Q & A with Nurse Practitioner Nancy Berman

Understanding HPV: A Q&A with Women’s Health Expert and Nurse Practitioner Nancy Berman

Finding out you have HPV can be confusing and even overwhelming, particularly if you don’t have all the facts first. But now you’re not alone. Here, Nancy Berman, a nurse practitioner in private practice, addresses some of the most common concerns and emotions patients may feel when they first learn they have HPV.

What do you say to women who feel embarrassed or ashamed about having HPV because it is a sexually transmitted infection?

I find that women who understand the basic facts about HPV before they are tested have an easier time finding out that they have tested positive. HPV is a skin cell virus. It can be passed by any "intimate" skin-to-skin contact, although it is most easily passed when there is sexual intercourse. It is important to know that almost everyone who has had sex with another person may become infected by HPV. I tell my patients that anybody who has been sexually active, even with only one partner who has had another partner, is at risk for becoming infected by HPV. This includes women having sex with women.

In my practice over the past 28 years, I’ve met a lot of women who have never heard of HPV. Every woman knows she’s supposed to get a Pap test, and the Pap test is a check to see if cervical cells are abnormal. The missing piece of information all along has been that the cause of these abnormal cells is HPV.

I’ve always said to women, we don’t select who should get a Pap based on their sexual history. We have always recommended cervical cancer screening to all women. It’s just that there has been a lack of education in the past and most women haven’t known that the cause of cervical abnormalities and cancer is HPV.

What are the most frequent misunderstandings that your patients have about HPV?

Many women do not realize that almost everyone will have HPV at some point . My patients who find out that they have a positive test for HPV often have questions, such as when did I get this, does my partner need to be seen and what can I do to get rid of the virus? I reassure them that most HPV will go away on its own. There is no treatment for HPV at this time, but knowing the virus is present tells me that I need to watch their cervix more closely as long as the virus is there. If abnormal cells develop, we can treat those changes to prevent them from becoming cancer cells.

My patients need to know that men have HPV infections but have less risk for the development of abnormal cells. The male external genital skin does not pose the same risk as the female cervix, even when HPV is there a long time. If you find out that you have HPV and you are in an ongoing relationship, you will not pass the virus back and forth. Whether you develop abnormal cells depends on whether the virus goes away or stays a long time, as well as other factors that are not well understood.

What's the most important thing to know if your healthcare provider says you need follow-up testing because you have HPV?

Understand that you’re not alone – and that at least you and your healthcare provider know this information so that your cervix can be monitored closely. It is important to obtain the follow-up care that your healthcare provider recommends because of your positive HPV test. I tell women that I am most concerned about the woman who has a long-term infection with high-risk HPV, doesn’t know it, and isn’t getting Pap or HPV tests.

In addition to more than 28 years of women’s healthcare experience in private practice in Michigan, Nancy Berman has taught extensively on HPV, Pap tests and other top women’s health issues. She has also served on the practice and patient education committees of the American Society for Colposcopy and Cervical Pathology and was recognized with its Colposcopy Recognition Award. She is a member of the Michigan Cervical Cancer Consortium and serves on the Governor’s Task Force on Cervical Cancer.