DEAR DR. ROACH: I am a 35-year-old female. My doctor did a Pap smear and a human papilloma virus (HPV) test that was positive for one of the “risk types” (16, 18 and 45 according to my chart) — but not one of the really bad ones. I am otherwise healthy. My Pap smears have always been normal.

I never did get my HPV vaccine. Should I get it? Should I worry? What are the chances of it going away? I am engaged to be married; how do I tell him? — V.S.P.

ANSWER: HPV is the cause of cervical cancer in women and head and neck cancer in men. Although there are many different types, only some of them are associated with cancer, but types 16 and 18 are the ones that are most associated with cancer. Over 70% of cervical cancer worldwide are due to one of these two, with another 4% due to type 45.

The risk of cervical cancer from other types of HPV varies, but there is still a chance that the HPV type that you have could lead to cervical cancer. So, you do need to have careful follow-ups.

Fortunately, most people do clear the infection without treatment. For all types of HPV, about 70% of infections will go away within one year, and 90% will go away within two years. Higher-risk types of HPV are less likely to be cleared, but 60% to 70% will go away by themselves.

You shouldn’t worry that you’ll get cervical cancer because with careful attention to your doctor’s advice, you can get treated if necessary long before the virus causes cancer. If necessary, your doctor will do a procedure called a colposcopy to find and remove the affected cells in the cervix to get rid of precancerous cells.

You should be completely honest with your fiance. I know this will be hard, but there must be honesty and trust between both partners. He should get the HPV vaccine if he hasn’t had it, and although it would have been better for you to get the vaccine before engaging in sexual activity, it’s still worthwhile to get the vaccine now. It protects you against future high-risk HPV types, many of which you probably have never been exposed to. There is also some evidence that the vaccine can help people clear the infection, even after they have been exposed.

DEAR DR. ROACH: I was born in 1963, and from what I’ve read, people who were born between 1963 and 1965 may not have been immunized with a live virus for measles; therefore, they may not be immune whatsoever. I would like to be checked for immunity, but our local lab cost is between $142 and $225. From what I understand, it isn’t covered by insurance.

I live in a community that has had an outbreak. I’m wondering if I should just pay the money to get tested (I have a grandbaby due in August) and see if I need the two-shot series, or if I should just get a booster? Also, I remember having German measles (rubella) when I was in high school probably around age 14, so I am worried that I don’t have immunity. Please advise. — L.B.

ANSWER: If you aren’t sure which measles vaccine you had, and you were born between 1963 and 1967, then I recommend getting two doses of the vaccine since you are in an outbreak setting. Most people will be immune, and you can certainly be tested. (I’ve never had a problem with getting the immunity test paid for by insurance.) But given the outbreak, the fastest way to be protected is to get vaccinated, with a second dose separated from the first by at least 28 days.