I have HPV that has manifested itself in warts. I have treated them over about ten years (perhaps never consistently enough), but they always come back. Until very recently, I have always disclosed the condition to sexual partners before intercourse. Three nights ago, however, I met a girl and we became EXTREMELY intoxicated and had sex. Only because of my intoxicated condition, I did not disclose my STD to her beforehand. We did not use a condom, and I did have a few warts at the time. The girl flew out the next morning, and it is not likely that we will see one another again.
Doc, should I track her down to disclose the fact that I have HPV?
To my understanding, there are few elements at play: First, according to a lot of the literature I've read, many, many sexually active people are exposed to HPV. One idea weighing in favor of not contacting the girl is "Why needlessly worry her if she did not contract the virus?" The best thing that could happen in that scenario is that she worry about it and never test positive for HPV. On the other hand, if I do contact her, just having information about the risk would allow her to (1) get screened sooner than her next annual and treat any symptoms that may arise, and (2) disclose the risk to her future partners.
Am I missing anything in that analysis?
Interestingly, I find that the law creates the wrong incentives here. It encourages non-disclosure, because if I now disclose my condition post-hoc, the girl contracts HPV, and she decides to sue, she will actually know who to direct a suit against. Whereas if I say nothing, she clearly would not know who was responsible for passing HPV to her (assuming I was not her first drunken one-night-stand). I want to do what is right, so I am not really concerned with legal ramifications, just wanted to make the observation.
I realize that I engaged in very risk behavior, and that I need to be tested. Thanks for your input, Doc.
You accurately define most or all of the pertinent issues, and you seem to understand there are no rigid rules -- so I'm not sure what I can add.
But I will start with a little skepticism about your diagnosis. It is very unusual for genital warts to keep recurring over 10 years. Has the diagnosis been confirmed (recently) by a knowledgeable health care provider, like an STD specialist or dermatologist? Not all genital bumps, even recurrent ones, are warts. If there is any doubt about the diagnosis, have it confirmed professionally.
The obligation to warn or inform partners about known HPV infection is not nearly as clear-cut as for most other STDs, for the reasons you state. Most important, there is no evidence that people who are informed about particular known exposures are at any lower risk of infection than those who aren't informed. That's because HPV is so common that most people are exposed anyway; for every partner who knows or discloses an infection, there probably are 10 others who are infected but do not know or disclose.
I agree with auntjessie's reply to you on the STD community forum. Regular partners clearly should be informed, because they will (or have been) repeatedly exposed. More important, it's common sense from a simple relationship standpoint. It's better for a spouse or regular partner to know about a risk ahead of time than to risk getting into an uncomfortable discussion in the event of a surprise diagnosis in the future. In more casual relationships, if/when a diagnosis is made, it's rarely possible to know where it came from anyway.
However, there certainly is room for many points of view, and some experts and/or sexually active persons would argue that any risk, no matter now small, should be disclosed. Also, the obligation arguably is greater for a known versus suspected infection. Some would say that a person with overt warts, or a woman with a currently abnormal pap smear, has more obligation than, say, the male partner of a woman with an abnormal pap, whose own health seems to be fine.
As for the legal issue you raise, I don't think it is a significant consideration. Even if a person has informed a partner s/he is infected, it is rarely possible to establish with any degree of certainty that that person was the source of infection. Often it is equally likely that transmission occurred in the other direction. There have been few lawsuits alleging irresponsible HPV transmission and even fewer successful ones.
So if you're looking for a black and white answer, you won't get it from this forum. But perhaps you now have sufficient perspective to consider what if anything to say to your recent partner.
Do get a professional confirmation of your current diagnosis if there is any doubt about your warts.
It never occurred to me that my diagnosis could be something other than genital warts. When I was in college and then again in graduate school, a doctor tested me with an acetic acid solution, and now that I think about it (per your suggestion) the appearance of the "warts" has changed significantly over the years--from originally being larger, skin-colored, cauliflower shaped warts appearing only at the base of penis to small, dark, almost flat spots appearing at different times on the base, scrotum, and very few on the penis. I am not asking for a diagnosis, but do you have an idea of what that might be so that I can research the issue further before seeing a doctor?
Thank you for your help and for this forum. I find it a tremendous value.
The earlier description fits well with warts but the current appearance does not sound at all like warts. I don't have any particular advice for further research, which can never give you a definitive answer. You're going to need to see a provider for that, so you might just skip the middle step and just visit an STD clinic or dermatologist.
As another aside, regarding the appearance of the "warts," my long time ago girlfriend of five years (with whom I was monogamous) never displayed any symptoms of warts or anything else, despite having unprotected sex with me for pretty much the entire duration of our relationship (during which time my "warts" were morphing into their current form, although three weeks before our relationship ended, she did receive abnormal results on a pap smear for the first time.
Alright, that' all. Thank you, and have a fantastic day!
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