STDs Expert Forum
Gardasil and Unprotected sex
About This Forum:

The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Gardasil and Unprotected sex

Hi Doctor,

I was diagnosed with genital warts about two months ago (2 very small warts at the opening of the urethra). I have been getting treated at the clinic and it finally looks like they are going away and i understand that i will always carry the HPV virus. Now, I am about to get into a relationship and i have not had sex with her so i know that she is not infected (also assuming that i do not carry another strain of HPV), i was wondering if it makes sense to have unprotected sex (vaginal, anal or oral) AFTER she receives Gardasil (which seems to be 90% effective against all strains of genital warts).

My second question is if you would recommend the vaccine for both of us?

And finally my last question is after a year or two of no warts (while it is laying dormant), would it be safe to engage in unprotected sex with a person that has not gotten Gardasil?

Thank you.
Related Discussions
239123_tn?1267651214
Welcome to the forum.  I'll try to help.  However, in addition to this reply, I encourage you to do some research about HPV.  You appear to have some basic misunderstandings.

It is unlikely you "will always carry the HPV virus" causing your warts.  HPV DNA may persist for life, but the large majority of HPV infections clear up to a point where they cannot be detected with testing or transmitted to partners.  If your warts do not reappear in the next few months, you can consider yourself cured.  After that, you can definitely have sex with partners who have not had Gardasil.

Second, almost all sexually active people catch genital HPV at one time or another, often several times.  Unless your future sex partner is a virgin, probably she has already had one or more HPV infections.

Don't get me wrong.  Gardasil is great, and it is good your partner is being vaccinated.  It will protect her against the 4 HPV types covered by the vaccine, probably including the strain that caused your warts.  However, she will not be fully protected until she comletes all 3 doses of the vaccine, which takes 6 months.  Before then, consistent condom use will be important to help prevent transmission. (She may be largely protected after 2 doses, but you can't count on it.)  It's also a good idea for you to be vaccinated.  Even though your warts probably were caused by HPV type 6 or 11, the vaccine will prevent you getting a new infection with the 3 other types covered by the vaccine.

There are over 100 HPV types, of which 30-40 primarily infect the genital area and are sexually transmitted.  Gardasil protects against only 4 types.  You and your partner will remain susceptible to all the others.  Fortunately, most infections are asymptomatic and cause no disease.  But this is why your partner will still need to have regular pap smears to check for HPV disease of the cervix, even after being vaccinated.

I hope this helps.  Best wishes--  HHH, MD
10 Comments
Blank
Avatar_m_tn
Thank you for your help Doctor, you have been very helpful.
My last concern is the following, I have had the warts since LATE JULY , but just recently over this past weekend (i went to the beach) i noticed that my urethra stung a little while in the water and the next morning the "Warts" had a white tip with puss inside and the left side of the penis head had tiny small bumps. Now the area where my "warts" are is very sensitive when it rubs against my underwear and after i urinate and for the past two days my penis feels sore about 30 secounds to a minute after i urinate.
I must tell you that ive been putting tree tea oil on the tip of my uretha (everyday) with a bandaid over it (a gauze) and i have a feeling that my urethra might have gotten irritated (such as the skin around my urethra from the bandaids)
I decided to stop doing the tree tea oil regimen because it was damaging my skin, and the puss in the "warts" have been on and off for about 3 days now and i am assuming they pop by themselves because the puss inside is not always visible.
I am really concerned this might be herpes, especially because of the pain after urination but also because warts do not have puss in them, i am scheduled to get tested for herpes later this week but i would like to know your opinion.
Please keep in mind this first popped up in late july.
I attached the following pictures:
http://img689.imageshack.us/img689/1732/issueh.jpg

no puss was present at the time, i apoligize for the picture quality but to see the wart
please focus on the urethra, you wil see two bumps, one on each side of the urethra opening.


