see if the man was also negative at that point in time? It could affect contraception choices.

Do condoms stop the spread of HPV to the cervix? I understand that close contact spreads it in general. But we do have readily accessible barriers in the form of condoms

And thanks both for your replies 😊

Condoms do NOT necessarily stop HPV infections. You need to realise that the infection can be transmitted via all manner of contacts - including deep kissing: At that point the entire body has been infected with the virus. The question then is where the wart/lesion outbreak will happen: it may happen (for females) on their cervix. Or it may happen if they get a breakout of warts on their vulva or other area of skin on their genital area. It can also manifest as throat cancer or other types of head/neck cancer. As such, a condom isn't terribly effective at preventing HPV transmission: it can help (for example if the infected partner has a shedding wart on the end of their penis) but preventing the transfer of semen isn't the only way to prevent infection sadly.
You should still wear condoms of course - because they absolutely are very effective (though not entirely effective - nothing is other than abstinence) at preventing other STDs. HPV is a far more tricky one to prevent because it can be transmitted via simply touching skin - or even deep kissing. It's less likely to result in an infection that way, but it can still happen. And the manifestation of the virus can happen in multiple parts of the human body, so "wearing a condom to prevent touching the cervix" indicates a misunderstanding of how viral transmission works and future cancers can develop.

@Caligirl80 thanks so much for such a detailed response. I had thought that an HPV caused a local infection, not a systemic one.

Should go without saying but only women who still have a cervix can get smear tests.

There is NO routine HPV blood test for men to see if they have the virus. Which is why it is so very important for boys to also be vaccinated when they are in school!

And of course there is no routine blood test for women either to see if they have the HPV virus - they have to wait for a smear test, and even then only get notification of a possible infection if there is a problematic smear test - but it doesn't necessarily tell them if they have been infected with HPV. And it doesn't help women who no longer have a cervix to know whether or not they have the virus.

As far as men are concerned the "testing" is generally done by looking for symptoms - like warts. Men (and women) can have an "anal PAP test" done - a similar idea to the cervical smear test. But it's not routinely done and it's generally offered only if there are visible issues or the person is more vulnerable (for example they have regular penetrative anal sex - which of course can apply to both men and women depending on their sexual preferences).

If you have any questions about any of this please ask your doctor or make an appointment to speak to someone at your local sexual health clinic.

You're welcome: Any virus will typically cause a systemic infection - that's why viruses are more annoying to deal with than bacteria oftentimes. The infection may "break out" or be "visible" in certain places - but that doesn't mean the virus hasn't infected your body. So, a good example again would be the Herpes Simplex Virus (Herpes): the initial infection with the version of HSV that causes mouth sores AKA cold sores may not have a cold sore at all: It typically causes people to have fever and feel pretty gross/under the weather/aches/pains etc. It can be a very dangerous virus for newborn babies to get - which is why one should never ever kiss a baby/young child unless you are the child's parent (and even then you must be incredible careful not to kiss babies on the mouth/eyes etc.

A person who has HSV - the cold sore variant - may hardly if ever get a cold sore. But that doesn't mean they don't have the virus. It's one of the reasons that people get a cold sore breakout if they are feeling run down/tired/stressed etc etc or have been battling a different bug - it'll provide an easier environment for the virus to flare up and for a cold sore to result.

HPV is similar in this regard: once you have the virus you have the virus for good - and it may show up as a wart on your private parts, or it may show up as a cancerous lesion on a cervix or someone's throat etc etc. There is anecdotal evidence to suggest that people who engage in more types of sex than others (so unprotected oral sex for example) may be more prone to HPV throat cancers than others - but then again they may have had more sexual partners...it's difficult to know for sure.
What we do know for sure is that the HPV vaccine works - and it prevents a long list of cancers - so it's awesome.

Hmm my ignorance/incorrect 'knowledge' seems to be due to speaking with the nurses when having my last couple of smears. To reassure you, I'm asking from curiosity, not medical need. Would you be able to answer one more question please?

If a woman had a negative HPV result on her smear tests and remained with the same partner for life (assuming they had only been with each other and both continued to be faithful) or if she then chose to live as a nun, is she then at zero risk from future HPV infections?

Many men carry it up their nose/throat so its not just sexually passed on, one of the leading causes of head and neck cancers in men

No, it can lie dormant & have been picked up years before by either party. Women can become infected by HPV even in a monogamous relationship for decades.

Really? By 'lie dormant' do you mean that in this period of time, the woman would have negative HPV tests from their smear tests?

100 per cent, yes.

Also in past they didn’t test for HPV re: in Smears, so you could have a clear smear & be HPV positive & unaware.

Well that's insidious! Is that because there's not enough virus present in the body to detect in this case? I suppose the tests have a limit to their sensitivity.

Thanks for answering my questions everyone. I wish I was born 15 years later! Book your smear tests!

Well, that's a question you need to ask a sexual health specialist doctor to get a full understanding.
But it is possible that, yes, you do have HPV already - it's just that it hasn't shown up on a smear test. It's also the case that, yes, your partner might also have HPV already - but he doesn't have any visible symptoms (genital warts are the classic indication) so who knows? Since we cannot be 100% sure that neither of you have HPV already - and since we can never be 100% that a partner will always be faithful (HPV can spread even via deep kissing - not even penetrative sex) the answer has to be that 1) You and/or your partner may well already have it - so you could develop illnesses related to it in the future and 2) if you keep having intimate relations with your partner then even if you don't have HPV now you could be infected with it in the future either because he's infected with it now and could give it to you, or he may (who knows what the future holds! You aren't connected at the hip 24/7) catch it in the future and inadvertantly give it to you if you have intimate relations with him after he becomes infected.

Given you can't be sure one way or another there's not much point losing much sleep over it. BUT you should be aware of, and pay continued attention to, potential symptoms of the various cancers that can be triggered by HPV. And given a lot of this means looking for visual signs of lesions/warts - and presumably you and your partner are sexually intimate - you can check each other. If you don't like that idea then make sure you are checking yourself as best you can, and/or get a GP or sexual health specialist to check. And keep getting your smear test together with all the other preventative medical tests (mammogram, colonoscopy etc) we are all so fortunate to be able to benefit from.

I don’t think so. Neither is genital herpes so the whole ‘full screening’ is a little bit inaccurate.

I believe HPV rates are dropping dramatically since the vaccine though?

I was told at my last smear I was HPV positive,which means I'll be getting annual smears for a bit (I would normally be changing to 5 years because of turning 50.) I'm too old to have had the vaccine.

In my early 30s, I had a few years of annual smears because changes had been detected. That might have been because of HPV, but who knows? They didn't test for it back then. So I have no idea when I picked it up, and I've had no visible symptoms such as warts. I've never missed a smear since I was first called I'm my 20s, but HPV wasn't always tested for, and I never tested positive till last year since they did, but it could just have been there dormant. So I don't know if it's since my younger days or from more recent OLD.

Standard STI tests don't test for everything- you can sometimes get separate tests I think, but it would only usually be tested if you were sympomatic.