A reader emailed me to tell me that a girlfriend of hers had been diagnosed with HPV and told by her doctor that she did not need medical treatment because her own immune system would ultimately get rid of the virus. This reader was concerned that I had not made this reality clear in my book and that I might be causing unnecessary panic by comparing HPV to herpes. Since I'm sure she is not the only reader who has this concern/critique of my use of the word "incurable" in relation to HPV, I wanted to clarify my position and those of trusted medical experts.
First, I want to make it clear that I agree that HPV is not exactly like herpes. From an epidemiological perspective, I choose these two diseases because they are viral (not medically curable), treatable, and transmitted via skin-to-skin contact that can occur even when sexual partners are consistently and correctly using barrier methods (condoms, dental dams, etc.). From a social-psychological perspective, I selected them because they produce longer-lasting stigma in women than most curable STDs but, unlike HIV, are rarely fatal.
In Chapter 1, I included the citation on p. 3 for an endnote which addresses and agrees with this reader's main point about the potential of 'clearing' HPV:
"While, in many cases, HPV infections are likely to be resolved by individuals' immune systems 'without clinical consequence' (Friedman and Shepeard 2007, 11), many cases do require treatment. Even after treatment, there is always the possibility that cervical lesions and/or genital warts could return because the virus may be present." (Damaged Goods? p.213)
Then, in Ch. 6, p. 125, I clarify that HPV and herpes infections are "officially" incurable, though their initial symptoms may disappear. The medical field agrees that, as a I state, "their viral infections could lay dormant and reemerge as symptomatic later on in their lives..." I purposefully chose the word "could" rather than "will" to get across the ambiguity that medical researchers have about the nature of HPV.
My recent search on the Centers for Disease Control and Prevention (CDC) website for "HPV cure" generated at least 6 locations where they assert something along the lines of, "There is no cure for HPV" (http://www.cdc.gov/std/Hpv/the-facts/default.htm). Another example is found on http://www.cdc.gov/std/hpv/common-questions.htm, where they present the question "Will I have HPV forever?" and answer that HPV "goes away" in most women within two years after diagnosis. Still, the CDC is very brief on these points, so I recommend the American Social Health Association (ASHA), one of the most respected organizations conducting HPV research. They address the myths and facts about HPV on their website (http://www.ashastd.org/hpv/hpv_learn_myths.cfm) which clarifies the role that a strong immune system "seems" to play in reducing the severity and frequency of HPV-related cervical dysplasia and genital warts. The ASHA also note that HPV infections often seem to be eliminated by the immune system "within about two years." Though, they present a more detailed explanation of why the immune systems of certain patients react differently than others, pointing out that the virus can remain latent (asymptomatic) and, in some, "remain in the body indefinitely, able to produce symptoms if the immune system weakens" (http://www.ashastd.org/hpv/hpv_learn_myths.cfm).
It's important to know that many women opt for medical treatments for their HPV infections even after practitioners tell them that it often resolves on its own: their reasons often center around the concern of the virus remaining in their body without them knowing it and not wanting to risk the reappearance of symptoms if stress or another illness were to weaken their immune systems. I think medical treatments which remove the HPV-infected cells are reasonable options for those who want to quickly reduce the risk of (1)infecting their sexual partners and/ or (2) having their infections/symptoms increase in intensity or frequency. become more serious (for example, if one's immune system were weakened). Also, a woman who plan to become pregnant soon after an HPV diagnosis may opt for medical treatment to reduce the already very small risk that she might pass it on to her baby during a vaginal delivery: see http://www.cdc.gov/std/HPV/STDFact-HPV.htm.
Personally, I consider myself to be reasonably 'clear' of the virus because no HPV-infected cells have showed up on any pap smears or in biopsies of colposcopy exams since my initial diagnosis. As you see when I offer up my own cervical HPV story in Appendix A (Damaged Goods? p. 200), I clarify that while I had fears of my HPV reemerging, it is now 15 years later and, as far as I know, has never reappeared.
I hope this post makes it more clear that, for many women, the symptoms of their HPV infections resolve without medical treatment. In Damaged Goods?, I felt it was important to present the fact that HPV is medically incurable, but, thanks to this reader writing to me, I can see how this fact may seem to conflict with many readers' understandings about what it means to be cured. My intention is not to produce more panic or anxiety in women facing HPV diagnoses. I wanted to write a book that infected women would find helpful, and ultimately, a source of hope that their HPV or herpes infection was by no means permanently damaging to them physically, morally, or socially.
