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Some HPV related concerns
About a year ago, my girlfriend gave me oral sex while I had what was a few days later diagnosed as an active wart on my penis by a dermatologist. There may have been a couple of other exposures as well at some point. I wish this had never happened. She has since been vaccinated with Gardisil (3rd dose was 6-8 months ago). She has had no problems since the oral wart exposure/s, but I am anxious:
1) What is her risk of getting RRP? I know it’s very slim for the general population, but what about someone who has in fact been exposed orally to a wart? Is it still nearly as slim as 1 in 30,000? I have read that although even AIDS patients rarely get it, people who get it sometimes have otherwise fine immune systems and they may have some genetically acquired localized immune deficiency. Should I be worried that she will get it?
2) Is she at increased risk for oral cancer? I know that most HPV 6/11 that cause RRP rarely cause cancer and that most visible warts don’t cause cancer, but should I be extra concerned because she was exposed to the wart?
3) Can we just go on with things as normal? We don't want to change our lives in any way, but on some rrp advocacy sites (and I know they are biased at times) it suggested she be actively monitored. This seems extreme if the risk is so minimal.
4) Do I need to worry about this because I have read it can flare up after 20 years? I really don't want to worry for all this time, but I want to know that she will be OK because she's all that really matters to me.
5) We had anal sex a few times with a condom on. I tried to make sure any possibly infected area was covered. Does she need examination or an anal pap?
Thank you.
Ps. I have been having an obsessive episode for the last few months and have contacted you somewhat frequently. I know its abnormal, I hope it will pass soon and that this will be the end of it. In the meantime, your help and knowledge has made my anxiety more manageable. Thanks.
1) What is her risk of getting RRP? I know it’s very slim for the general population, but what about someone who has in fact been exposed orally to a wart? Is it still nearly as slim as 1 in 30,000? I have read that although even AIDS patients rarely get it, people who get it sometimes have otherwise fine immune systems and they may have some genetically acquired localized immune deficiency. Should I be worried that she will get it?
2) Is she at increased risk for oral cancer? I know that most HPV 6/11 that cause RRP rarely cause cancer and that most visible warts don’t cause cancer, but should I be extra concerned because she was exposed to the wart?
3) Can we just go on with things as normal? We don't want to change our lives in any way, but on some rrp advocacy sites (and I know they are biased at times) it suggested she be actively monitored. This seems extreme if the risk is so minimal.
4) Do I need to worry about this because I have read it can flare up after 20 years? I really don't want to worry for all this time, but I want to know that she will be OK because she's all that really matters to me.
5) We had anal sex a few times with a condom on. I tried to make sure any possibly infected area was covered. Does she need examination or an anal pap?
Thank you.
Ps. I have been having an obsessive episode for the last few months and have contacted you somewhat frequently. I know its abnormal, I hope it will pass soon and that this will be the end of it. In the meantime, your help and knowledge has made my anxiety more manageable. Thanks.
MEDICAL PROFESSIONAL
This is your 4th post since last July regarding your concerns. As you n o doubt know, we ask clients not to post more than2 questions on our sites within any 6 month period. You are well beyond this and your questions are really becoming both somewhat redundant and getting further and further along the “what if” trail. I will answer your questions directly but will not entertain further follow-up questions. It is past time for you to calm down and move forward without more concerns either about your pat GF, her risk to you, or your risk for yourself or your current GF.
While I applaud your concern for your GF, I hope that I can give you confidence that you need not be concerned. I will go straight to your questions with generic answers but will add that, having finished her HPV vaccine series, all of the comments regarding your GF’s risk I make above are estimates that are likely far too high:
1. RRP. The risk is tiny. RRP is primarily an infection acquired by infants at the time of delivery. While some adults do get laryngeal HPV-related papillomas, the relationship and risk as it related to oral sex is vanishingly rare. You estimate of less than 1 in 30,000 is likely in the right ball park and if anything, is lower.
2. Dr. Handsfield has recently addressed this questions very well. I will just paste a slightly modified version of his answer in here. "As far as oral sex, HPV, and oral cancer, just forget it. HPV is infrequently transmitted by oral sex. And despite the media attention about oral cancer, it's not a big deal. In the entire US, there are only about 6,000 cases of oral or throat cancer per year that are due to HPV-16, the main genital type that has been implicated; and those occur almost exclusively in people age 50 and over. And it is not at all certain that those people acquired their oral HPV through oral sex. (If one of the articles that concerns you is the one by Dr. Bernadine Healy, former head of the NIH, please disregard it. Her article has been heavily criticized by HPV experts for its non-objective, inflammatory slant.)
3. Yes, by all means go back to normal.
4. No!
5. Condoms work and greatly reduce the risk for HPV transmission. Condom use and her vaccination make this a non-concern.
EWH
While I applaud your concern for your GF, I hope that I can give you confidence that you need not be concerned. I will go straight to your questions with generic answers but will add that, having finished her HPV vaccine series, all of the comments regarding your GF’s risk I make above are estimates that are likely far too high:
1. RRP. The risk is tiny. RRP is primarily an infection acquired by infants at the time of delivery. While some adults do get laryngeal HPV-related papillomas, the relationship and risk as it related to oral sex is vanishingly rare. You estimate of less than 1 in 30,000 is likely in the right ball park and if anything, is lower.
2. Dr. Handsfield has recently addressed this questions very well. I will just paste a slightly modified version of his answer in here. "As far as oral sex, HPV, and oral cancer, just forget it. HPV is infrequently transmitted by oral sex. And despite the media attention about oral cancer, it's not a big deal. In the entire US, there are only about 6,000 cases of oral or throat cancer per year that are due to HPV-16, the main genital type that has been implicated; and those occur almost exclusively in people age 50 and over. And it is not at all certain that those people acquired their oral HPV through oral sex. (If one of the articles that concerns you is the one by Dr. Bernadine Healy, former head of the NIH, please disregard it. Her article has been heavily criticized by HPV experts for its non-objective, inflammatory slant.)
3. Yes, by all means go back to normal.
4. No!
5. Condoms work and greatly reduce the risk for HPV transmission. Condom use and her vaccination make this a non-concern.
EWH
Thank you and I promise that I will not post again after this. I should have mentioned, however, that the anal sex with condoms was before the vaccination. Does this make it anymore of a concern or is it still a non-concern? I promise this is the last thing I will ask and from here on out will take your advice to just move forward. Thank you again.
MEDICAL PROFESSIONAL
No change. End of discussion. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
