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HPV transmission & question about types
This is a question directed for doctor Handsfield, if possible, since it relates to a previous post of his.
Doctor: Four years ago I went to the doctor with a small bump on my penis. I believe it was only a single bump, but I can't quite remember. The doctors said it could be a wart; they applied some topical medicine to remove it. They couldn't verify if it was definitely a wart, and seemed to say that 'proving' whether it was or not would be a waste of time and effort. It went away easily, and I've never had a recurrence of anything similar.
I was wondering if you still hold by the opinion you gave in this post:
http://www.medhelp.org/posts/STDs/How-Long-Should-I-Wait/show/454908
I know since then in other posts you have clarified points you have made, which is why I am asking.
Essentially: I'm a diagnosed obsessive-compulsive, and my main concern is a guilty feeling regarding telling future partners. I'd rather avoid an inane scenario in which I say "I had what might have been a wart 4 years ago, but it cleared up, and according to experts..." Most people wouldn't stick around to hear that "according to experts" part.
What I'm asking then is: (1)in your opinion, can I refrain from mentioning this to future partners, given the 4 years of no-warts-ness?
(2) Is it correct that the 'wart-causing' strains (6 and 11, I think) are not the ones linked to certain cancers...and also that the strains that cause warts are more easily 'passed' by the immune system?
(3) And is it true that HPV is really an 'inevitable' part of sexual activity (whether that's a wart-causing strain or otherwise), so that most people out there have or have had one strain before, which they've since 'cleared' in many cases (meaning it's no longer transmissable)?
In short: can I just stop worrying so damn much and lead a normal, safe sex life without having to broach this discussion whatsoever with new partners?
Doctor: Four years ago I went to the doctor with a small bump on my penis. I believe it was only a single bump, but I can't quite remember. The doctors said it could be a wart; they applied some topical medicine to remove it. They couldn't verify if it was definitely a wart, and seemed to say that 'proving' whether it was or not would be a waste of time and effort. It went away easily, and I've never had a recurrence of anything similar.
I was wondering if you still hold by the opinion you gave in this post:
http://www.medhelp.org/posts/STDs/How-Long-Should-I-Wait/show/454908
I know since then in other posts you have clarified points you have made, which is why I am asking.
Essentially: I'm a diagnosed obsessive-compulsive, and my main concern is a guilty feeling regarding telling future partners. I'd rather avoid an inane scenario in which I say "I had what might have been a wart 4 years ago, but it cleared up, and according to experts..." Most people wouldn't stick around to hear that "according to experts" part.
What I'm asking then is: (1)in your opinion, can I refrain from mentioning this to future partners, given the 4 years of no-warts-ness?
(2) Is it correct that the 'wart-causing' strains (6 and 11, I think) are not the ones linked to certain cancers...and also that the strains that cause warts are more easily 'passed' by the immune system?
(3) And is it true that HPV is really an 'inevitable' part of sexual activity (whether that's a wart-causing strain or otherwise), so that most people out there have or have had one strain before, which they've since 'cleared' in many cases (meaning it's no longer transmissable)?
In short: can I just stop worrying so damn much and lead a normal, safe sex life without having to broach this discussion whatsoever with new partners?
MEDICAL PROFESSIONAL
"I guess what I'm asking is--can one still be relaxed about the issues above if it's been years and years, even if one is in a relationship in which no condoms are being used (because the other partners STD history is clear, etc)?"
Yes, of course. That describes the large majority of married couples and others in long-term committed sexual relationships.
Yes, of course. That describes the large majority of married couples and others in long-term committed sexual relationships.
MEDICAL PROFESSIONAL
Nobody can guarantee there is never a potential for reappeance of warts or other HPV infection years later, with the potential to transmt the virus to a partner. It happens but is uncommon. But since HPV is almost always a trivial medical condition, it's just not a big deal, which is why I consider this a relationship issue, not one that has any relationship to disease prevention or HPV transmission.
That's all for this thread. I won't have any more comments. If you require more feedback, I suggest you start a discussion on the HPV community forum.
That's all for this thread. I won't have any more comments. If you require more feedback, I suggest you start a discussion on the HPV community forum.
MEDICAL PROFESSIONAL
Thanks for re-posting your question in a new thread. I'll go directly to your question:
1) Absoutely you can (and should) refrain from telling future partners. If and when you develop a committed relationship, you might want to discuss it with that person -- but that's in the general spirit of openness in relationships, not because there is significant transmission risk.
2) Yes it is true that the wart causing HPV types, mostly HPV-6 and 11, rarely if ever cause cancer; and the high risk types that cause cancer typically do not cause warts. I don't know that the low risk types are more easily eradicated than the high risk ones. But types 6 and 11 generally are cleared sooner, typically 6-12 months, versus 12-24 months for HPV 16 and 18. fpr exa,[;e/
3) Yes it is true that genital HPV is pretty much inevitable. In the US, at least 80% of persons have genital HPV at one time or another. The only people not likely to get it are those rare persons whose only lifetime partners are other -- i.e. neither one ever had sex with someone else and never will. That's really rare.
