Classic Marysue. Always surprised you manage to be vitamin D deficient 🥴 go get some sunlight. Women lose bone density sooner and worse than men do and you need vitamin d to absorb calcium.
What are your decisions on scheduling with Madeline? If we aren't doing tomorrow then can you pick a time next week with me CCd on the email? And if we go next week, can you please carve out a small bit of time before the meeting to iron out what we're bringing to the table, together? I understand how busy you are. I'm asking for you to move our work up a little bit on your ranked list of priorities, please.
Since you didn't tell me not to send it I'm going to go ahead and give you the information I was referring to in my previous email. I'll color it green so you can skip it and see if I said anything else after. I'm sending this from a place of love, not judgment or snark or anything like that and I'm not going to ask you to give me information about your health, though I'm always happy to hear you out and offer whatever I can give for your needs and comfort and safety, when you volunteer such information to me.
Anyway, please do read this and consider it carefully, for yourself. I could be wrong but for some reason I thought you might appreciate this information confirming from a language model instead of being written in my voice. I cut out a ton of information to make it straightforward as possible. Here you go:
HPV basics:
A normal STD test does not rule out HPV. HPV usually is not tested like other STDs.
There is no perfect “did I catch HPV from him?” test. HPV can show up later, stay hidden, or clear on its own. Most HPV infections clear within about 1–2 years and never become cancer.
What to schedule:
1. OB-GYN / Planned Parenthood appointment
- Ask: “Am I due for a Pap smear or HPV test?”
- Ask about high-risk HPV testing, especially HPV 16/18.
- Ask whether you should get Gardasil 9, the HPV vaccine.
2. STI follow-up:
- Confirm your test covered HIV, syphilis, chlamydia, gonorrhea, trichomonas, and any oral/rectal exposure if relevant.
Vaccine:
It may not be too late.
HPV vaccine works best before exposure, but it can still protect against HPV types you have not had.
Usually:
- Recommended through age 26
- Possible by doctor discussion from 27–45
- Not typically licensed after 45
Cancer risk:
Cervical cancer usually takes years, often 10–20+ years, to develop after persistent high-risk HPV. The main protection is staying up to date on Pap/HPV screening.
What to do now (if you choose):
- Book OB-GYN or Planned Parenthood.
- Ask about Pap + high-risk HPV test / genotyping.
- Ask about Gardasil 9.
- Use condoms/barriers, but know they just reduce HPV risk rather than eliminate it.
- Avoid smoking if applicable.
- Follow up on any abnormal Pap/HPV result.
Mmm
And just in case you want to see the full report pulled by our good frienemy chatgpt (with everything sourced from the CDC website where you can find this all for yourself and more), I'm going to go ahead and leave that below, in red so you can intentionally avoid it if you would prefer not to see it at all:
I’d treat this as two appointments/tasks, not one: (1) cervical-cancer prevention/screening with an OB-GYN or Planned Parenthood/sexual-health clinic, and (2) a complete STI-risk review to make sure your “basic STD test” covered the right organisms and exposure sites.
The big takeaways
A clear basic STI panel does not rule out HPV. CDC states there is no general test to determine a person’s overall “HPV status,” and HPV tests are mainly used for cervical-cancer screening, not as a “did I catch HPV from this partner?” test. There is also no approved HPV test for the mouth or throat.
HPV can also be impossible to time. CDC notes that people can develop symptoms years after sex with someone who has HPV, which makes it hard to know when they first got it. A positive HPV test later would not prove it came from this specific partner, and a negative test soon after exposure would not prove zero exposure.
Most HPV infections do not become cancer. CDC says about 9 out of 10 HPV infections go away on their own within two years, and NCI says most HPV infections clear within a year or two; short-term infections do not cause cancer. The cancer risk is mainly from persistent high-risk HPV over years.
What tests to ask about
Ask for a cervical cancer screening review, not just an “HPV test.” The useful options are:
Pap test / cytology: looks for cervical cell changes or precancerous changes. CDC says Pap testing detects precancers—cell changes that might become cancer if not treated.
High-risk HPV test: looks for HPV types linked to cervical cancer. CDC says FDA-cleared HPV tests can detect DNA or mRNA from high-risk types, and some tests identify HPV 16 and 18 specifically.
Co-testing: Pap + high-risk HPV test together.
Genotyping: ask whether the HPV test includes HPV 16/18 genotyping or extended genotyping. This matters because CDC’s STI guidelines say colposcopy is recommended when HPV 16 or 18 is detected, even if cytology is normal.
Colposcopy/biopsy: not usually something you request just because of exposure. It is the follow-up if your Pap/HPV results or a visible lesion justify it.
For age-based screening, current U.S. guidance is not perfectly identical across organizations. CDC says ages 21–29 generally get Pap testing every 3 years, and ages 30–65 should discuss HPV-only testing, co-testing, or Pap-only screening options. HRSA’s updated guideline says ages 21–29 should use Pap every 3 years, and ages 30–65 should use primary high-risk HPV testing every 5 years as the preferred option, with co-testing every 5 years or Pap every 3 years as alternatives. ACS recommends starting at 25 with primary HPV testing every 5 years as preferred, with self-collected HPV testing every 3 years, co-testing every 5 years, or Pap every 3 years as other options.
