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Home Ask the Experts Ask the Experts Did my husband cheat?

Did my husband cheat?

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I recently had an abnormal Pap smear and, on follow-up, was confirmed to have abnormal cells caused by HPV. I don’t believe my husband has cheated on me, but the material I can find on the Internet really has conflicting information – some sites say you can have HPV for weeks, months, or even years before it’s diagnosed, but others say it usually shows up in a few months! Who’s right? I’ve had regular Pap smears throughout my adult life, too.

This is a common question that inevitably seems to emerge when HPV is found with someone in a long-term and (it’s assumed) monogamous relationship. First, it’s important to stress that Pap smears are not specific tests for HPV. Rather, they are designed to detect “disease” of the cervix, for example, abnormal cell changes that are precursors to cervical cancer.

Also, while Pap tests deserve enormous credit for greatly reducing cervical cancer rates in countries that have widespread screening programs, it should be noted they aren’t very sensitive, and can often miss disease that is present. The success Pap smears have as a tool for reducing cervical cancer is due to consistent, regular screening coupled with the fact cervical cancer tends to progress fairly slowly, often taking many years to become invasive.

You’re right about the information being confusing. While the average “latency” period of the virus is often thought to be anywhere from one to eight months, it can actually vary widely. Exactly “how” widely? It’s difficult to say with certainty, but experts typically agree it may take years after exposure before lesions associated with HPV (that is, warts or cell changes) are detected clinically.

Most women with HPV probably experience the virus as a transient infection that is either cleared or suppressed by the immune response, and will not be likely to ever have an abnormal Pap smear as a result.

However, HPV may actually exist in skin cells in what is known as “residential” infection. This is where the virus exists in basal epithelial cells in very small numbers, separate from human DNA, and can effectively hide from the immune system without causing disease (such as cervical cell changes) that Pap tests can detect. This may go on for an indefinite number of years. It’s difficult for researcher to pin down exactly why some experience lesions while other do not, but co-factors could involve smoking, pregnancy, stress, diet, or a host of other things that can affect the immune system.

We understand it’s frustrating that no one can offer a definitive response to your individual circumstances. If there was no reason to suspect infidelity prior to the HPV diagnosis, it’s difficult to look at this diagnosis, taken by itself, as an indication that anyone has been unfaithful. The “who” and “when” questions, however, may never truly be answered.