ISSUES IN COUNSELLING

ISSUES IN COUNSELLING

There is a balance to be reached between ‘over-normalising’ a diagnosis of a viral STI and failing to empathise with the potential

psychological impact of a diagnosis. It is important to address any concerns generated by the individual by the proactive provision of

information and education e.g. handouts, directing the individual to reputable sources of information e.g. www.hpv.org.nz, and

referral to a sexual health specialist if required.

KEY INFORMATION FOR PERSONS WITH HPV INFECTION
Vaccination against HPV has been available for many years and everyone who is eligible should have it.
80% of unvaccinated adults will pick up HPV at some point in their life. In most people, it causes no symptoms (you won’t know you have it) so is therefore unavoidably shared mainly through sexual (including oral) skin-to- skin contact.
In most people the virus is harmless and causes no symptoms and will not develop into warts, pre-cancer or cancer.
In a few people, HPV causes genital warts which are harmless and different from the types of HPV that cause abnormal cells or cancer.
Partners will inevitably share HPV. There is no way to know which partner it came from or how long ago. Having HPV does not mean that a person or his/her partner is having sex outside the current relationship.
There are treatments for genital warts and abnormal cells.
There is no treatment to eliminate HPV itself. HPV is usually dealt with by your body’s immune system.
HPV does not affect fertility.
HPV does not stop you having a normal sex life.
There is no single HPV test (such as a blood test) to check for HPV status at multiple body sites. This means there is no test that can help answer the questions “Do I have HPV?”, “Does my partner have HPV?”, “Has my HPV gone?”, “Can I have the vaccine?”

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KEY INFORMATION FOR PERSONS WITH ANOGENITAL WARTS
Routine STI screening does not include testing for either HPV or HSV. There is no sure way to know when HPV was acquired.
If left untreated, genital warts may go away, stay the same, or increase in size or number.
If warts are in the pubic region avoid shaving or waxing as this may spread the warts.
Genital warts do not turn into cancer.
The types of HPV that cause genital warts rarely cause cancer.
Women with genital warts need to have regular cervical screening and follow the same management pathways as women without visible genital warts.
Genital warts can develop months or years after acquiring an infection with HPV. Genital warts can be passed on to another person even when there are no visible signs of warts.
There is no sure way to know when HPV was acquired. Sex partners who have been together tend to share HPV, even when both partners do not show signs of HPV. The presence of genital warts does not mean that a person or his/her partner is having sex outside the current relationship.
Although genital warts are common and benign, there is considerable psychosocial impact of this diagnosis.
There are treatments for the conditions caused by HPV, such as genital warts. However, treating genital warts does not treat the virus itself. For this reason, it is common for genital warts to come back after treatment, especially in the first 3 months.
Inform current sexual partner(s) that genital warts may be transmitted to a partner(s). Partner(s) may benefit from getting tested for other STIs. A current partner may already have HPV, even though she/he may not have visible signs of warts.
Abstinence from sexual activity with new partners is strongly recommended until the warts are gone or removed. HPV may remain and can still be passed on to partners, even after the warts are gone.
Condoms may lower the chances of transmitting genital warts if used with every sex act; however, HPV can infect areas that are not covered by a condom and condoms may not fully protect against HPV.
There is an HPV vaccine available for males and females that prevents genital warts but it will not treat existing HPV or genital warts. This vaccine can prevent most cases of genital warts in persons who have not yet been exposed to wart-causing types of HPV.
It is not clear if there is any health benefit to informing (future) partners about a past diagnosis of genital warts. This is because it is not known how long the virus remains after warts are gone.

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KEY INFORMATION FOR WOMEN REGARDING CERVICAL CANCER SCREENING
HPV is a common infection and often clears by natural immunity. A positive HPV test does not mean that a person has cancer. Most women who have HPV do not develop abnormal cells or cancer.
HPV is often shared between partners and can lie dormant for many years; having HPV does not imply other sexual contacts, nor should it necessarily raise concerns about a partner’s health.
Most cervical cancers can be prevented by HPV vaccination and having regular cervical screening. Vaccination, regular screening and following NCSP recommended guidelines if any abnormalities are identified, is the most effective pathway for women to follow to prevent invasive cervical cancer developing.

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KEY INFORMATION ABOUT PREVENTION
HPV vaccination, ideally before ever having sex, is the first line of defence and the most effective way of preventing HPV. See Preventing HPV Cancers by Vaccination: What Everyone Should Know (www.hpv.org.nz)
Condoms used consistently and correctly may lower the chances of acquiring and transmitting HPV and developing HPV-related diseases, such as genital warts and cervical cancer. However, HPV can infect areas that are not covered by a condom, so condoms do not fully protect against HPV.
Limiting the number of sex partners can prevent HPV. However, it is important to note, even people with only one lifetime sex partner can get HPV.

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