What now?

I recently fooled around with a guy (including performing oral sex) who told me AFTERWARD that he has HPV.  Caught off guard, I didn't know what questions to ask him.  Now I've done some research and told him I need talk to him so I figure out how best to protect/prepare myself for whatever may come of this.  I have a feeling he has genital warts, because I noticed some bumps in the area.  I know I need to find out what type HPV he has, but other than that, what questions should I ask?  Also, what is a reasonable amount of time to let go by before I get myself tested?  And does my being in the middle of my Gardasil vaccine series have any bearing on whether or not it may have been transmitted?  Further, I know Gardasil protects against 4 types of HPV, including the types that cause the majority of genital warts - but does it protect 100%?  Or is there still a risk?  And if I ever encounter a potential sex partner with HPV in the future, is there any real way to protect myself, since using a condom can only do so much?  

Thanks!

[Edward W Hook, MD]

Before I start to address your questions, please let me comment that this guy has done the right thing by you in telling you he has HPV.  Many persons would not have been forthright.  I hope that my comments below will help to put things in perspective.  Because I don’t' know what sites you've been looking to for information, I will add one more.  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)..

The topic of HPV and genital warts is a complex one. HPV is the most commonly acquired STD.  Over 85% of sexually active women and a similar proportion of men (there is less information available for men) will have HPV infection at some time in their lives.  In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  the types of HPV that cause nearly all visible warts, HPV 6 and 11, rarely cause cancer.  Conversely, the types which are associated with the largest proportion of cancer, types 16 and 18 rarely cause visible genital warts.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-10 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  No, on to the questions and comments you've made:

1.  It really is not important for you to know what type of HPV is causing his HPV.  Few men are aware when they have other HPV types.  HPV 6 or 11 is far and away most likely and if it is some other type, I am not sure what one would do with the information.

2.  Your really don't need to be testing.  As indicated above, nearly everyone has HPV.  What you do need to do is 2 things -1.  get the HPV vaccine which you are already ding and which should reduce your risk for getting visible genital warts tremendously and 2.  like all women, get regular Pap smears to check the rare consequence of warts that we are really concerned about - pre-cancerous changes which need to be treated to prevent development of cancer.

3.  Your HPV vaccine should offer partial protection at this time.  How much is hard to say.

4.  If you have other sex partners, you can be just about sure that you will encounter HPV so don't even think that you can avoid it.  Condoms are still a good idea for many reasons and they do reduce risk for HPV but worrying too much about HPV is really not a terribly productive thing to do.

Hope these comments help. I am not trying to minimize the importance of understanding the issues of HPV but also trying to put things into proper perspective.  EWH

[RickH1051]

A related discussion, What does "resolved" mean? was started.