"The Human papillomavirus (HPV) infection is common, manageable and often temporary. With the right information and timely follow-up, a HPV positive result isn't a crisis, but the start of preventive care to keep women healthy long-term," said obstetrics and gynaecology specialist Dr Jamil Omar at a recent media session organised by Brego Life Sciences.
The conversation surrounding women's health is increasingly important, especially as the country continues to expand HPV-based cervical screening in line with national targets to eliminate cervical cancer as a health threat. Yet despite increased screening, one question still lingers: If I am HPV positive, what happens next?
For many, the moment they see the words "HPV-positive" on a report, confusion, fear and worst-case scenario assumptions strike. But HPV-positive doesn't always mean cancer.
According to Dr Jamil, the first and most important thing women need to understand is that HPV is often harmless.
"A HPV-positive result means that the human papillomavirus has been detected in the cervix," he explains. "It doesn't mean you have cancer, and it doesn't mean you'll get cancer."
HPV is one of the most widespread viruses globally. Studies suggest that a significant proportion of sexually-active women will encounter it at some point in their lives, often without ever knowing. In most cases, the body's immune system clears the infection naturally.
The real purpose of HPV screening, Dr Jamil highlights, isn't to diagnose cancer but to identify women who might need monitoring to ensure that no abnormal cervical cell changes develop over time.
Testing HPV-positive triggers a series of follow-up steps, but these are measured, rather than emergency-driven.
"The next step depends on your risk profile," says Dr Jamil. "This includes your age, the type of HPV detected, and whether any abnormal cells were found in the initial test."
Some women are advised to repeat the HPV test or undergo a cytology (Pap) test in six to 12 months. Others, particularly those with high-risk HPV types or abnormal cell findings, might be referred for a colposcopy – a closer examination of the cervix using a specialised microscope.
What we look for during this period is straightforward: whether the virus clears on its own and whether any cervical cells begin to show early, pre-cancerous changes. Detecting and treating these changes early is what prevents cervical cancer from developing in the first place.
Medical reports often use terms like "low-grade" or "high-grade" abnormalities, which can sound distressing but are simply clinical ways of describing how much cervical cells have changed.
Low-grade changes usually indicate mild abnormalities that often resolve on their own.
High-grade changes suggest more significant alterations that may require treatment to prevent progression to cancer. The difference in these classifications explains why some women are monitored with repeat tests while others are scheduled for more immediate procedures.
"It's not that one pathway is more dangerous than the other," Dr Jamil clarifies. "It's about matching the level of intervention to the level of risk."
Although most follow-ups are scheduled months apart, there are certain symptoms that prompt an earlier medical review. Unusual vaginal bleeding, bleeding after intercourse, persistent pelvic pain or abnormal discharge are considered "red flags" and should be discussed with a doctor earlier than the next routine appointment.
"These symptoms don't always indicate cancer," Dr Jamil notes, "but they should never be ignored."
For many women, the waiting period between a HPV-positive result and their next appointment can be more stressful than the test itself. Dr Jamil recommends treating the follow-up as an opportunity to ask questions and gain clarity, not something to fear.
He advises patients to bring their previous test reports, a list of medications and any questions they may have. Common and useful questions include: What type of HPV was detected? Do I need additional tests? What symptoms should I monitor at home?
Having these answers, he says, helps women feel more in control of their health journey and reduces unnecessary anxiety.
The emotional aspect of HPV follow-up is often underestimated. Many women spend months worrying about worst-case scenarios, especially if they turn to online forums or unreliable sources for information.
Dr Jamil suggests focusing on self-care during this time: staying physically active, maintaining strong social support and limiting excessive Internet searches that might amplify fear.
"Remember that most HPV infections clear naturally," he says. "Worrying doesn't change the outcome, but taking care of your overall health supports your immune system."
While there is no guaranteed way to eliminate HPV quickly, healthy habits can support the body's ability to clear the virus.
Dr Jamil emphasises the importance of balanced nutrition, avoiding smoking, managing stress and attending regular check-ups.
These measures don't act as a cure, but they create the best possible environment for the immune system to do its job.
Malaysia's cervical screening strategy is evolving, with HPV testing increasingly used as the primary screening method rather than the traditional Pap smear. This shift aligns with global evidence showing that HPV testing is more sensitive in detecting early risk.
"HPV testing allows us to identify potential problems earlier, before cell changes become significant," Dr Jamil explains. "That means we can intervene sooner and prevent cancer more effectively."
Despite national targets to achieve 70% screening coverage among eligible women, uptake remains low. Barriers such as embarrassment, fear, lack of awareness and persistent myths about HPV continue to discourage many women from getting screened.
Part of the challenge, Dr Jamil says, is stigma. Because HPV is transmitted through intimate contact, discussions around it are often avoided in families and communities.
Normalising these conversations can have a powerful ripple effect. When women understand that HPV is common and manageable, they are more likely to attend screening, follow up on abnormal results and encourage others to do the same.
Clear information, delivered in a culturally sensitive way, is key to overcoming hesitation – especially among younger women and first-time screeners.
Dr Jamil believes that knowledge is one of the most powerful tools women have.
"Cervical health is in your hands," he says. "Attend regular screenings, follow up on your results, and don't let fear or stigma stop you from seeking care. Early action saves lives," he concludes.
