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STDs  (Expert Forum)
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Hpv risk?
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which 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.

Hpv risk?

by panicky28, Jul 07, 2008 12:46PM
Hello, about 4 years ago I was diagnosed with low and high risk hpv. I was treated, and my last 3 paps have been normal. I was also tested for both low and high risk hpv back in December and the test came back negative, I assume this means my body cleared the viruses.

Well, 2 nights ago I was with someone I have been casually dating. We are not exclusive, and we did not have sex. We did engage in some heavy petting, and there was genital to hand to genital contact. Not safe, I know, and now I regret it. There was also some contact but with underwear barrier, and also  a condom on...but I know that is still not completely "safe".

I have no idea if he has anything (as there is no accurate hpv test for me, and it was dark and I couldn't see if there were any warts present).


I really don't want to have to go through the whole hpv mess all over again. I get regular paps and am healthy otherwise. I just hate feeling diseased.

I would love to get the hpv vaccine, but my doctor won't give it to me because I am too old (28)

I have an appointment to get my annual pap this friday and I am going to ask for the HPV test as well, but I am not sure if it would pick up anything this quickly. I just want to be able to have a healthy, normal sex life and still be safe.


I am just wondering what my risk is here, and if it is a big deal.

Thank you for your help!

by Edward W Hook, MD, Jul 07, 2008 02:51PM
Let's start by addressing your risk.  You have some, limited degree of immunity from your prior episodes of HPV but still have some risk since just about everyone who is sexually active gets HPV sooner or later.  If you get it, odds are that your body will also get rid of it without therapy in 6-12 months.  As a result, I do not recommend HPV testing since there is no reason to treat a positive test.  The indication for treatment of HPV-related problems is Pap smear abnormalities, not the presence of HPV itself.  In addition, the actual risk of your exposure is not terribly high- there was condom protection (partial, if not more), as well as the presence of intervening underwear.  In addition, transmission from genital to hand to genital is unusual.  

Most doctors will give the HPV vaccine to women over 26.  The problem is that you would have to pay for it yourself since most insurance companies will not pay for vaccine n women over 26 - the vaccine itself costs about $360.00 and there may be additional administration costs.  You might want to discuss this further with him/her.

For addition information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA)..

Hope this helps.  EWH


Member Comments (10)

by panicky28, Jul 07, 2008 03:05PM
To: Dr. Hook
Thank you very much. I was doing a little more research and have a follow up to this question, but it is about molluscum.

I have noticed recently some clear bumps on my lower stomach righy above my pubic area. I was sexually active with one individual back in march, who had recently had a full std check including a herpes test. but now I am wondering if these bumps are molluscum. I did the bad thing and I popped them, they had fluid inside (like a blister). I am not sure if molluscum behaves that way. I am going to ask my GP on friday as well, but peace of mind would be helpful too. I have also had some other bumps  but I believe they were clogged sebaceous glands.

These were very very small, I would never have noticed them if I hadn't been seriously inspecting my skin.

Thank you again.

by Edward W Hook, MD, Jul 07, 2008 03:13PM
Molluscum is best diagnosed with direct inspection as you will have Friday however what you describe is not typical for molluscum. Molluscum lesions have a white "core", not the clear material you describe.  EWH

by panicky28, Jul 07, 2008 03:21PM
To: Dr. Hook
Great. The other bumps I have had did have a "core" but they were not as raised, they also did not bleed after the core was extracted.
I will make sure to have my GP check everything out though.

Thank you again!

by panicky28, Jul 08, 2008 02:08AM
To: Dr. Hook
I just looked over the HPV "myths" on the ASHA website, and I am a bit confused. In one place it mentions clearance, and in another it says that the virus can be "latent" for years. How can you tell if you cleared it or if it is just latent?

I had a negative test in December, I thought that means my immune system cleared the virus. Should I worry that it is just latent?

by mayflowers, Jul 08, 2008 12:24PM
*bump*

by panicky28, Jul 08, 2008 01:48PM
To: Dr, Hook or Dr. Handsfield
I am still very confused, and quite worried. I just did a search and pulled up this from the CDC
http://www.cdc.gov/eid/content/14/6/888.htm

which states that it is possible to transmit between hands and genitals.

by panicky28, Jul 08, 2008 03:30PM
do I need to pay again to get my follow up questions answered?

by Edward W Hook, MD, Jul 08, 2008 04:46PM
No, you don't need to pay but you do need to be patient.

As for the ASHA website, we're talking about apples and oranges although both are related to HPV.  Clearance does occur in most HPV infections even without therapy.  This is true both for visible warts and for the "flat" warts which cannot be seen but are detected by Pap smears.  This latter group, which represent a small proportion of all HPV can linger, or persist. You have no evidence of persistent infection.  Just continue to get your usual Pap smears.

Hand to genital transfer.  Anything CAN happen.  At the same time for this to occur is very, very rare.  Most of the warts that occur on the hands do not infect the genital tract well.  Remember, the CDC' stance tends to be the most conservative possible.  EWH

by panicky28, Jul 08, 2008 06:21PM
To: Dr. Hook
I am so sorry for my impatience, I know it is coming off poorly online. I really am patient I am just new and not sure about how things are handled. I don't want to impose :-)

oh, and to be clear I meant genital to hand to genital...as in he touched his genitals and then touched mine right after, THAT is my main concern here.

Thank you again, you are putting me at ease which helps a lot.
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