How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

For over 5 years, I’ve been battling the human papillomavirus (HPV) and complicated procedures related to HPV.

After finding abnormal cells on my cervix, I had a colposcopy, as well as a LEEP. I remember staring upward at the lights in the ceiling. Legs up in stirrups, my mind fueled by anger.

Being in a vulnerable position such as a colposcopy, or even a Pap test, infuriated me. The people I had dated, or were dating, were not probed and prodded.

Despite not knowing I initially had HPV, the burden to handle this was now my responsibility.

This experience isn’t isolated. For many folks, discovering you have HPV and having to deal with it, while informing their partners is often a solo responsibility.

Every time I’ve left the doctor’s office, my conversations on HPV and sexual health with my partners were not always necessarily positive or helpful. Shamefully, I admit that instead of calmly addressing the situation, I resorted to exasperated sentences that only confused or scared whoever I was talking to.

Most people will have HPV at some point in their lives — and that is a risk

About 43 million Americans had an HPV infection in 2018 and nearly all sexually active people will have HPV in some form, at some point, in their lives, if they aren’t vaccinated.

HPV is the most common sexually transmitted infection (STI). While it’s transmitted through anal, vaginal, and oral sex, or other skin-to-skin contact during sexual activities, contracting the virus through blood, sperm, or saliva is unlikely.

Often, it can affect areas in the mouth during oral sex.

The good news is that most immune systems fight this infection on their own. If left unmonitored, HPV may manifest as genital warts or cancer of the throat, cervix, anus, and penis.

For people with a cervix, HPV types 16 and 18 cause 70 percent of cervical cancer and precancerous cervical wounds. People with a penis over 50 are also seeing an increase in HPV-related mouth and throat cancer.

But before you worry, contracting HPV itself is not equivalent to getting cancer.

Cancer develops slowly over time and HPV is a virus that can cause those developments, alterations, or changes to the body. This is why HPV prevention and education are so important. Knowing you have HPV means that your doctor can make sure it doesn’t progress to cancer.

It appears that there may need to be a shift to take this virus more seriously. Many men we spoke to required their partners to educate them on the subject.

It’s not a virus that only affects cervixes

Even though both parties can contract the virus, it’s often women who have to inform their partners. Aaron* says he learned about HPV from a previous partner but didn’t get more information on his own about protection and infection rates.

When asked why he didn’t look into the virus more seriously, he explains, “I just don’t think, as a male, I’m at risk for HPV. I think most women have it more than men. A previous girlfriend of mine told me that she might have had HPV before, but she also wasn’t that knowledgeable of where she contracted it.”

Cameron* believed that HPV primarily affected women. No partner had ever talked to him about the virus and that his knowledge was, in his words, “embarrassingly clueless.”

In a world where STIs still carry the weight of stereotypes and stigmas, discussing HPV can be a terrifying process. For people with a cervix, this stressor can lead to silent shame surrounding the virus.

Andrea* explains that even though she gets tested after each new partner, she still contracted HPV a few years ago.

“I had one wart and freaked out. I immediately went to the doctor and I haven’t had any issues since. But it was a very terrifying and isolating moment. I never told any of my partners about it because I assumed they wouldn’t understand.”

Yana believes the lack of education also makes it hard to communicate with a partner. “It’s also really challenging […] when you yourself are pretty confused about what HPV is. I was scared and told my partner that it went away and we were fine. Instead, I would have loved more dialogue and more understanding from my partner who seemed to act relieved when I told him that we were both ‘cured’ of the infection.”

Ignorance is bliss, and for people with a penis, sometimes this plays a vital role in the conversation surrounding HPV.

35 million people with a penis in the U.S. have HPV

Jake* told me that HPV is a big deal to him. “Men should know if they have it and be open.”

However, it’s not easy to diagnose HPV. Most symptoms of HPV aren’t visible, which could be why many don’t consider HPV as serious as it can be.

And it’s easy for the responsibility to fall on those who have a cervix. People with a cervix are scheduled to receive a Pap test 1 to 3 years to screen for cervical cancer or abnormal cells, and it’s often during this screening that HPV is detected.

