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Confusing information about HPV transmission
Dear Doctor,
I wrote to this forum a few months ago regarding my concerns about nonsexual transmission of genital HPV. I wanted to make sure that I don't spread the virus to other people through nonsexual, everyday contact and the response I got here put an end to my worries. I was happy to move on with my life.
Recently, a friend (who also has HPV) sent me a link to the June 2006 issue of The Scientific American in which she pointed at a letter to the editor by Dr.Diane Harper of Dartmouth Medical School. This got me a little bit confused and curious, so I wanted to ask for your thoughts.
Dr.Harper writes:
"[...]Fingernails and the skin around them contain the same types of cervical cancer-causing HPV as the anogenital skin does, allowing autoinoculation from simple habits such as toilet hygiene or tampon insertion. This virus is ancient and omnipresent in all environments[...] Thus, all references, surveys and propagation of 'educational' materials that assert cervical cancer is transmitted solely through sexual contact are deceiving and do the public a disservice. [...]"
I don't want to go back to worrying about non-sexual transmission but the last sentence of the quote keeps confusing me. It sounds like Dr. Harper is saying that if the public was told about a non-sexual transmission aspect of the infection, they could take some steps to prevent or reduce it. Unfortunately, she doesn't mention what those steps may be.
Should I be concerned? How does this apply to me as a person infected with high-risk HPV?
I was wondering if you could share your thoughts on this.
Thanks a lot.
MEDICAL PROFESSIONAL
Welcome back to the forum.
Dr. Harper is well known in the HPV field for her atypical perspectives, which do not represent the consensus of STD experts and HPV researchers.
It is true that HPV DNA can be found on the fingers -- especially under the fingernails -- of people who have HPV infections elsewhere, especially the genital area. Most likely it represents contamination of the fingers due to touching the genital area. It does not necessarily mean the skin of the fingers is infected with the virus, and having HPV DNA on the fingers does not necessarily mean the virus can be transmitted by hand contact. The research is very solid: infection with the genital types of HPV is rarely diagnosed in persons who have not had vaginal, anal, or (rarely) oral sex.
So you definitely should not "go back to worrying about non-sexual transmission" of HPV. That would be the case even if you had a genital HPV infection, which -- as Dr. Hook informed you in your past thread -- is unlikely. Almost certainly you are not "a person infected with high-risk HPV".
You need to get a grip on HPV. While not to be minimized, the fact is that genital HPV is inevitable in all sexually active people. Happily, the large majority of infections do not lead to any serious health problem -- and that includes infection with the cancer-causing HPV types. Having such infections is a normal part of human sexuality. There is no point in worrying about it. If you cannot come to a point of understanding and accepting this, you should consider professional counseling. It is not normal to be so resistant to scientific fact and repeated, reasoned reassurance. I suggest it from compassion, not criticism.
Regards-- HHH, MD
Dr. Harper is well known in the HPV field for her atypical perspectives, which do not represent the consensus of STD experts and HPV researchers.
It is true that HPV DNA can be found on the fingers -- especially under the fingernails -- of people who have HPV infections elsewhere, especially the genital area. Most likely it represents contamination of the fingers due to touching the genital area. It does not necessarily mean the skin of the fingers is infected with the virus, and having HPV DNA on the fingers does not necessarily mean the virus can be transmitted by hand contact. The research is very solid: infection with the genital types of HPV is rarely diagnosed in persons who have not had vaginal, anal, or (rarely) oral sex.
So you definitely should not "go back to worrying about non-sexual transmission" of HPV. That would be the case even if you had a genital HPV infection, which -- as Dr. Hook informed you in your past thread -- is unlikely. Almost certainly you are not "a person infected with high-risk HPV".
You need to get a grip on HPV. While not to be minimized, the fact is that genital HPV is inevitable in all sexually active people. Happily, the large majority of infections do not lead to any serious health problem -- and that includes infection with the cancer-causing HPV types. Having such infections is a normal part of human sexuality. There is no point in worrying about it. If you cannot come to a point of understanding and accepting this, you should consider professional counseling. It is not normal to be so resistant to scientific fact and repeated, reasoned reassurance. I suggest it from compassion, not criticism.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
Escpecially when you consider a) HPV cannot be transmitted by casual contact and b) normal, healthy human beings all carry virulent staph, strep, and many other germs that ARE easily transmitted and can be fatal. Worrying about HPV under the fingernails is ridiculous when every time you shake hands or sit next to someone on a bus you could be picking up a fatal infection. It doesn't happen often, but it's a lot more common than transmitting or catching HPV by means other than unprotected intercourse.
MEDICAL PROFESSIONAL
No comment, except to say that the large majority of persons interested in or concerned about HPV do not experience the level of "uncertainty and confusion" that you do.
A related discussion, Can I transmit HPV if a guy fingers me? was started.
Oh, I am sure.
I can't imagine that many people walking around feeling like a biohazard :)
I can't imagine that many people walking around feeling like a biohazard :)
Dr. Handsfield,
I truly respect you and Dr.Hook and I really appreciate your advice. This is not a follow-up question but rather some of my thoughts that I want to share.
I think the reason why HPV made me so anxious is the uncertainty that surrounds it. As far as I can tell, no other STD is surrounded by this much uncertainty and confusion.
When my girlfriend told me she was diagnosed with high risk HPV and cervical cell changes, the first thing that came to my mind was to go get tested so that I knew whether I was infected or not. But I was told there is no test for males! That was only the first one of the uncertainties. Now, I know that the majority of infections "clear up" on their own. I know that genital HPV is "very rarely diagnosed in persons who have not had vaginal, anal, or (rarely) oral sex". I read most of your and Dr.Hook's answers to other HPV transmission questions here on this forum and I have also visited the ASHA and CDC websites. But when I look at the statements by the experts, they always contain phrases like "most likely", "does not necessarily", "rarely", "almost certainly", "large majority". Always leaving a small possibility and always lacking a solid "yes or no" answer. I understand that, as in life, nothing in medicine is 100% but I guess you would agree that with HPV -unlike most other STDs- there is much more uncertainty and it is frustrating.
Dr.Hook's advice (back in 2010) helped me put my mind at ease and I was not going to come back here seeking more reassurance if I had not seen the letter in which Dr.Harper says "all references, surveys and propagation of 'educational' materials that assert cervical cancer is transmitted solely through sexual contact are deceiving and do the public a disservice." I wouldn't let that letter confuse me if it was written by some random person either, but as far as I know Dr.Harper is the lead researcher in the development of the HPV vaccines. That is why I ended up finding myself here again, confused and looking for advice.
As laypersons with no medical expertise, all we can do when faced with a medical situation is to turn to the experts for advice and I understand that even among experts, sometimes there may be differing views and opinions.
Let me say that you have once again put my mind at ease. You are right. I do need to get a grip on HPV and your response is exactly what I needed to do that. I will read and re-read it. I think I also need to get used to living with a certain amount of uncertainty in life.
Finally, I do understand that you are suggesting that I consider seeking counseling out of compassion and not criticism and I appreciate it.
Thank you very much doctor.
Best wishes.
You are reading content posted in the STDs Forum
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