positive low risk hpv

[monica1107]

i am a female in late 20's. i tested positive for low risk hpv. i have several questions because my pcp is the one who did the pap and seems like a gyn or std expert would have more knowledge and i don't have insurance and much money to have another counsultation with another dr. so here goes.......

1. i don't have any visible warts, does this mean that i will get warts later?
2. what do i do if i see warts? where to go?
3. can i still have sex with my partner? he doesn't have any visible warts at this time either.
4. now what? am i suppose to repeat my pap in 6-12 months?
5. is oral sex okay? will i get warts orally?
6. i had little lesions(2) around my anus and went to the dermatologist and they did a biopsy. the results were that they were not hpv (dx:squamous papilloma)...so is it possibly related to the positive hpv pap i had? could it be like a "pre" hpv wart warning that my body is giving me?

thanks in advance

[Edward W Hook, MD]

Generic answer first, then on to your specific questions.  The topic of HPV and genital warts is a complex one.  I will try to provide some facts.  For addition 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)..

HPV is the most commonly acquired STD.  Over 85% of sexually active women 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.  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.  With this as background, let's address your questions:

1.  Not necessarily.  Many people never see any manifestations of their HPV infections.
2.  There are multiple options.  Your local STD clinic may be helpful.  Often treatment takes several visits for application of local therapy.  As noted above, another option is to just wait them out - in many persons they ressolve by themselves.  
Finally, there are several topical medications that your health care provider could prescribe for you if you wished to treat them, should they appear.
3.  Sure.  He's been exposed and, despite not seeing them, he may have given them to you. In any case, you should discuss the infection with him.  
4.  That's about it - repeat PAP and don't let this get to you.  HPV infections are present in just about everyone at some time in their life.
5.  Oral sex is OK.  Oral warts occur but very rarely.
6.  Nope, the biopsy results indicate that they are unrelated.

Hope this helps.  Take a look at the web site.  EWH

[Edward W Hook, MD]

Stright to your questions:

1.  No risk
2.  It does mean that an infection is present and thus could be detected through your PAP smear
3.  It is low risk, I would say 6 months.  If no change or gone, then 12 month interval thereafter

EWH

[monica1107]

thank you so much for your reply. i would like to ask 3 more questions. sorry i didn't ask them before but it's kinda overwhelming right now and kinda of hard to swallow....

1. can i share utensils, drinks, etc with my kids and also kiss them on the lips?
2. my positive low risk hpv status at the current moment...does it mean that i'm hpv "active?"
3. when should i do a repeat pap? 6months? 12months? my dr seems to not have much knowledge since a pcp and not gyn.

thanks again so much!!!