Potentially cancer-causing HPV infection - Help

[matt808]

I am a 22 year-old male in an open relationship with a 26 year-old female. I and her frequently have unprotected sex (she takes birth control pills). A month ago, I had unprotected oral sex (her on me) followed by protected vaginal sex with a different 21-year old woman and I have since had unprotected vaginal/oral sex with my girlfriend. I recently found out that the woman I had sex with once was discovered to have precancerous cells forming in her cervix (she claims that her has never has any genital warts). My concern is that I may have contracted a cancer-causing strain of HPV and passed it on to my girlfriend. My questions are:

1- What are the odds that I have contracted a cancer-causing strain of HPV based on that one ("protected")encouter?

2- Knowing that this IS a cancer causing strain, what are the odds that my girlfriend, if infected, will get cancer?

3- What are the odds of me eventually getting cancer if I am infected?

4- How should I and my girlfriend be monitored from here on knowing that we may both be infected with a cancer-causing strain of HPV?

5- What additional information, if any, should I ask the HPV infected woman I had sex with for? (about her condition, type of strain, etc.)

[Edward W Hook, MD]

I thought I had answered these questions.  Please re-read my answer an look at the web site.

You are asking for specific percentages when such data just do not exist. There are no per exposure estimates of transmission.  Further, as I said, testing is NOT recomended, regular PAP smears of the such all women get are.  I also indicated that the odds of getting cancer from a high risk strain are tiny, less than 1% particularly if she gets regular PAP smears.

  EWH

[matt808]

Thank you for your quick answer Doctor.

I would pehaps like slightly more specific information if that's possible.

My main concern is that because my one-time sexual partner has developed pre-cancerous lesions, does that not suggest that, if I am infected, I am carrying a higher risk strain? Does that not merit a more careful handling of the situation?

The most important thing to me is that I not put my girlfriend in danger. I have had unprotected sex with her several times since I was potentially exposed to the virus. Is it possible that I have already transmitted the virus to her or does HPV have an incubation period where a newly infected person does not transmit? (its been a month since I was exposed)

Piece of mind is also very important to us, how long should we wait before she should be tested?

Are the odds of getting cancer from a 'high risk' strain still relatively low? Are there any specific probabilities on the subject of cancer risk per strain?

Thank you so much for your time doctor!

[Edward W Hook, MD]

Welcome to our Forum.  rather than try to answer your specific questions, I'll try to provide general information which, I think, may prove more helpful to you.  The bottom line is that if you have now had sex with two or more persons who have had sex with others at some time in the past, you have probably already been exposed to HPV and may well be currently infected.  In studies of women with a single partner, the rate of acquisition of HPV is 25-30% per year and with more than 1 partner, the rate accelerates over time. Most of us in the field believe that HPV is to be expected for virtually all sexually active persons.  Of those who become infected, only a tiny minority (in the range of 1%) go on to develop cancer and those are able to be detected early and cured with PAP smears.  That said, we want to do what can be done to prevent HPV. for this reason we strongly endorse the HPV vaccine for all sexually active persons.  While rather expensive it is highly effect for prevention of the HPV types that cause over 90% of genital warts and about 66% of cervical cancers.  

Monitoring/testing for HPV is not necessary of recommended.  for women, monitoring for the adverse consequences of the virus, i.e. abnormal PAP smears remains the recommended approach.   Testing for HPV would just cause confusion. For men there is no current recommendation for monitoring at all, other than to watch for lesions and have them evaluated if they appear.  

You can ask directed follow-up questions of me on this forum if you wish.  At the same time, there is more to learn than I can do in the limited time/space available.  For additional 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)..  EWH