Yes you definitely "can just stop worrying so damn much and lead a normal, safe sex life without having to broach this discussion whatsoever with new partners".
Here some other threads about informing partners and other general information about HPV that you might find helpful. At least one of those has links to still others. However, a word of warning, given your self-acknowledged OCD: try to avoid seeing nunanced or minor differences that don't exist. Dr. Hook's and my answers often are tailored to the specific question asked and don't always apply to others with similar problems. Don't let your OCD lead you hang on trivial differences that don't matter.
http://www.medhelp.org/posts/STDs/HPV--Informing-past-partners/show/763292
http://www.medhelp.org/posts/STDs/Confused-about-hpv-interpretation/show/763984
http://www.medhelp.org/posts/STDs/concerned/show/980849
Regards-- HHH, MD
1) Absoutely you can (and should) refrain from telling future partners. If and when you develop a committed relationship, you might want to discuss it with that person -- but that's in the general spirit of openness in relationships, not because there is significant transmission risk.
2) Yes it is true that the wart causing HPV types, mostly HPV-6 and 11, rarely if ever cause cancer; and the high risk types that cause cancer typically do not cause warts. I don't know that the low risk types are more easily eradicated than the high risk ones. But types 6 and 11 generally are cleared sooner, typically 6-12 months, versus 12-24 months for HPV 16 and 18. fpr exa,[;e/
3) Yes it is true that genital HPV is pretty much inevitable. In the US, at least 80% of persons have genital HPV at one time or another. The only people not likely to get it are those rare persons whose only lifetime partners are other -- i.e. neither one ever had sex with someone else and never will. That's really rare.
Yes you definitely "can just stop worrying so damn much and lead a normal, safe sex life without having to broach this discussion whatsoever with new partners".
Here some other threads about informing partners and other general information about HPV that you might find helpful. At least one of those has links to still others. However, a word of warning, given your self-acknowledged OCD: try to avoid seeing nunanced or minor differences that don't exist. Dr. Hook's and my answers often are tailored to the specific question asked and don't always apply to others with similar problems. Don't let your OCD lead you hang on trivial differences that don't matter.
http://www.medhelp.org/posts/STDs/HPV--Informing-past-partners/show/763292
http://www.medhelp.org/posts/STDs/Confused-about-hpv-interpretation/show/763984
http://www.medhelp.org/posts/STDs/concerned/show/980849
Regards-- HHH, MD
MEDICAL PROFESSIONAL
"...condom or not, proceeding without disclosing this long-ago wart occurrence would be acceptable in your book--hence "safe"--given all that is known about HPV."
I agree.
That also is truly the end of this thread. The moderators cannot address every additional minor anxiety-driven notion that comes to mind.
I agree.
That also is truly the end of this thread. The moderators cannot address every additional minor anxiety-driven notion that comes to mind.
Dr, apologies--the outside commenter (somewhat annoyingly) raised a new anxiety on my part. I do apologize for extending this thread..
I guess my anxiety is stemming from my use of the phrase "safe sex life" in my intiial question--I didn't mean to imply that it was okay not to disclose to future partners provided a condom was used in every instance...rather that, condom or not, proceeding without disclosing this long-ago wart occurrence would be acceptable in your book--hence "safe"--given all that is known about HPV.
This is it for me & this forum--continued research does no good with OCD--but I would appreciate if you could clarify that opint.
I guess my anxiety is stemming from my use of the phrase "safe sex life" in my intiial question--I didn't mean to imply that it was okay not to disclose to future partners provided a condom was used in every instance...rather that, condom or not, proceeding without disclosing this long-ago wart occurrence would be acceptable in your book--hence "safe"--given all that is known about HPV.
This is it for me & this forum--continued research does no good with OCD--but I would appreciate if you could clarify that opint.
MEDICAL PROFESSIONAL
Sorry, this isn't your thread and I deleted your additional comment. My brief reply wasn't intended to open an ongoing discussion.
Quick question as I was reading this thread with interest. When the questioner asks about "safe sex life" you're not refering specifically to "sex with condoms," are you? I'm assuming that your advice on transmission after years & years is the same wether or not one is using a condom (though obviously condom use is to be recomended as a matter of course always, for anyone)
I guess what I'm asking is--can one still be relaxed about the issues above if it's been years and years, even if one is in a relationship in which no condoms are being used (because the other partners STD history is clear, etc)?
I guess what I'm asking is--can one still be relaxed about the issues above if it's been years and years, even if one is in a relationship in which no condoms are being used (because the other partners STD history is clear, etc)?
