a REAL HPV answer....?

[sugarsphinx007]

Thank you, Doctor, in advance for this question. I did go through the past forums and answers before typing this,but it didn't specifically fit that well to my situation. My question/situation is this:
  
I've dated someone for 2 yrs now, we had gotten tested a few times and decided to do away with condoms after such time/results. About 2 months ago, he noticed bumps on my anus. I shrugged it off as another side effect of having severe IBS, and most likely a tear or irritation of some sort. I eventually went to the clinic, it was indeed HPV. They have been treated and are gone. However, during the time we were waiting to see if they went away previously, we continued to have sex, leaving the part in question out of any encounters, just in case.
Now I am wondering how to have a sexual relationship, still, with a minimum of any other fiascos. And Im not getting any definitive answers. I would bet that my partner does have it, just hasn't shown any symptoms. Could have even gotten it from him. We're used to carrying on in the bedroom a certain way, and I just want to know, once and for all, what is ok and what isn't. We would both have the same strains, engaging in all kinds of encounters, where by rights, this should have gotten farther than a few little bumps on one person. It may not be the most diplomatic question, but what's going on and, really, what can we get away with and be ok?
I've heard oral sex is a worry, I've heard it isn't. Is it, and how much? I know if my anus is involved in anything, protection, obviously, but what about him? How much of a risk am I with no visible warts? Do genital ones stay only in a genital area ? I had a nurse tell me this could be absolutely anywhere on my body and I needed to be aware of that, and could even spread it further to myself (toweling off out of the shower, shaving, etc...), how accurate is that? I'm just really frustrated and just want to know what to do from here on out. Any help would be amazing. Thank you.

[Edward W Hook, MD]

The topic of HPV and genital warts is a complex one.  I will try to provide some facts.  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)..  Unfortunately however, there is much that remains to be learned about HPV.

You have HPV and this concerns you.  It should not.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 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.  For men there is far less risk of any sort.

You are correct that your partner likely has HPV.  Who gave what to whom is a question which cannot be answered with any accuracy and really should not be a concern either.  As far as continued sexual activity, neither of us on this site feel strongly that the presence of warts or HPV infection should constrain your sexual activities with your partner in any way (including oral sex).  Should a wart appear, it can be treated.   Similarly, you should have regular Pap smears to prevent the really important, but rare consequences of this most common of STDs.

Hope these comments help.   EWH

[sugarsphinx007]

Thank you SO much, but I wasn't so much asking that question because of a major concern or worry (I know ultimately, HPV really isn't a huge deal), and that warts can be easily treated, it's just they're a pain to deal with and I would prefer to not have them spread or pop up anywhere else. I was basically just wondering what I could do with my partner the way we usually do (little or no protection worries), and/or what I should think about protecting a little more, without it spreading anymore to anywhere else. As far as treatments go, warts are easy, but I would prefer to not go through that again if I can help it. Ive always really just been asking what can we get away with (w/ little worry), and what should we change or think about a little more (avoid, or protect) if I want to keep the possibility of seeing warts again, down?

....And your help is greatly appreciated.

[Edward W Hook, MD]

Sorry if I got off track.  arriers (i.e. condoms mostly) are the major means of protection and they are not perfect but they are proven to reduce risk, both for warts and for HPV in general).  EWH