My phone rang in class. It was my gynecologist calling me in the one time slot I told him not to. I hurried from the front of the giant lecture hall to the exit in the back to answer. He told me my pap test had come back abnormal and that I had low-grade squamous intraepithelial lesions.
I nervously asked if that meant I had HPV, and he responded saying there was no way to be sure because his office did not give HPV tests to people under the age of 25. I continued to press him — asking if I would get cancer, if I needed to alert all of my partners, what would happen next. He said I wouldn’t have to be so worried if I practiced safer sex. He told me I went to UC Berkeley, so I was intelligent and should very well know that no glove meant no love. He concluded by telling me the lesions would likely clear on their own and to return in one year (versus the normal returning in three years) to see what was happening.
A year?! I was very upset. He hadn’t answered my question about alerting my partners, and the idea of waiting a year to see what was happening made me feel powerless. But above all that, there was his comment about me being intelligent enough to know better.
My laptop has a giant condom sticker with bold writing stating “JUST WEAR IT.” My partners make fun of me for it all the time, saying I don’t practice what I preach. While I’m not as stringent with condoms as I very well should be with my main partners, I ensure we all get frequently tested for STIs. But my doctor’s comment brought up one very important point — HPV is not something tested for in an STI screen. When someone requests a “full panel,” this is not included. For penis-bearing folks, their penis can carry the virus, but testing for it is hard and is only done in research studies. For vagina-bearing folks, the cervix can be swabbed, but this is only done routinely after the age of 30 at most places, and only during a pap smear.
A few months after this conversation, I was visiting my hometown and went to get a drink with an old friend. Somehow the topic turned to pap smears and I learned that she had the same diagnosis — low-grade epithelial lesions. We toasted to being “women of the world,” and she shared that she had the same feeling as me: powerlessness when told to just return in a year. This inspired research on my part — why were our doctors writing us off?
It turns out they were just following the national guidelines. According to these, 21 to 24 year olds do not get HPV tested because they are so likely to have the virus. This is from a combination of factors, namely that younger people are more likely to have more sexual partners and that the cells in the cervix that are more susceptible to being infected are more exposed in younger people. Younger people are also more likely to clear the virus on their own (and show no signs of affecting the cervix), so the medical establishment sees no reason to cause unnecessary panic.
Still, I had fear in the back of my head. When I was getting my first Gardasil shot at the age of 12, whining to my mom about having to be pricked with a needle, she told me why it was important. When she was in her late teens, younger than I am now, she had to have her cervix frozen twice in an attempt to kill precancerous cells. She described the process as being very painful and feeling like she was “dripping like a popsicle” while at work because her cervix was thawing at her desk. My mom didn’t complain about much, so I knew that she must have been in serious pain.
Despite this warning, I never had the second or third shot. Twelve-year-old me assumed that I’d be using a condom every time. My older brother previously had a pregnancy scare with his girlfriend, so I figured I was going to be safe every time. But mainly, I was terrified of needles. When I got the call from my doctor, I thought back to how little 12-year-old me knew. While it’s not too late to get the other two shots now, they’re much more effective if they’re administered before having any sort of sex for the first time.
I still don’t know if I have HPV. After telling one of my partners, he stopped wanting to eat me out because he had read that it could cause oral cancer. I know I will likely clear the virus, and if I do not, my regular screening will allow me to stop whatever cells before they become cancerous. Still, the uncertainty gets to me, but there’s not much more I can do than live my life as healthily as I can.
Kylie Sammons writes the Tuesday column on Sex. Contact her at [email protected].