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Possible Exposure/Differences in Incubation Time for low-risk and high ...
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The STD Forum 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.

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Possible Exposure/Differences in Incubation Time for low-risk and high risk HPV

I am F/20s, and I have been dating the same person for 4 yrs, he is the only person I have ever had sex with. He had previously had many encounters before me. We have both been tested for STDs (all negative) and I have never had an abnormal pap, nor any other reason to suspect any type of STD. Therefore, if I contracted HPV, it would have been from him and it would have been 4 years ago.

That being said, about a year ago I drank too much and through the little I do remember, I might had sex with someone else, no idea who and doubt it would have been protected. I have been retested for pretty much everything (negative). Had a pap 3 months after, normal. 7 months after I noticed some small bumps that I worried might be warts, however the dr said everything looked fine. I have come clean to my bf, and he forgives me for whatever I might have done, although he has much more faith in me than I do in myself, so if something were to pop up, I don't know if he would be so forgiving. So, some questions.

1. It seems from this forum, that most warts show up in 2-6 mths, and that after this time, you are pretty much in the clear (however this was in response to people who used protection). At the same time, HPV can stay dormant in the system for yrs and then pop up clinically. When I was checked 7 months post incident can I assume I am in the clear, or is there still a decent chance that warts could pop up?

2. Is there a difference in incubation time between high-risk HPV and low-risk HPV? Granted, most infections clear up on their own, but if abnormal pre-cancerous cervical cells were to appear from an exposure, how long does it generally take?

I have noticed some "new" small bumps on my inner labia, which have sparked these concerns. I have an appointment to have them looked at, but it is not for awhile. Thank you so much for your help
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I'll try to help.  First, congratulations on a common-sense, self-protective slant on HPV.  More women should do what you are doing, seeking general information and considering strategies for prevention.  But second, I fear you have gone too far in your search for knowledge.  I have the sense you are overthinking the risks of HPV.  Anyway, I'll start with some general comments, to put my replies to your specific questions into perspective.

As a sexually active human being, you can expect to have a genital HPV infection someday; it happens to almost everybody.  Having had one (and perhaps two) lifetime sex partners, that alone predicts a 20-30% chance you have had HPV already; and since your known partner had several partners, your chance may be somewhat higher than that.  Also, a small proportion of HPV infections probably are acquired by heavy petting (e.g., hand-genital contact) -- another reason a low no. of sex partners doesn't indicate someone is not at risk.

In other words, HPV doesn't behave in the way most people think about most STDs -- literally everyone is at risk, not just those with high risk sexual lifestyles. Further, when someone does show up with HPV, usually it is not possible to know when or from whom it was acquired.  Finally, pap smears really are not a test for HPV.  Women with HPV can have normal paps for years, then pop up with an abnormal one.  (An abnormal pap is good evidence HPV is present; but a normal pap is NOT evidence that HPV is absent.)

These are exactly the reasons that the two main HPV prevention strategies are necessary for all women, not just those with apparent risks for STD.  Those strategies are 1) to be immunized with Gardasil, the vaccine that prevents the 2 HPV strains that cause almost all genital warts and 2 others that cause about 70% of cervical cancer cases.  Once immunized, the chance of important HPV disease is markedly reduced -- even though infection with other types isn't prevented.  And 2) get regular pap smears, which is virtually 100% protective against serious HPV disease.

For all these reasons, I believe you should stop searching on line for bad news about HPV; get immunized; then don't worry very much about it.  Just have a normal sex life, by which I mean you should choose your partnerships based on your own standards and attractions; risk of HPV should not be a consideration.  (Of course, maybe a little common sense if a prospective partner is known for sure to have an active infection at the time -- but that really won't come up very often.)

Finally, remember that almost all HPV infections are trivial affairs.  Even with the high risk types, actual invasive cancer is rare.  And warts are an unpleasant inconvenience, not a health threat that is worth losing sleep over.

OK, lecture over.  On to your specific questions.

1) True, warts normally appear within 2-3 months (maybe as long as 6 months) after exposure.  After that time, it is unlikely someone was infected with a wart-causing ("low risk") HPV strain -- but not impossible.  In rare cases warts may pop up years later.

2) The incubation period -- the interval from catching HPV and appearance of visible warts or pap smear abnormalities -- is no different, to my knowledge, for high risk HPV types (e.g., HPV-16, 18, 31, 45, and others) or low risk ones (e.g., HPV-6 and 11).  However, it is certainly more common for high-risk than low-risk types to cause abnormal pap smears many years later.

3 [below]) I suggest you cross that bridge when you come to it.  But if someday you have an abnormal pap, you should expect to not know exactly where or when you caught it.  It could be from either partner.

You're doing the right thing by having your labial bumps examined.  But most genital warts look just like warts.  Most people have had warts on their hands as kids.  If you did, that's pretty much what you could expect genital warts to look like.

I hope this helps.  Best wishes--  HHH, MD
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Sorry, one more question
3.) If my yearly pap next month turns up abnormal from HPV, is it more likely that I received it from my bf or this other possible encounter? What if exam shows warts, what are the respective likely-hoods?

Thank you so much again, and I apologize if this has been covered before, but I couldn't seem to find it on the previous forums.
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Avatar_f_tn
Thank you very much for your response, it definitely helps ease my concerns. I definitely am over thinking, probably due the extreme guilt and ambiguity concerning the whole situation. Either way, it was good to get some clearer answers about everything!
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