HPV from handjob?

Just got done (mostly) worrying about HIV from a sex worker handjob, and now my brain has moved on to HPV. Are there any cases of HPV being spread via hand/warts on the hand? (I didn't look close enough to see any such thing). The woman was fully clothed, so I'm not concerned about the genital-hand-genital route. Would she have had to recently touched her own genitals for this to even be possible?

Sorry if this is an idiotic question. My brain just won't stay quiet after this incident. Thanks.

[phatkickr]

HPV thru Oral has chances but thru hand genital is 0.001-10%.

[DasKapital]

No. Even if she touched her own genitals, it is extremely unlikely that you could contract HPV in this way. HPV (like herpes) spreads via direct skin to skin contact. I remember the Drs. on the Expert Forums saying something along the lines of that in their combined 60 years of medical practice, they've never seen it. I can't be positive on this, you'd have to check those forums. In any event, the likelihood that you contracted HPV from a handjob is so small, it doesn't warrant such worry. I, for one, wouldn't worry.

Also, phat- again, where are you getting those numbers from? They're wrong. While there is a possibility of contracting HPV through oral sex, it is remote (nowhere near 10%, oral warts are EXCEPTIONALLY rare), and hand-genital HPV transmission just doesn't happen. The HPV virus that infects the skin on one's hand isn't the same that infects one's genitals.

[phatkickr]

The number is not 10 but I meant 0.001 to 0.0010 which is again the same = 0.001 which is  too small and meaningless.

[upnorth283]

Thanks, DasKapital, for your response! And thank you phat, for clarifying the 10/.0010 thing!! Yipes :)

Now that I've had a few weeks to get past this incident, I'm feeling more and more like all my worry was/is guilt. I really appreciate getting feedback on here, though. Thanks again.

[lucas272]

I would like to clarify/correct one point you made. HPV-16 and other genital strains have been found in hands [1]. The word infect is tricky. No research to my knowledge has shown whether it is deposition or infection of the HPV virus. it is thought to be deposition because hpv in hand is much more transiently found compared to HPV in genitals. it still is not known whether the HPV found in the hands can transmit to the genitals, but one study suggests it can happen because HPV was found to spread to different anatomical areas by auto inoculation thought to be mediated by hands [2]. These studies need to be replicated to really know definitively.

1. ^ Winer, R. L.; Hughes, J. P.; Feng, Q.; Xi, L. F.; Cherne, S.; O'Reilly, S.; Kiviat, N. B.; Koutsky, L. A. (2010). "DETECTION OF GENITAL HPV TYPES IN FINGERTIP SAMPLES FROM NEWLY SEXUALLY ACTIVE FEMALE UNIVERSITY STUDENTS". Cancer Epidemiology Biomarkers & Prevention 19 (7): 1682–1685. doi:10.1158/1055-9965.EPI-10-0226. PMC 2901391. PMID 20570905

2. Hernandez BY, Wilkens LR, Zhu X, et al. Transmission of human papillomavirus in heterosexual couples. Emerg Infect Dis. 2008 Jun;14(6):888–894. [PMC free article] [PubMed]

[DasKapital]

Fair enough. I construct my answers on the basis of the science I've read to date. I try not to think too much about what "could" happen, because that is a rabbit hole down which I think I'd go forever :).

In any event, point taken, but until it is replicated and a trend is documented, I am wary of conclusions. Still, an excellent point.

[DasKapital]

Still, if you're saying the chances are .001, that means you're saying there is a 1 in 1000 chance of transmission via oral sex. Considering the number of people that engage in oral sex cross-referenced with the number of people with HPV infections, that's still very high, I believe. Further, I don't know that I've ever seen an actual rate of transmission via oral sex documented anywhere. That would be a useful number to know, though.

[phatkickr]

@upnorth - Pls don't feel too relaxed. You will resort to same thing again - you prolly already have.
HandJ is cool and its enjoyable ... but don't do anything more because you will come back here with more pain. Most importantly we can save many people/men/women from this ordeal.  

Enjoy!

[lucas272]

seriously, you really shouldn't worry about this.  you can't get tested and you most likely will not get any symptoms.  if you are going to be super concerned you may consider getting the gardasil vaccine which protects you against some common HPV strains.

[lucas272]

i'm not sure if my calculation/reasoning is accurate but you might want to look at this article:

Hernandez BY, Wilkens LR, Zhu X, Thompson P, McDuffie K, Shvetsov YB, Kamemoto LE, Killeen J, Ning L, Goodman MT. Transmission of human papillomavirus in heterosexual couples. Emerg Infect Dis. 2008 Jun;14(6):888-94.

