I'm trying to determine how at risk I am for contracting genital warts from my boyfriend. He had a diagnosis of a small genital wart made visually 2 years ago. It was treated and he remained symptom free for 2 years, until it recurred about 3 months ago. We abstained from sexual contact until 3 months AFTER treatment of the recurrence, and only have had condom-protected sex. I also have the Gardasil series, and was fully vaccinated long before we ever had any sexual contact whatsoever. My OBGYN told me that with condoms and the vaccine, my chances of contracting warts were basically nil.
My concern is this: He was with one (American) girl before leaving for Australia, and one girl while in the country, when he noticed symptoms. I know Australia provided free Gardasil to all girls who were eligible around 2007. If he picked up the infection while there, is it likely that because many girls are vaccinated, that he is carrying a strain that my vaccine does not cover? Should I now really worry?
Welcome to our Forum. I'll try to help. First let me congratulate you however- you are doing everything, and I do mean everything right. Having gotten the HPV vaccine, abstaining for three months following his apparently successful therapy, and talking with him truthfully about exposures and partners. I wish everyone would do that.
As far as HPV is concerned, because you have done all this you are as protected as can be. At the same time, remember that, at least just before the era of the vaccine, virtually everyone got HPV. The predominant HPV types in Australia are the same as we see in the U.S. so your vaccine will be a great help in reducing your risk for infection. Your risk for HPV under the current circumstances are low but, because the vaccine does not cover all HPV types, not zero. Thus my advice, like that of your OB is not to worry and to move forward without concern.
I hope this addresses your concern. If not, you can reply as part of this thread. EWH
Thanks Dr. Hook! I understand that HPV is a trivial issue. I feel like I've done everything I can to reduce my risk of contracting warts. Because Gardasil is very effective and condoms offer at least 70% protection, is it safe to assume I likely will not contract this infection? I know that Gardasil does not cover 10% of strains that cause genital warts, but are those particular strains very common? I'm a biomedical researcher, and so I've looked into many, many case studies regarding condyloma, and in the overwhelming majority (I'd say greater than 99%) are caused by HPV strains 6 and 11. Can you provide some insight as to how common the other 10% of strains are? Or, do you suggest I just trust the vaccine, prophylactics, and not worry?
As i said, I agree with your OB. At this point you are doing everything that you can do and to continue to worry about this will only have a negative impact on your mental and sexual health.
There are over 100 different types of HPV but, as you point out, the HPV vaccine you took covers the two types that cause over 95% of visible genital warts. When you combine this with your use of condoms and the fact that not all exposures lead to infection, worrying further about HPV is not productive.
My advice is the conclusion that you appear to be coming to, trust the vaccine, condoms and the fact that most exposures do not lead to infection. I hope these comments help. EWH
One final question: is the use of oral contraceptives associated with increased risk of HPV acquisition? I've seen this rumor floating about on the web, and wondered if there was any truth behind it, particularly because I just began the pill myself.
I am not aware of data that suggest that OCPs increase the risk for HPV. Some studies may suggest this while others do not and if there is any risk it is quite small and substantially outweighted for most women by the protection it offered agaisnt unplanned pregnancy. EWH
Sorry about posting another question, but this will be very quick. It's my understanding that after a partner has been treated and has not wart recurrence for 3 months, transmission to partners is very unlikely. Would it be safe after this point to have unprotected sex with my boyfriend (coupled with birth control pill and the fact that I've been vaccinated)? I know the risk is never zero, but with no recurrence and my vaccine history, I still feel pretty safe.
I just read a quote by Dr. Handsfield that made me worry a bit. It involves recurrences and infectiousness. He stated to another individual that "given your unusually prolonged history of recurrent genital warts, perhaps there is more chance you are still infected and possibly still infectious at this point." My boyfriend had a recurrence almost 3 years after the initial diagnosis of genital warts. He had one small bump that was treated the first time. As I indicated, he was treated and we waited 3 months to have sex. Does the fact that he had a recurrence years after initial treatment indicate that he is going to have a persistent infection, and is therefore more contagious?
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