Doctor,
I missed this the first time 'round, and I'm assuming it's what you're mentioning here:
"Second, it is reasonable to consider the nature of the relationship. Most important, it's probably wise to tell current or future committed partners, e.g. when a long term relationship seems on the horizon, about past STDs. In the event such a partner later develops an HPV problem -- say warts or an abnormal pap smear -- it's generally better to have had "the talk" well ahead of time, and not in response to a new diagnosis and possible emotional crisis."
What I DON'T understand, based on everything I've read here, is how that would even be an issue 4 years after the initial occurrence...
I missed this the first time 'round, and I'm assuming it's what you're mentioning here:
"Second, it is reasonable to consider the nature of the relationship. Most important, it's probably wise to tell current or future committed partners, e.g. when a long term relationship seems on the horizon, about past STDs. In the event such a partner later develops an HPV problem -- say warts or an abnormal pap smear -- it's generally better to have had "the talk" well ahead of time, and not in response to a new diagnosis and possible emotional crisis."
What I DON'T understand, based on everything I've read here, is how that would even be an issue 4 years after the initial occurrence...
Gah. Apologies, and this will be my last follow-up, but I have to say now this is causing me more anxiety. (My own hang-ups.) I don't want to be interpreting this as being that 'casual partners' are less worthy of knowing about a risk to their health...whereas a 'long term partner' somehow deserves that knowledge more.
I just don't want to be exposing anyone to risk. And in the case of that 'long term partner'--assuming we'd slept together for a while, and THEN broached this conversation--I don't want that person to think I'd put them at risk and simply not mentioned it!
I hope you understand my concern here. I guess the question is not "What would be gained" but simply my original question: After all this time, should I actually be concerned whatsoever about passing this on--to a casual partner or to a potential 'long term' partner--or can I safely know that it's no longer a concern?
I just don't want to be exposing anyone to risk. And in the case of that 'long term partner'--assuming we'd slept together for a while, and THEN broached this conversation--I don't want that person to think I'd put them at risk and simply not mentioned it!
I hope you understand my concern here. I guess the question is not "What would be gained" but simply my original question: After all this time, should I actually be concerned whatsoever about passing this on--to a casual partner or to a potential 'long term' partner--or can I safely know that it's no longer a concern?
MEDICAL PROFESSIONAL
"What would be gained?" I don't know. Maybe nothing, maybe a lot. Seems to me it depends on the relationship and what the mutual expectations are about past sexual and medical history. In any case, this is irrelevant to casual partners and "someone I am dating", only intended for your consideration if and when you are heading into a potential long term commitment.
Dr. Handsfield--
If you can please just clarify that point:
"If and when you develop a committed relationship, you might want to discuss it with that person -- but that's in the general spirit of openness in relationships, not because there is significant transmission risk."
If there's no significant transmission risk, what would really be gained by bringing this up? Again, the thought of having this conversation--whether with a casual partner or someone I am dating--is a source of great anxiety. If I'm not putting anyone at risk I'd prefer not to...so I'm just a little confused by what you intended?
If you can please just clarify that point:
"If and when you develop a committed relationship, you might want to discuss it with that person -- but that's in the general spirit of openness in relationships, not because there is significant transmission risk."
If there's no significant transmission risk, what would really be gained by bringing this up? Again, the thought of having this conversation--whether with a casual partner or someone I am dating--is a source of great anxiety. If I'm not putting anyone at risk I'd prefer not to...so I'm just a little confused by what you intended?
Dr. Handsfield,
Thanks as always for your measured and patient reply. My only remaining concern is your response in (1) regarding 'openness in relationships'...If the issue is not a risk of transmission I don't quite see what would be gained by bringing this up? Unless what you're inferring is along the lines of "this is something that occasionally causes me anxiety, so...here it is." I'm just a little confused by why I shouldn't tell future partners..but might want to think about telling someone in a committed relationship.
Thank you also for your understanding of how OCD works--indeed, while my questions may (HAVE) been answered in various forms elsewhere, OCD is a tough beast to convince in all cases. (As my splitting-hairs question above should be evidence of, I imagine.)
Thanks as always for your measured and patient reply. My only remaining concern is your response in (1) regarding 'openness in relationships'...If the issue is not a risk of transmission I don't quite see what would be gained by bringing this up? Unless what you're inferring is along the lines of "this is something that occasionally causes me anxiety, so...here it is." I'm just a little confused by why I shouldn't tell future partners..but might want to think about telling someone in a committed relationship.
Thank you also for your understanding of how OCD works--indeed, while my questions may (HAVE) been answered in various forms elsewhere, OCD is a tough beast to convince in all cases. (As my splitting-hairs question above should be evidence of, I imagine.)
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STDs can't be transmitted by casual contact, like hugging or touching.
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