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HPV: genital vs oral strains
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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.

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HPV: genital vs oral strains

I was in a monogamous relationship in which both me and my girlfriend were each others' first/only partners. We broke up, and two months later I had protected intercourse with a prostitute. The sex was brief, the condom didn't break, and lubricant was used. Three weeks later, my girlfriend and I saw each other, and she gave me unprotected oral sex.

I've read several other questions here regarding HPV, but I'm still not quite clear on the difference between genital and oral strains of HPV, especially since most other sources of information on the internet don't distinguish between them. What I want to know is, what are the chances my (ex)girlfriend has oral HPV now (assuming I'm still the only person she's ever been intimate with), and if she has oral HPV, does that mean she also has genital HPV?

I understand this question is nitpicking, but we might start having sex again in the future, and if she does not have genital HPV now, then I'm sure she would want the chance to decide for herself if she wants Gardasil -- in which case I would explain the situation to her.

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I would not call your question nitpicking but it really does get into some of the fine points of HPV and HPV biology.  There are some important points here which I will address.

First and foremost, even though it is your last question, I would recommend the HPV vaccine for your GF.  Her risk for HPV is quite low but even if she were to get one strain of HPV, there are 3 others covered by the vaccine.  This is the reason that the vaccine is recommended even for persons who have had HPV or evidence of HPV before.  The vaccine is well tolerated and highly effective.

Second, your risk from receipt or protected sex with a commercial sex worker is very, very low.  While she may well have had HPV, most exposures to STDs of any sort do not lead to transmission of infection and condoms are protective. These two facts greatly reduce the likelihood that you got HPV from the single exposure you mention.  

Third, there is little risk that even if you had HPV the your ex became infected through oral sex performed on you.

Finally, there are over 100 different strains of HPV with new strains being detected regularly.  Different types tend to have "preferences" for where the cause infection. The strain that has received attention both as a cause of oral sex and for about half of cervical cancer in women is HPV 16.  If the virus is present in the oral cavity or on the genitals it  is still the same type of virus.  

I hope these comments are helpful to you. EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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