There are limitations to HPV testing for people with a penis. The author of the book, “Damaged Goods?: Women Living with Incurable Sexually Transmitted Diseases,” says that a biopsy on a “male patient’s oral cavity, genital, or anal area,” can be sampled and analyzed for HPV. But this test is only available if there’s a lesion to biopsy.

When I followed up with Aaron* to see if he would be in favor of these tests, he said, “Pap tests for women are much easier, it makes sense for them to do that, rather than going through an anal exam.”

Fortunately, there is a vaccine for HPV, but insurance companies may not cover the cost once you’re over the recommended age. The vaccination can be expensive, sometimes costing more than $150, given in three shots.

So when a vaccine isn’t accessible, the next course of action can be prioritizing education and furthering comfortable conversation around STIs, especially the most common and preventable ones. HPV can be discussed openly and honestly by our educational systems, healthcare providers, in relationships, and in medical resources.

Jake* learned about HPV from his partner, but wishes his doctor reached out during his check-ups. “My partner shouldn’t be teaching me everything there is to know when it affects both of us equally.”

Many people interviewed agreed and admitted that more research would help them become more educated on the topic of HPV

Amy* says, “a previous partner of mine had HPV. Before we even kissed, he wanted me to know he had HPV. I wasn’t vaccinated so I suggested I do so prior to any kinda swap of fluids.”

She continues, “Our relationship ended many moons ago and I am HPV-free mainly due to his maturity in handling the situation.”

Andrew* who has experienced HPV from previous partners knows how to handle conversations but still believes not enough people are aware they could be carrying it.

When asked if he thought people with a penis were knowledgeable about HPV, he says, “I’d say it’s a mix, some are very aware and others just think HPV equals warts and don’t even know they could, and likely have, or are carrying it.”

He also acknowledges that usually women have to initiate the conversation. “From what I have encountered in my own life, I would say it takes most men to have a female partner who previously had HPV for them to be fully aware of what it is, looks like, behaves like, and how it is different for the sexes.”

Irene* explains that she wishes people were more committed to safer sex practices, “[It is] still a significant physical and financial expense that women have to shoulder.”

After contracting HPV, Irene needed a colposcopy. A colposcopy can cost up to $500, and that’s without a biopsy which can be up to $300 more.

If you have any unusual warts, growths, lumps, or sores around your genitals, anus, mouth, or throat, see a healthcare professional right away.

As of now, there’s no conducive HPV test for people with a penis. Some healthcare providers offer anal Pap tests for those who may have an increased risk of anal cancer or a lesion to biopsy.

It’s imperative for all people who are sexually active to find comfort and ease in discussing STIs and sexual health with a partner

The more we discuss it, the more we will understand it.

For anyone, educating yourself and not solely relying on your partner for information is the best outcome for the future of your health and the health of any sexual partners.

If you’re someone with HPV or if you’ve had another STI, normalizing the status by talking with a partner or a potential new partner is always beneficial. It can also open dialogue about the Gardasil vaccine and how to protect yourself from further infections.

Researchers at JAMA Oncology published a study that “estimated that more than 25 million American men are eligible for the HPV vaccine, but they haven’t received it.” Mutual monogamous relationships don’t always protect you from the virus, either. HPV can lie dormant in your body for up to 15 years before showing any symptoms.

Overall, the most efficient way to keep your body healthy is to utilize condoms, encourage regular physicals, and keep up a healthy lifestyle (diet, exercise, and avoiding smoking) to lower your risk for cancers.

With 1 in 9 people with a penis living with oral HPV, it’s important to teach children about the future of the virus and the possible reality of its outcome — for both their partners and themselves.

S. Nicole Lane is a sex and women’s health journalist based in Chicago. Her writing has appeared in Playboy, Rewire News, HelloFlo, Broadly, Metro UK, and other corners of the internet. She’s also a practicing visual artist who works with new media, assemblage, and latex. Follow her on Twitter.