HPV and current risk of transmission

[jeffcarolina]

Here's my situation:

My ex girlfriend tested positive for a high-risk strain of HPV when we were together, and it is undoubtedly from me. She had only one partner before me, and I'm almost certain they took each others virginity. My case is different, however, since I've had quite a few sexual partners. We were together for nearly 3 years, and we've been broken up for almost a year now.

The last person I slept with besides her was before our relationship, and occurred months prior. It is a definite fact that neither of us were unfaithful to each other, so I'm assuming there is no other active HPV infection and could only have been contracted about 4 years ago. Longer most likely.

Now I understand that many questions on this subject border on morality, including mine. But I still need to hear it from a doctor. What I want to know is, given the current medical knowledge of this virus, is it reasonable for me to believe that I can live my life normally at this current point in time, without 'having the talk', and engaging in sexual
relationships, (either protected or not, answer for both) without posing a considerable(or any) risk of transmitting the ORIGINAL HPV virus that I contracted many years ago? I understand that any new sexual partners that I have pose a serious risk of me contracting a new strand, but I'm focused on this current moment in time. Also, the number seems to be that condoms are 70% effective protection against HPV supposedly, but what do doctors actually think it is? I'm guessing considerably more?

It seems like I'm going to put myself through hell with judgement and rejection due to the general population being either misinformed about HPV or just completely in the dark about it.... and the reality of it is that my future sexual partner is much more likely to have an active infection of a different strand, which makes me, with an almost guaranteed cleared infection being a less risk to that person.

Thanks in advance.

J

[H. Hunter Handsfield, M.D.]

There is no legal limit on age or anything else.  Once any prescription medication (including a vaccine) is licenced for use, it can legally be prescribed for anybody.  However, the official approval currently is only for females age 9-26.  A particular provider or clinic may or may not agree to give it to someone else; if so, health insurance won't cover it.  The HPV vaccine costs $120 for each of 3 doses, to which the doctor or clinic will add fees for the office visit etc.  So the total is usually $500+.

[jeffcarolina]

Can you get the vaccine if your 27? Or is there an age limit

[H. Hunter Handsfield, M.D.]

I meant to also mention Gardasil, the HPV vaccine.  It protects women from the 2 high risk HPV types that cause about 70% of cervical cancers and the 2 types that cause almost all genital warts.  All sexually active young women should be immunized.  Although not yet approved for use in men, that will come in the next year or two.  If and when you discuss your possible past HPV infection with partners, also suggest they talk to their health care providers about getting the vaccine.

[H. Hunter Handsfield, M.D.]

You are asking among the most common and, for some people, the most troublesome and uncertain of all questions about HPV.  The answers are complex and fall in the realm of personal judgment and ethics more than science.  There are no hard and fast rules.  As it happens, within the past week I have addressed exactly these issues in great detail, so my comments below are brief.  Please read the following three threads:

http://www.medhelp.org/posts/show/763292
http://www.medhelp.org/posts/show/763984
http://www.medhelp.org/posts/show/761416

The quick replies are that even if you were the source of your ex's HPV infection, you may no longer be infected.  Most infections go away in a few months, so you aren't necessarily going to transmit it again.  Further, virtually any partner you're likely to meet, and most partners you have had in the past, have been infected with HPV before and likely will catch it again.  Getting HPV, including the high risk types (which are the most common types), is a normal and expected consequence of human sexuality.

For these reasons CDC and most experts believe it is not automatically necessary to inform past or future partners when HPV is diagnosed or suspected.  But other people disagree.  Also, the nature of a relationship might be important.  In a potentially long-term, committed relationship, often it's better to discuss past HPV and other STDs early on, to avoid the risk of a more difficult conversation if the partner develops an abnormal pap smear, genital warts, etc.

The threads I recommended above go into these issues in great detail.  Please read them and then feel free to return with a brief follow-up if something isn't clear.  Also, you might visit MedHelp's HPV community forum.  You will get lots of opinions on all sides of these issues.

I hope this helps.  Best wishes--   HHH, MD