No one answered my posting, so I think it may have been missed.
I was wondering if I (male) can get the high risk HPV strains via receiving fellatio or giving cunnilingus even though, correct me if I'm wrong, most of these strains are found in the cervix? If transmitted to the mouth via cunnilingus, could it then be transferred via vaginal sex? I don't know if the HPV virus travels throughout the body or is local to the site of infection.
Also, would high risk HPV strains be transmitted when using a condom during intercourse? I realize that HPV is transferred from skin to skin contact, but are high risk HPV strains that can cause cervical cancer also found outside the vagina such that they can be transmitted via condom protected intercourse?
By high risk HPV strains I mean only the ones that increase the risk of cervical cancer
It is rare but not impossible. If you are in a committed relationship it would even be more rare but again not impossible. The research is just not there. They believe that oral sex may be related to the acquiring of oral HPV. Then you have to remember that only a small amount of cases of HPV causes cancer, you have to be persistently HPV positive. The thought at the present is 15-25% of oral cancer is related to HPV of that they think (remember think) that many of those are related to HPV 16 which is high risk HPV. Most people that are sexually active get HPV at some point and clear the virus, often with no symptoms. It also may be that genetics are involved and it is possible that some may be more susceptible to HPV, they just don’t know. It appears there is a lot of worrying about oral HPV for a very small number of cases in the US.
There is no test for men but if you are in a committed relationship your partner could be tested for HPV with her Pap, if she has a negative Pap and negative HPV test then pretty much no risk. It becomes more complicated if she tests positive by the Digene HPV test (the only one in the US market that is FDA approved) because it will be positive for one of thirteen HPV’s and does not tell you which one and can be inaccurate. I would want an accurate result and know exactly what HPV I had. So in this case I would find a lab that did PCR HPV testing that could tell her exactly which genotype. If you are not in a committed relationship then you have to understand that the risk of oral HPV is still small and your risk is less if you use a condom in the range of 70-80% of not picking up the virus but since HPV transfer is skin to skin, condoms are not 100% reliable. The biggest risk for oral cancer is cigarette smoking and prolonged alcohol use. If you are healthy with a good immune system, use condoms and limit your partners your risk should be low. I would not worry about oral HR HPV.
Thanks for your response. I understand that one can limit exposure and that oral cancer is very rare and usually triggered by other factors (e.g., smoking and drinking). I still don't have answers to my questions in the original posting, but maybe as you said the research is not there, true? :-(
Actually, HPV is complicated and not well understood by anybody. There is little known about it and many studies have conflicting results. Most physicians struggle with understanding it and many of the test results can be inaccurately reported. Most physicians rely on tests to help them but in this case many women go through colposcopy for no reason—the physician is being safe and maybe does not want a law suit. And sometimes more profitable; more tests equals greater revenue for both the physician and the test manufacturer. Safe medicine is not always good medicine. Many women are coming back to their Dr.’s for tests every 4-6 months and having colposcopy’s and biopsies and that is a huge revenue generator and the physician does not explain it. There are a lot of frightened women that think they are at risk for cancer. Insurance companies ask if you have had an abnormal Pap in the past and that is a reason to deny coverage or increase a premium for no disease or pay out of pocket (there are over 3 million abnormal Paps a year in the US). In the case of the current HPV test I do not think it should be done in women under 30 that is when the results are most unreliable. It has put a huge cancer scare out to many women and men that is not warranted and they will never get cancer. Medicine has never been an exact science, physicians should use their best knowledge combined with a good history. To answer your questions specifically, if you are one of the unlucky ones (very rare) you can get oral HPV from having oral sex. You can pick up the virus with intercourse even with wearing a condom. High risk HPV is not only found in the female cervix, it is found in anal and oral cavities. It has been found on hands and under nails in some studies, again probably more rare. You might never have signs of HR HPV but you could pass it on to someone else (that is how it is passed to most women as most men do not show signs). You can get penile cancer from HPV (very, very rare in the U.S. 0.2%, but there is a higher incidence in Africa and South America). But most clear the HPV in 6-12 months! The problem with HPV is most don’t want to wait to see if it resolves and that goes for physicians too. There is no reason to be retested or treated in under one year, if you were one of the very rare, very unlucky ones these are slow growing changes in the cells and would take years to manifest to cancer—Why would you want to be treated when there is a better chance (greater than 90%) the HPV could resolve on its own with a healthy immune system. A transient HPV infection is common.
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