In the article, there were 39 female-to-male transmissions of any type of HPV in heterosexual couples during many months of repeated testing for HPV. The rate of HPV transmission from cervix to penis was found to be 17.4 transmissions per 100 person-months (other articles have found similar rates or as low as 5 for female to male transmission).  I believe this means (here is where I am not sure) that there ~20% probability of HPV transmission of any HPV type from infected partner to non-infected partner over the course of a month of heterosexual sex (includes couples using and not using condoms regularly).  Of all the HPV types transmitted only 2 of the 39 transmissions were HPV-16/18 (so ~5%).  Only 4 of the 39 transmissions were women's hand to man's genital (~10%).  Taken together I would say about 20% * 10% = 2% transmission from women's hand to man's genital over multiple exposures over the course of 1 month from an infected partner. They did not quantify number of exposures per month.  Even less transmission 5% * 2% = 0.1% hand to genital transmission of HPV-16/18 for one month exposure with infected partner.  Keep in mind that the numbers in this article could be off because of detection methods for HPV, etc.

[lucas272]

note 32/39 female to male transmissions were cervix/urine to any genital region as opposed to 4/39 female to male transmissions were hand to any genital region. So hand-genital is 12.5% less efficient than genital-genital (not 10% as stated above). So 12.5% * 17.4% = 2.17% hand-genital for any HPV type over multiple exposures over the course of 1 month from an infected person or 2.17 transmissions per 100 person-months hand-genital.  Rate of one time hand-genital occurance is likely much less I would venture to say 10-fold less or 0.2% for any HPV type if exposed to infected person?

[lucas272]

I still don't full understand all the variables.  This paper mentioned incidence of transmission of HPV among new couples over a 6 month period is 17% (~10 sexual acts per month), but computer modeling has per-act of sexual intercourse transmission at a median of 40%. I guess the per-act is higher than the 6 month incidence because the latter takes into account that not everyone has HPV to infect. So I think I am incorrect above in dividing 2% transmission hand-genital by 10-fold to get 0.2% per-act transmission hand-genital.  To be safe I would say it is likely no more than 4% per-act transmission hand-genital of any HPV type with a new infected partner.  That's pretty small and worth not worrying about.

[lucas272]

Computer modeling paper:

Burchell A, Richardson H, Mahmud S, et al. Modeling the sexual transmissibility of human papillomavirus infection using stochastic computer simulation and empirical data from a cohort study of young women in Montreal, Canada. Am J Epidemiol. 2006;163:534–543.

[lucas272]

The Canadian cohort mentioned above was 17% at 6 month for cumulative incidence.  

cumulative incidence = number of persons who develop HPV during specified period / number of persons at risk (baseline)

That same cohort incidence rate of 14% per 10 month (14 cases / 1000 women-months... 14/100 women per 10 months) for high-risk HPV and 12.4% for 10-month incidence rate for low-risk HPV.

inicidence rate = number of persons who develop HPV during specified period / sum of length in which persons are disease free

[upnorth283]

@phat: don't worry, this was a one time only occurrence.

@lucas272: whoa, that's some serious research. So, I read the heterosexual couple study. One thing they never clarify is whether the hand-to-genital transmissions followed recent or immediate genital contact. In other words, are they implying that someone with HPV just always has it on their hands??? Or is the inference that the person touched their genitals and THEN touched the other person?

Just to clarify: my "incident" came (no pun intended) at the end of a massage. I referred to her as a sex worker because I have to assume, based on my experience, that she does more than just HJs after massages. I don't intend on finding out, though. Anyhow, does that have any bearing on the risk? There was literally no chance that her hand had been on her genitalia recently (i.e. within an hour), so my concern is basically whether she'd just 'carry' the virus around on her hands and be able to transmit it that way.

Thanks again for all the thought put into this!

[upnorth283]

Also, now that the wheels are turning: if my situation is a risk, wouldn't that basically mean that I could shake someone's hand, go to the bathroom, touch my penis, and give myself HPV? Is that the case?

[lucas272]

I think the take home message is that there is still little knowledge about HPV transmission from hands to genital.  It probably does happen, but it is very very very low incidence.  It is unlikely to get infected.  As for the hand shake transmission... I think it is very unlikely because there probably has to be some "massaging" for the virus to spread.  There have been some cases of virgins who turn up with HPV, so nothing is impossible.  But again... the incidence is just too low to worry about.  I think my estimates were way too high for hand to genital transmission (it is probably well below 1% per act). By the way, HPV is usually cleared/undetected within 6 months-2 years.  Best thing to do is to keep healthy and keep your immune system strong and probably not a bad idea to wash hands after using the bathroom. :-)

[lucas272]

as for always on their hands or recent transmission... hard to know and to study.  one paper did claim that HPV in hands seemed to be deposition rather than true infection because it was cleared between follow-up visits (~4 months).  

[phatkickr]

Ask the masseuse to wear gloves for HJs.  20% less pleasure but 100% reason to not remember HPV.

[DasKapital]

I'm just going to leave this here. There seems to be a lot of unjustified concern over HPV transmission from hand to genital contact.

http://www.medhelp.org/posts/STDs/Handjob-from-stripper---Possible-STD/show/1027151

If anyone wants experts' advice on this, peruse the experts forum. They know more than anybody on this side of the forums will. They've actually been practicing medicine.