Blank
Avatar_m_tn
i forgot to add, do you recommend anything for the skin irritation or rawness from the bandaids, or is it better to just let it heal naturally?
How can i get rid of the sensitiveness and/or puss?


thank you.
Blank
239123_tn?1267651214
Herpes cannot last for moer than 2 months.  Most likely the irritation is due to the tea tree oil, which is very irritating, and not to warts themselves or to herpes.  However, an online forum is not the place to find answers to this sort of problem.  You should immediately return to the provider who has been treating your warts and let him or her evaluate the problem.

We don't evaluate posted photos on this forum.  Sorry.  I'll be happy to comment further after you report what your doctor or clinic says when you are reexamined.
Blank
Avatar_m_tn
Gardasil is not 90% effective.  Gardasil effectiveness is actually considerably higher than merely 90% — I think it is close to 100% effective against those HPV strains that cause 90% of the genital warts.

P.S. Interesting fact: the 4 strains that Gardasil covers are not even the most popular HPV strains, they're just those strains that are most common to cause any symptoms.
Blank
Avatar_m_tn
Thank you for the Gardasil info, i actually got my first shot today, and my partner is getting hers next week.
Doc,
I just got tested today for Herpes so i am waiting on the results, which i was told would take 3-4 days. Also got tested for Chlam and Gon and results came back negative, but i was diagnosed with NGU (was given doxycycline for treatment), which is strange to me because when my warts first appeared back in july, i was also diagnosed with NGU (turned out to be chlam) and was given at the time doxycycline and since symptoms (discharge) were persistent, i was  given Azithromycin about 3 weeks after and everything cleared.

This worries really worries me, especially because i am unable to rule out herpes at this point. I am going to set up an appointment with a Urologist tomorrow but in the meantime, do you know what can possibly be going on with me?

Thank you
Blank
Avatar_m_tn
I forgot to add that havent had sex since july---so we can rule out reinfection.
This is the 3rd time in 2 months that im being treated for NGU.
Blank
239123_tn?1267651214
Herpes is not a cause of persistent/recurrent NGU.

There is no reason not to be having sex with your regular partner.  Persistent/recurrent NGU is not know to have any important health impacts on either affected men or their sex partners.  When NGU persists after all the antibiotics you had, most likely it is just residual inflammation without infection.  I don't expect any more antibiotics will have any effect.  In any case, follow your urologist's advice about it -- but don't worry about herpes as a cause.
Blank
Avatar_m_tn
Hi doctor,
I received some sad news this morning, the doctor told me i was exposed to HSV-2. The test was IGG (not sure what kind) and the number he gave me was 1.37--he also added that anything over 1.10 is considered to be positive. I am a bit frustrated because i have seen 4 different doctors in the past two months and not one of them told me they thought i had herpes.Please doc, I would like to know the following:

1) what are the chances this is a false positive? considering that i have had no outbreaks or obvious signs of herpes
2) If in fact i am positive, should i start taking any type of medication? My doc told me not to since i havent had any lesions but i would really like to reduce the chances of future outbreaks
3)What are my chances of passing this to my new partner? What is the best way to reduce these chances?

Possible exposure was approx 10 weeks ago and i havent had intercourse since then.

thank you
Blank
239123_tn?1267651214
Don't panic about herpes.  It is true that a result of 1.37 is technically positive for HSV-2.  However, most such persons in fact do not have HSV-2; probably 60-70% of the time the result is false positive.  Many doctors are unaware of this problem with the HSV blood tests.  

Here is a thread that explains it some detail; although 2 years old, the information remains accurate:  http://www.medhelp.org/posts/STDs/IGG-Test-Result-Confusion/show/593272

Follow the advice there about having a confirmatory test.  If the result is confirmed positive, that will be the time to address your questions about medication and the risks of transmission to your partner.  For the time being, you should discuss the result and the uncertainty with your partner, and perhaps start using condoms for the time being.  But the odds are that it will turn out your positive result is false and you are not infected.

If you do have HSV-2, it does not explain your recurrent/persistent NGU.

That will have to end this thread, which has gone on quite a while and is well off the original topic of HPV and the HPV vaccine.  If you have questions about HSV and/or NGU, please start a new thread either on this forum or the MedHelp herpes forum.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank