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UofW question Dr. HHH Ex with HPV HSV 2
I am a male with HSV 1 oral who ended a relationship with my ex girlfriend who had HSV 2 Genital only and HPV for two years prior to meeting me. Her HPV may have been higher risk as she had a LEEP procedure a couple months before we engaged in any sexual activity to remove problems found during a routine OBGYN visit. We had condom protected genital sex only a few times, but engaged often in oral sex due to it's lower risk nature. Our relationship lasted for about six months.
I visited my doctor at the end of the relationship in 2009 and received murky answers, and thanks to this site I am now much more educated.
I was tested by WB roughly 6 months after our last sexual encounter at university of washington and received a negative result for HSV 2 and positive for HSV 1 (which I knew I already had orally) I have never noticed any lesions although I look for them often. My ex only had one noticeable outbreak (which was questionable if that indeed was what it was) during our time together, we were not sexually active during the outbreak (she was not taking valtrex or any other treatment for her HSV).
(It has now been two years since I left my ex)
We were told that LEEP removed the HPV, but I know now that is incorrect and I am likely infected.
My Questions:
1. Am I clear on the HSV 2 at this point? Do I need to disclose anything regarding my HSV 2 exposures?
2. I have had one oral sex partner and a second condom protected genital sex partner after I got my WB results. So six months after my last exposure I had new two partners in 2010. Due to unclear guidance from my doctor I did not disclose my HPV infection to either of the two new partners. I would have if I knew there was risk. Should I call them now and tell them?
3. What were my partners risks for HPV and HSV 2?
4. I understand HPV is an expected outcome of sex, but since the LEEP procedure indicates a higher risk type does this change the rules for disclosure?
I visited my doctor at the end of the relationship in 2009 and received murky answers, and thanks to this site I am now much more educated.
I was tested by WB roughly 6 months after our last sexual encounter at university of washington and received a negative result for HSV 2 and positive for HSV 1 (which I knew I already had orally) I have never noticed any lesions although I look for them often. My ex only had one noticeable outbreak (which was questionable if that indeed was what it was) during our time together, we were not sexually active during the outbreak (she was not taking valtrex or any other treatment for her HSV).
(It has now been two years since I left my ex)
We were told that LEEP removed the HPV, but I know now that is incorrect and I am likely infected.
My Questions:
1. Am I clear on the HSV 2 at this point? Do I need to disclose anything regarding my HSV 2 exposures?
2. I have had one oral sex partner and a second condom protected genital sex partner after I got my WB results. So six months after my last exposure I had new two partners in 2010. Due to unclear guidance from my doctor I did not disclose my HPV infection to either of the two new partners. I would have if I knew there was risk. Should I call them now and tell them?
3. What were my partners risks for HPV and HSV 2?
4. I understand HPV is an expected outcome of sex, but since the LEEP procedure indicates a higher risk type does this change the rules for disclosure?
MEDICAL PROFESSIONAL
Yes, you have correctly interpreted Dr. Koutsky's study. The only potential uncertainty is whether her research patients were typical of the general population of university-age men, but they probably were. If the risk level remains similar beyond a 2 year period, it is likely that well over 50% eventually would acquire high risk HPV types.
That will end this thread. Take care.
That will end this thread. Take care.
Thanks Dr. HHH. Again your words are encouraging. I know that anxiety induced questions are a pet-peeve of this site, so I will not abuse the privilege to speak with you. You actually replied just as i was about to tack on one last question. Your replies actually have been incredibly prompt. I'm betting you are the guy who is never late for a meeting? haha.
Your University provided some interesting background on High Risk HPV in Men, which somehow I found comforting, as it appears to be very common. The quote was from an abstract from Laura A. Koutsky:
"We have been conducting a longitudinal study of the natural history of HPV infection in young men at the University of Washington in Seattle, USA and previously found the cumulative incidence of HR HPV infection over a two-year period to be 47.9%"
Can I take this to mean that nearly one in two men may have an HR HPV infection at any time over the course of two years, or am I misinterpreting? If so, could you clarify? that is all I will have. Your valuable time is greatly appreciated and I am indebted to you, Sir.
Your University provided some interesting background on High Risk HPV in Men, which somehow I found comforting, as it appears to be very common. The quote was from an abstract from Laura A. Koutsky:
"We have been conducting a longitudinal study of the natural history of HPV infection in young men at the University of Washington in Seattle, USA and previously found the cumulative incidence of HR HPV infection over a two-year period to be 47.9%"
Can I take this to mean that nearly one in two men may have an HR HPV infection at any time over the course of two years, or am I misinterpreting? If so, could you clarify? that is all I will have. Your valuable time is greatly appreciated and I am indebted to you, Sir.
MEDICAL PROFESSIONAL
Your former partners' paps are none of your business and I strongly urge you to say nothing to them. You are not responsible for their adherence to pap test recommendations, which is absolutely no different than for all women.
I'm not aware of any more precise data than those that you quote, except that most experts believe 80% is an underestimate. Probably closer to 90-95% of all women (and men) acquire HPV at least once. I would guess that up to 50% get a high risk type at least once, maybe more.
Try to stop obsessing about this. HPV isn't worth so much angst!
I'm not aware of any more precise data than those that you quote, except that most experts believe 80% is an underestimate. Probably closer to 90-95% of all women (and men) acquire HPV at least once. I would guess that up to 50% get a high risk type at least once, maybe more.
Try to stop obsessing about this. HPV isn't worth so much angst!
Thank You Dr HHH. Your response was very helpful. I am still trying to digest all of this, as I still have some heavy guilt. I do not know if my second two partners get regular PAPs so I am unsure if I should inform them of their risk to encourage them to be checked or if that would cause undo anxiety.
I did some further research with JAMA studies, and it appears that 15% of women at any time have high risk HPV. I also understand that 80% or more women get HPV in their lifetime... Do you know a specific statistic for women to get HIGH RISK HPV over their lifetime?
I hope it does not sound as if I am being trivial, just trying to weigh my partners' risk levels against causing them undue worry.
I did some further research with JAMA studies, and it appears that 15% of women at any time have high risk HPV. I also understand that 80% or more women get HPV in their lifetime... Do you know a specific statistic for women to get HIGH RISK HPV over their lifetime?
I hope it does not sound as if I am being trivial, just trying to weigh my partners' risk levels against causing them undue worry.
MEDICAL PROFESSIONAL
Welcome to the forum, and thanks for your question. FYI (mostly for other users who might be reading): it is only by chance I'm answering it. Dr. Hook and I take questions randomly, without regard to specific requests. Our opinions and advice never differ significantly.
Half or more of the sex partners of HSV-2 infected people never catch it, even after several years of regular unprotected sex. Your risk is thus quite low, especially with only a few episodes of unprotected vaginal sex. Second, since you obviously have been alert to the possibility, you probably would have noted symptoms if you had become infected. Third, the blood tests are very accurate, and your negative Western blot is highly reliable. So in combination, the relatively low risk, no symptoms, and test results amount to virtually 100% certainty you were not infected.
The large majority of HPV infections are cleared by the immune system within several months, and your partner's LEEP indeed probably sped up that time frame. That said, there never are guarantees about HPV. But since all sexually active people are infected at one time or another, often several times, and most infections are never noticed and clear up, it really doesn't matter very much. You were not wrong to have said nothing to your subsequent sex partners. Not everybody agrees on this, but that's my perspective.
Those comments cover your questions, but to be explicit so there is no misunderstanding:
1) For sure you don't have HSV-2 and need not say anything to future partners.
2) Even without condoms for vaginal sex, in my opinion there was no ethical obligation to inform your partners of your past partner's HPV infection.
3) Your latest partners were at zero risk for herpes -- and probably for HPV, but as I said, there is never any way to know for sure about HPV. However, those women undoubtedly have been exposed to HPV before (including high risk strains) and will be again. In the long run, your history makes no difference in their risk of HPV.
4) No, your partner's likely high risk infection makes no difference. In fact, the high risk HPV strains are the most common of all, i.e. more common than most low risk HPV types.
I hope this has helped. Best wishes-- HHH, MD
Half or more of the sex partners of HSV-2 infected people never catch it, even after several years of regular unprotected sex. Your risk is thus quite low, especially with only a few episodes of unprotected vaginal sex. Second, since you obviously have been alert to the possibility, you probably would have noted symptoms if you had become infected. Third, the blood tests are very accurate, and your negative Western blot is highly reliable. So in combination, the relatively low risk, no symptoms, and test results amount to virtually 100% certainty you were not infected.
The large majority of HPV infections are cleared by the immune system within several months, and your partner's LEEP indeed probably sped up that time frame. That said, there never are guarantees about HPV. But since all sexually active people are infected at one time or another, often several times, and most infections are never noticed and clear up, it really doesn't matter very much. You were not wrong to have said nothing to your subsequent sex partners. Not everybody agrees on this, but that's my perspective.
Those comments cover your questions, but to be explicit so there is no misunderstanding:
1) For sure you don't have HSV-2 and need not say anything to future partners.
2) Even without condoms for vaginal sex, in my opinion there was no ethical obligation to inform your partners of your past partner's HPV infection.
3) Your latest partners were at zero risk for herpes -- and probably for HPV, but as I said, there is never any way to know for sure about HPV. However, those women undoubtedly have been exposed to HPV before (including high risk strains) and will be again. In the long run, your history makes no difference in their risk of HPV.
4) No, your partner's likely high risk infection makes no difference. In fact, the high risk HPV strains are the most common of all, i.e. more common than most low risk HPV types.
I hope this has helped. Best wishes-- HHH, MD
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.
