HPV fingering, receiving oral sex

[xworriedwell]

Hello Dr,

Thank you for the excellent service you provide out here.

My concern is oral and finger transmission of HPV. I am not at all proud of my actions but it’s another alcohol related strip club experience. I was at a strip club a few months ago and fingered a few of the dancers. From one I also received very brief (~20 sec) unprotected oral sex.
My concerns are the risk of me contracting HPV from these events.

1.) What is the risk of me contracting HPV from fingering?
2.) Is it possible only my finger could get infected and I could transfer that to my wife?
2.) What is the risk of me contracting HPV from the brief oral encounter? Can someone have a genital HPV infection (even asymptotic) in their mouth and then transmit that to their partner who is receiving the oral sex? Or do only the oral HPV types infect the mouth?

I’ve read some of the other posts in the archive and this topic doesn’t always seem clear. It seems as though these are low risk activities but then some posts seem to indicate these transmissions are frequent. I’ve been married for 20 some years and this is not typical behavior. Thus please understand my concerns.

Thanks

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  I'll try to help.

My first advice is that nobody should go around worried about catching HPV.  Everybody gets it one time or another; at least 80% get a genital-type HPV infection, and probably everyone gets non-genital HPV as well.  (The majority of the 100+ HPV strains do not primarily infect the genitals and are not sexually transmitted.)  As for the genital strains in particular, as a non-virgin human being you can assume you have been infected and may well be infected again.  Fortunately, the large majority of infections never become apparent and clear up without ever causing any significant health problem.  So HPV really shouldn't be on your mind at all.  And it especially is not a concern after sexual exposure other than genital-vaginal or genital-anal sex.

With that as background, on to your specific questions:

1) Hand-genital transmission appears to be rare.  The genital HPV types do not easily infect non-genital sites, and certainly are unlikely to infect the fingers.

2) There is no realistic risk of such transmission.  You might be able to pick up HPV infected secretions under your fingernails (without actually becoming infected) and then transmit to your wife if you didn't wash after fingering another partner.  You will agree this isn't very likely.

3) Oral HPV infection can be acquired by oral sex, but the frequency is unknown.  Probably not very often, but it happens.  Even more than for genital infection, oral HPV rarely causes disease of any kind.  Oral to genital HPV transmission is not know to occur; any risk to your wife from this route is very low, if any risk at all.

Even monogamous for 20 years, you and/or your wife may well have had HPV before you were married; if either of you had other partners before you connected with one another, you can be quite sure you were.  Further, some HPV infections persist for life, then show up with a problem like an abnormal pap smear.  So if your wife ever has an abnormal pap smear -- which is the most common way that HPV shows up at all -- most likely it would not have originated from your non-intercourse sexual adventures outside your marriage.

Bottom line:  HPV really isn't a likely outcome of your extramarital activities.  You really need not worry about it.

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

[xworriedwell]

Thanks again - Best wishes as well.

[H. Hunter Handsfield, M.D.]

Yes, oral sex is low risk for HPV in all combinations and directions of transmission.  I agree you had no risk at all for HIV.

Any time someone sees his or her own need for professional counseling, it's always a good idea to follow through.  And as they say, recognizing a problem is the first step in confronting and resolving it.

Thanks for the thanks.  Take care.

[xworriedwell]

Thanks again Dr, you’ve put my mind to ease.

Just to clarify you in 3 you say that “Oral to genital HPV transmission is not known to occur; …” – this refers to both mouth to penis and mouth to vagina? So I really had no risk from my brief unprotected oral activity.

Also I went to the local clinic today to get HIV tested but the clinic didn’t want to test me due to the low risk. However, I persisted (and made a donation) to have the test, at least for peace of mind. Based on the wealth of archives on the risk of my actions I assume you agree with the low HIV risk?

I am personally devastated by my actions and will pursue counseling for my guilt.
Thank you again for your outstanding service.

[xworriedwell]

Dr  H.

My wifes "wart" turned out to be nothing more than a stubborn ingrown hair. You were right all along of my exposure risk. I guess "(perceived} symptoms are not a valid indication of infection" for infections other than only hiv. Thanks for getting me through a very anxiety filled time.
For all the "worried wells" ready this thread listen to the doctors out here - they are experts in this field and know what they're talking about. Once they offer their answer or reassurance accept it and move on. You'll drive yourself crazy thinking of all the worst case what if scenarios - and of course I say this knowing I was guilty of it.

Best wishes in the future success of your medhelp forums. Your forums provide an excellent service out here for information on stds and hiv that seems to not really be found elsewhere. However, with all due respect, I truly plan to not be back.

Thanks again.

[H. Hunter Handsfield, M.D.]

This also carries no realistic possibility of transmission.  If you or your wife ever develops warts or other evidence of genital HPV infection in the future, it will not be from your strip club contact.

That will have to end this thread.  Try to put this non-exposure event behind you.

[xworriedwell]

Hello Dr – one last anxiety filled question … I promise
What is the possibility if I had fingered a stripper and then went to the bathroom without washing my hands first. Could I infect myself via that route? From my hand to my genitals?
Thank you for all your attention – this has been a major source of anxiety in my life right now.

[H. Hunter Handsfield, M.D.]

This is not at all how a wart would behave.  And even if it were a wart, the "inner thigh" is not a likely location for the genital (sexually transmitted) types of HPV.  Of the 100+ types of HPV, only about a third are sexually transmitted at all.

If your wife's bump recurs or persists, it should be professionall evaluated.  But I doubt it's a wart or that it is related in any way to your strip club adventure.

[xworriedwell]

Hello Dr. – me again

If this counts as a second question please let me know and I’d be happy to post it as such.

The reason for my question is that my wife had a small bump on her inner thigh that she said looked like a pimple (I never actually saw it before she messed with it) near the end of November. However when she tried to squeeze it she said it didn’t pop, or bleed. She said it hurt when she squeezed it and she also picked at it. But when she picked at it she said she didn’t remove any skin or anything. The “pimple” got rather bruised from her picking and squeezing and swelled a little. Since then she has just left it alone and it has been getting better. The swelling is gone and it seems just a smaller bruise remains on her skin. There is no longer any bump from swelling, it’s flat with her other surrounding skin. It’s been about 6 weeks since she noticed it and agitated it.

I’m not looking for a specific diagnosis but in general would a wart act like this? If this was an early wart would it just kind of go away after her manipulation or could it be something else? She goes in for a physical in a few weeks and will have the dr look at it but it may be almost gone by then.

When she told me about it I searched the internet for her symptoms and it got me rather concerned it could be a genital wart. From your original response it sounds as though hpv is unlikely but I can’t help thinking this is related.

Thanks again