STDs Expert Forum
HPV
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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

Hi doctor,

I have read your posts on HPV and just some questions for you.

I am young male and two years ago was given Gardasil to protect against HPV types 6,11, 16,18. I know this protects againsts 90% of genital warts and some hpv that cause cancer.

7 weeks ago I met a girl and one nite we engaged in oral sex. She performed on me and then me on her. One occasion. I have had no previous sexual encounters. She is not a virgin but didn't have any signs of hpv.

I know that different types of HPV affect different areas of the body like HPV 7 for hand warts..etc and that these cannot be transmitted to genitals. I realise that there are about 30 types that affect the genitals.
I have read that HPV 6,11 and 16 are the types that are common to both oral hpv and genital hpv. Gardasil protects against these so on that basis my liklelihood of getting hpv from this encounter is pretty meaningless concern?. I know that at some point we will get hpv but I am concerned about genital warts and want to put my mind at rest.

Is there a pretty meaninless risk here?
Oral to genital very unlikely to transmit hpv?  
What hpv types are common to both oral and genital for transmission from this episode?
Genital to oral unlikely to get hpv from this episode because of my gardasil protection?

Can i assume that I have avoided hpv from this episode and move on wihout concern?
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Welcome to the Forum. Your asking goo questions, the sorts of questions that are still under investigation.  The answers I'm about to give you will reflect current consensus about the questions you ask.  The definitive answers to questions about the transmissibility of other HPV types, oral transmission, etc however are still being clarified.  I point this out before I address your questions so neither we, nor another client, will comment on things they've learned on the internet or from isolated studies which may not reflect the current consensus.  If you or others prefer to believe them that is, of course up to you but it is not a debate that is productive or helpful to engage in.

Congratulations on getting the vaccine.  As more men, as well as women do, HPV rates will gradually begin to decline. Currently herein the U.S. only about 30% of women in the recommended age range have been vaccinated thus far and the rate is far lower for men.  Again, congratulation on your approach to HPV and keeping yourself healthy.

In answer to your questions- yes, your risk from this encounter is low.  Currently it appears that the rates of transmission and acquisition of HPV through oral sex are far lower than for ano-genital sex (the consequences of concern- cancer are also lower as well, in fact is proportionately lower still, i.e.  even with oral HPV, the risk of cancer is lower than for the genital tract).   Clearly on rare occasions, HPV types 6 and 11 can be transmitted to the oral cavity.  Your vaccine will help prevent this. The other HPV type which has gotten the most "attention" in the oral cavity is HPV 16 which has been associate with oral cancer.  Your vaccine should provide good protection for this as well.  As you know there is a lower but still very small risk for other types.  

Summary.  The data are not yet conclusive however your risk for having gotten HPV from this episode is low, very low and not something to worry about.  I would move forward.  EWH

p.s.  In addition, I should add that, other than getting the vaccine, the other best thing a person can do to avoid oral HPV and its consequences is to go to your dentist regularly. Dentists are increasingly attuned to, looking for, an treating oral HPV on the rare occasion that it occurs.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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