Frequently I have encountered patients who are understandably concerned about when or where they were exposed to the HPV virus (or other STD's) and are anxiously desiring answers. I have spent many hours counseling patients on this subject and what is most disturbing to me is that I will often find patients wanting answers to “their" concerns only so they can call their partners who are awaiting an explanation.
I see women burdened with the task of trying to find a plausible explanation for an abnormal finding on a routine exam or a “symptom" that brought them to their health care provider. It is tragic to see this, since in many cases the problem should no more be a concern of hers than her partner's.
Women are often times more involved with the health care system starting at an early age ......menstrual problems , birth control issues, pregnancy and most notably: routine screening procedures (ie. pap smears , STD testing). This can inherently make women appear to be the origin of problems in a relationship, when in fact, they are simply the first one to bring a medical problem in a relationship to the attention of a health care provider..... an abnormal test result (pap smear) or the clinical manifestation of a medical condition (pelvic infection).
When I am asked about the various “mutually-at-risk conditions" between partners ( herpes, HPV, chlamydia etc.), I explain to the patient what the condition is , as best I can, and give supporting literature to share with her partner. When there is any indication that the findings are affecting her relationship or being construed as her fault I will encourage an appointment along with her partner to address any disagreements or “misunderstandings" in the relationship that might have come about as a result of this finding.
There are patients who are truly shocked and devastated about their diagnosis and clearly are lacking the emotional support they need once they leave the office. It is stressful in itself to find out about any medical condition and when this is compounded by the fact that one is being unfairly accused of being the source of the problem it is even more difficult to deal with.
It is imperative for anyone dealing with this situation to get the answers that best explain her personal set of circumstances. This effort is well worth the time and leads to a far better mutual understanding in the relationship.
Lastly, one should not overlook a very important clinical matter relating to any new findings of this sort. It is important that the patient's partner be evaluated and treated when indicated. I have seen patients treated on more than one occasion for the same problem because the partner would not get evaluated/ treated. This should never happen and should prompt the patient to address any concerns in the relationship that might contribute to this problem.
This article is a general statement about the “burden of proof" often placed on women when dealing with STD's . I will deal with more specifics in the near future.
Douglas Penta MD
