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Latest Study on Oral HPV from JAMA

With all due respect to Dr. Hook and Dr. Handsfield, it seems as though the most recent findings about oral HPV run counter to the advice they've given regarding oral sex and the possibility of acquiring HPV.  Feedback is appreciated.
http://www.npr.org/blogs/health/2012/01/27/145958225/study-1-in-14-people-has-oral-hpv-infection
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101028 tn?1419603004
not much seems alarmist to me at 4 a.m. when I'm reading journal articles at work to stay awake ;)

just because hpv is detected, doesn't mean it's a good chance of transmitting it either. herpes is more my thing than hpv is but I can't recall any articles that looked previously at oral hpv infection and genital detection of the same types in monogamous couples. will give me something to look for this weekend when I work again I suppose :)  If I find anything worthwhile, will post it.

1 out of every 3 of us contracts hpv at some point genitally anyways in our lifetime. we are surrounded by it pretty much. It's part of why we don't routinely test females for hpv who have normal paps and why we don't bother doing penis/anal paps on males ( besides you fellows hear emory paper and rubbing over your penis and tend to run the other way  ). Unless it causes obvious warts to remove or is a cancer associated type, really nothing we can do and all it does is worry folks for no good reason.  
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Avatar universal
I think you're spot on Grace.  If you click on the some the links contained in the article, there's a quote from a doc warning of a pandemic.  You're right, ideally, 'casual' sex is not that exciting when compared to genuine, healthy relationship, but these days the latter is a veritable needle in a haystack. :-)

Again, my main point was that the article makes oral sex seem like high-risk behavior with regards to HPV while the good doctors here suggest otherwise.  Perhaps the article is a bit alarmist, but when I saw that it was published in JAMA I figured it must be of some merit.
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101028 tn?1419603004
honestly I see no pandemic at all to worry about ( I didn't get that from the editorial at all even ).  We've all been having unprotected oral sex forever.  The rates of oral hpv haven't really changed at all and I don't think there's been any real change in the rates of genital hpv either.   If anything, between the hpv vaccines being more widely available as well as widely recommended for both males and females and the increased education overall for protected oral sex, the incidence of infection in theory will be even lower over time :)

If everyone had protected oral sex for the first year with a new partner  and always had protected oral sex with random partners, there would be about 10 posts a day here on the forum and I'd be exhausting my netflix membership since I'd have so much more time to watch tv :)  Oh heck I would probably even feel guilty enough to leave the house to do volunteer work instead of staying home in my pj's to do it online ;)   We know many non-std related bacteria and viruses can cause urogenital symptoms as well as indeed std's do get transmitted from them.  When assessing your risk from an encounter, indeed saying it's almost risk free is actually appropriate but from the educational side that I am more concentrated on, it's really naive to be having unprotected oral sex with relative strangers!   Does that make any sense at all?   I know it sometimes gets confusing!
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1415174 tn?1453243103
ricardo83,
I cut and paste the link in and it gives me a list of places to go. No article. Oh well, I will side with JAMA and agree with what is said.
mkh9
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Avatar universal
Also, a critical concern is/was the safety of, um, 'tending to the colonel.' (cunnilingus).  Both doctors have emphasized over and over again that it's very safe and virtually risk free.  Again, the JAMA study seems to indicate otherwise.  
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Avatar universal
Grace, thanks for the thoughtful reply.  My main issue in posting was the apparent disparity in perceived risk that the good doctors here at Medhelp perceive and what the study indicates regarding oral sex and HPV.  For example, one of the doctors in the JAMA study fears a virtual pandemic of sorts occurring in the the next 10 years whereas, as you pointed out, both doctors consider oral sex to be safe sex.

The link ought to work.  I just checked it via cut and paste.  Thanks for the responses.
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1415174 tn?1453243103
The link you gave me doesn't go anywhere. I can't comment if I can't find the paper to compare. There is a link at the bottom that says all you need to know about HPV, is that it? Otherwise, I don't see it.
thanks,
mkh9
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101028 tn?1419603004
yes indeed this latest study does show that oral hpv is fairly common. That said, it still isn't a huge issue for oral sex.  

If you read the study, the main type of hpv that is associated with head and neck cancers, hpv 16, is just 1% of the types of hpv that were found orally during the study.  so at this point, even though we know you can contract hpv orally , it really doesn't matter as far as a long term health issue.  We could scrape under your fingernails and find a higher incidence of hpv 16 than that!!  

So yes, you can transmit hpv orally - we've known that for years, just this study really breaks it down nicely and was well done. It really isn't an issue though and the incidence of oral warts, regardless of the type, are very low in general. Since the real hpv concern would be developing cancer eventually , either orally or genitally, it's a non-issue. Warts themselves are just a cosmetic concern, not a health risk so it's only the cancer causing types that are really the concern.  We really can't statistically make a difference in getting a risk down from 1% to 0.

thankfully both current hpv vaccines cover hpv 16. Repeating this study in 10 years, would be even more interesting from the medical geek point of view :)  

on this forum, we always recommend if your pants are off, a condom should be worn. even though the overall incidence of std's from oral sex is very low, it protects you from both std's and non-std related infections, saves you worrying as well as saves you from having to frequently test.  I know both Dr HHH and Hook both don't recommend protected oral as much as we do but really it's the smart thing to do if you aren't with a regular partner whose std status you are aware of and trust.  

hope that helps :)

grace
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Avatar universal
If you scroll down a bit, Dr. Handsfield (see link below) states that the acquisition of HPV via oral sex (specifically questions 12 and 13) wherein he states " Oral warts are rare, despite the frequency of oral exposure to HPV and undoubtedly to warts themselves."  This, in my opinion, seems quite at odds with the recent study found in JAMA.  It'd be great if either doctors could chime in and clarify their previous statements in light of this new study.  Here's the link to Dr. Handsfield's Q & A on HPV: http://www.hpvforum.com/forum/forum_posts.asp?TID=584
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1415174 tn?1453243103
Would you direct me to the Q&A  you are talking about so I can compare?
thanks,
mkh9
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1415174 tn?1453243103
Ok, I read the article what is your question? I'm not sure what Dr. Hook and  Dr. Handsfield say but the article seems to be correct from what I know about HPV, and oral or cervical cancer.
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Avatar universal
This online Q & A with Dr. Handsfield is a good example of advice that seems to run counter to the above NPR link via JAMA.  Please note that I'm not, in any way, trying to discredit Dr. Handsfield nor Dr. Hook as they provide an invaluable service with their expertise.  Nonetheless, this latest report seems to be cause for great concern.
http://www.hpvforum.com/forum/forum_posts.asp?TID=584
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