HSV and HPV testing

Dr. HHH

I'm a 27 yr old male. Not very sexually active is last few years. 7 mo. ago, made regrettable mistake of having condom protected sex with what I’d call low grade sex worker at massage brothel front. sex was brief. It’s been a traumatic event for me. Sounds like my risk of contracting anything from this is low other than HSV, HPV. I’ve been seeking mental help but not very helpful as their knowledge on STD’s is so limited. So here are my questions. Of note; long time reader, first time poster. No genital symptoms since incident.

1. I got an IGG type specific HSV-1 and 2 test 16 weeks. after incident, negative for both. Can I be sure I don’t have herpes. Read it can take 6mo. for antibodies to seroconvert, should I test again now (6 months +) to be sure.

Ok here’s where it gets dicey, I know there is no FDA approved test for men for HPV or even for women for external GW unless they are present but I have some questions provided money isn’t an issue, and I could find a DR or someone to preform them.

1. I’ve read that HPV produces antibodies in the blood. I thought HPV was on skin and not blood bourne. Why can’t I get antibody test for 6, 11 maybe even 16, 18 or would this be useless/impossible. Or bad cause strain 6 could show up but might never get warts anyway. Or is that not at all how HPV antibody’s work and it would just show HPV antibody’s for HPV 1 (common warts) and be confusing. Can you help me understand HPV antibodies.

I’ve read that in research studies they can do emery scraping of penis, doesn’t sound practical outside research setting. But

1. Would it be painful?
2. Would it be Disfiguring?
3. Would it even be accurate, like where I had scraped could be negative but could have virus in other area.
4. If last possible exposure was 6 mo. ago could it be negative but just be latent or in incubation and show negative but then I could still develop warts from that incident.
5. Would the test tell what strain I have?

Thanks

[H. Hunter Handsfield, M.D.]

As you seem to understand, you had a low risk exposure.  Even though there are small risks of HSV, HPV, and other infections with condom-protected sex, the chances of infection from any single exposure are much too low to worry about.  Had you been my patient, I would have recommended against any testing at all.  As you seem to realize yourself, the main problem here is your anxiety and guilt over a sexual event that most people would not find particularly unusual or inappropriate.  You might need counseling; I doubt my answers are going to be sufficient to calm your nerves.  But here they are:

1) Herpes:  The negative type-specific HSV test proves you were not infected with either HSV-1 or HSV-2.

Re HPV:  You are correct that there is no approved test for HPV.  There are no blood tests for anybody, except those used in research.  There is no point in testing anyway.  As a man who apparently has had at least a few sex partners in your life, you can be sure you have already been infected with HPV, probably more than once.  If you had a positive test, it would not say when or where you were infected.  If infected, you can expect the infection to have cleared up, and that it will never cause a health problem for you or a future sex partner -- and that includes infection with the high risk types, i.e. those that can potentially cause cancer.

You can't get the HPV tests you ask about, so it's really not useful to go into detail.  But rubbing the penis with emery paper is not painful and certainly not disfiguring.  (It's no different than rubbing a finger gently with fine sandpaper for 10 seconds.)  But no it would not be accurate.

I strongly recommend that you just drop all your concerns about HSV and HPV, which are irrelevant to your health.  Deal with the obvious underlying emotional disorder.  I suggest it out of compassion, not criticism.  You don't need a mental health professional who is particularly knowledgeable about these infections.  Ask your primary care provider for a referral.

Good luck--  HHH, MD

[SSKing]

This has been helpful. HSV is out of my mind, no longer worried about having it at all. Thanks you sir.

HPV, I understand I've probably had infection in past and cleared and you say "chances of infection from any single exposure are much too low to worry about" but I'm just trying to figure out how low we're talking here. Not even HPV infection but me getting genital warts from this incident 7 mo. ago. It was my last sexual exposure and before it, it had been several years.

I know there are no guarantees here but is there going to be a point (now) 7mo. post exposure with no symptoms or some time in the future with no symptom and such brief condom protected exposure that I can be like 99% sure, I'm not going to get genital warts from this event?? I know if I did it wouldn't be life threatening but am just trying to realistically understand the chances of it happening at this point from this. Hope you can answer my follow up question here.

Thanks so much for all your help either way. It’s meant so much to me and really helped ease my mind!

[H. Hunter Handsfield, M.D.]

Nobody can calculate the risk for HPV for any particular exposure.  Obviously, the chance you're going to get genital warts from this particular exposure is low, but nobody can say more.  My point is that it doesn't matter, because it isn't worth worying about.

Why are you trying to talk me into believing you really were at risk?  And why are you trying so hard to convince yourself?  You came here for reassurance.  I gave it.  Accept it and move on.

I won't have any further comments.

[SSKing]

It was just I wasn't sure how low we were talking as far as genital warts are concerned, like 1 in 10,000 low, 1 in 1000, 1 in 100, 1 in 25 low. I guess impossible to say really and it doesn't matter, because it isn't worth worying about is your message.

If no more comments thats all good.

Thanks for everything.

[jasonm30]

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[allisonkoz]

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