So the practical ask is: “Am I due for cervical screening, and based on my age and history should we do Pap alone, primary high-risk HPV testing, or co-testing with HPV 16/18 genotyping?”
Is there a waiting period?
There is no clean HPV equivalent of “test at X days and you’re clear.” HPV testing is not designed as a recent-exposure test.
A high-risk HPV test may be negative because you were not infected, because the infection is not established/detectable, because the sampled site did not contain detectable virus, because the type is not included in the test, or because your immune system already suppressed it below detection. CDC also emphasizes that HPV can be passed without symptoms and may appear years later.
For cervical cancer specifically, the timeline is usually long. CDC says HPV-related cancer often takes years, even decades after infection to develop. WHO says cervical cancer generally takes 15–20 years for abnormal cells to become cancer, though it can be faster—around 5–10 years—in people with weakened immune systems such as untreated HIV.
Is it too late for the HPV vaccine?
Probably not, depending on your age.
CDC recommends HPV vaccination through age 26 if not adequately vaccinated. For adults 27–45, vaccination is not routine for everyone, but CDC supports shared decision-making with a clinician; it may still help prevent infection with HPV types you have not yet encountered. CDC also emphasizes that the vaccine prevents new HPV infections but does not treat existing infection or HPV-related disease.
ACIP/CDC says HPV vaccines are not licensed for adults older than 45. It also says no Pap test or HPV test is required before deciding whether vaccination is appropriate; cervical screening should simply continue according to guidelines.
If you start the vaccine series at 15 or older, CDC’s schedule is typically 3 doses at 0, 1–2 months, and 6 months.
What you can do to reduce risk now
The most evidence-backed steps are:
Get up to date on cervical screening and follow up on any abnormal results. CDC says abnormal results usually do not mean cancer, but follow-up is important because treatment can prevent cervical cancer from developing.
Ask about HPV vaccination as soon as practical, especially if you are 45 or younger and expect any future new partners. CDC notes that a new sex partner is a risk factor for a new HPV infection at any age.
Use condoms or barriers, knowing they reduce risk but do not fully prevent HPV because HPV can infect skin not covered by a condom.
Do not have sex while either partner has visible genital warts until evaluated/treated; CDC specifically advises avoiding sex when genital warts are present until they are gone.
Avoid smoking if applicable. NCI lists smoking and secondhand smoke as factors that increase cervical cancer risk in people with high-risk HPV.
What to bring or ask at the appointment
Bring or write down:
Date(s) of exposure, type of sex, condom/barrier use, and whether oral/anal exposure occurred.
What the man means by “has HPV”: genital warts, high-risk HPV, abnormal anal screening, prior partner report, or something else.
Your age, vaccine status, last Pap date/result, any prior abnormal Pap/HPV results, immune-system issues, smoking status, pregnancy possibility, and symptoms.
Ask: “Am I due for Pap or HPV-based screening?” “Can we do high-risk HPV testing with 16/18 genotyping if age-appropriate?” “Do I need colposcopy only if results are abnormal?” “Should I get Gardasil 9 now?”
Also consider confirming your “basic STD test” included HIV, syphilis, chlamydia, gonorrhea, and trichomonas where appropriate, with throat/rectal swabs if those sites were exposed. That is separate from HPV, but it is worth tightening up after a new STI-related disclosure.
Yep that's all sorry if this offended you but I'm still in a place where I care about your health and safety and well-being and all that so I was hoping you'd appreciate having it. (EDIT: I kind of popped off here unexpectedly so I'm also going to color the rest of this section grey so you can once again choose for yourself whether or not you're interested in reading it.) Bella had/has a pretty ugly HPV she got back in high school that we thought was HSV until she got test results back. Idk if I trust what she said about it back then. I know he had some kinds of HPV since college at least because he was always bringing up his common and harmless it is and blah blah blah just trying to convince himself he wasn't fucked up in the head about it. I thought for a long time that the list of women he fucked was a way for him to feel better about what he had by giving it to as many people as possible. That was a piece of the start of my initial drift away from loving him as deeply as I had. I was gentle about it at first but time and drunken conversations with him and watching him live his life the way he did, feeling him get meaner and more selfish, I came away from all that with a perspective that showed much crueler, darker possibilities about who he really was. Is. I still did my best by him and treated him with love and an open mind, especially when we had so many of our drunken deep talks. But I never trusted him again, and I listened to him using the same technique for months and months to self validate this idea that he really genuinely believed in christianity and worshipped the christian god, just so he could fuck bella. Which I think he did for like one week before giving up on the relationship and getting divorced. Anyway. That's a lot of context you probably didn't care to hear.
Anyway!
Please let me know what you decide about the meetings