HPV

I am a male. Today a dermatoligist said that I had genital warts and HPV. They almost certainly came from a sexual encounter (unprotected oral sex with a female) outside my marriage nine months ago (my only transgression in nearly 20 years of marriage).

Now I must figure what I need to tell my wife to protect her (the infidelity alone will be hard enough on her).

What is the responsible thing to tell her? I want to make sure I don't either overreact or underplay the risks.

Thanks for any advice. This will be the hardest conversation of my life.

[H. Hunter Handsfield, M.D.]

Even though wart virus infections are almost never serious -- it's an inconvenience, not a health threat -- it is proper to inform your wife.  However, it is too late to "protect" her from infection, assuming you and she have been having unprotected intercourse.  It sounds like you have been infected for 9 months.  Even though your warts apparently developed recently, for that period you have been exposing her to your active HPV infection.  If she was susceptible, she has been infected by now, probably within the first 2-3 times you had sex after your indiscretion.  Your wife could be immune, if she has been infected in the past with the same HPV type that is causing your warts.  But there is no way to know.  Either way, at this point there is no need to change your sexual practices with her.

Your wife should be examined.  If warts are found, they can be treated.  If none are seen, then she will just need to keep an eye out.  If no warts appear within the next couple of months, then you can be pretty sure it's not a problem.  Her exam also should include a pap smear.  It might be abnormal, but if so, it likely would not be a cause for great concern.  The "low risk" types of HPV that cause genital warts often cause low-grade pap smear abnormalities, but not ones likely to lead to future cervical cancer.  So she should be prepared for the possibility of an abnormal pap, but probably of the sort that can just be re-tested periodically until it clears up on its own.

Of course, all this assumes the diagnosis of genital warts is correct.  You have had a number of obviously anxiety-driven questions and comments in this and the community forums for several months, which makes me concerned that this also could be an overreaction.  If there is any doubt, please double check with the provider to diagnosed you, and/or consider getting a second opinion.

Regards--  HHH, MD