HPV Transmission

[david1234]

Dear Sir,

I am currently under the care of a specialist in the UK - the president of the STD Association, which from what I beleive this was the position that Dr Handsfield previously held in the US.

I first had visible warts just over two years ago, and was at points, having new outbreaks very frequently. The size of frequencys of the outbreaks began to wane about 8 months ago untill I was left with one recurring wart that was getting smaller and smaller. This has now been removed and I believe that it has cleared up.

My specialist has told me that now, four weeks since the wart has been removed, I can begin to have sex with my girlfriend again with NO fears of transmission (she really really doenst want warts - fair enough)    

As proof of this he covered the areas of my penis where i have had warts with a vinegar solution and said that If there were any warts UNDER the skin then they would show up. Nothing showed up and he says that my outbreaks are over and that I can begin to have (risk free) sex.  

Now, on this forum I read people saying that you have to wait SIX months before transmission becomes impossible/unlikely

Furthermore I have read that the vingar test is liable to false negatives. I proposed this to him and he said in fact the only dangers are false positives.

Where do I stand, does your expert opinion corroborate? Can I continue to have sex with my girlfriend?

Many thanks,

David

[H. Hunter Handsfield, M.D.]

I have spent the past 3 days at an STD research meeting in New York, jointly conducted by the American STD Association and it's UK counterpart, the British Association for Sexual Health and HIV.  Assuming "STD association" refers to BASHH, in about 5 hours I will be having dinner with your physician.

Suffice to say that because there are no definitive research studies and there is room for variable interpretation of the available data, equally qualified experts have differing opinions about HPV transmission risk, how long the risk might persist after treatment, the utility of diagnostic tests like acetowhitening (the vinegar/acetic acid test), and such things.

There are no black and white answers in these areas and your doc's perspective on these issues is just as valid as mine.  Since he is your physician and I am only a distant voice who hasn't examined you, and since his expertise equals mine, I suggest you follow his lead.

In any case, it probably doesn't matter. If you and your girlfriend were together before and during the time your warts appeared, you can be sure she already has been exposed and likely infected.  If so, she is immune to catching the same HPV strain again.  So most likely there is no risk to her even if your infection has not entirely resolved.

I hope this helps.  Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

And by the way, I never said it is necessary to wait 6 months after resolution of warts or other HPV infection before resuming unprotected sex.  I have referred to that as a pretty surely safe time, while also recognizing that many infections resolve more quickly than that.  Others last longer.  As I suggested above, the data here are very soft and no hard and fast guidelines exist.

[david1234]

Yes exactly BASHH, I will not write his name on this post out of respect for his privacy, although he is the 'Immediate Past President,'  you should say hello, a very good guy!

I am sure he won't be offended by me searching out a concurring opinion. Although, yes, I understand that there is no hard and fast quantative data on the matter.

We were not together whilst I developed warts, and as such she may or may not have previous exposure.

Well, I wish to err on the side of caution in this matter. Furthermore, my Doctor's opinion was not one tailored to myself morevover it is a belief that upon using the acetic acid test, if nothing becomes white then one is not able to transmit the virus. I have however been told by my previous specialist that he has undertaken much research into HPV and that it is his particular area of interest.

I'll give it another five months. We have waited over a year so another five months can't be disasterous.

Mant thanks

[H. Hunter Handsfield, M.D.]

The initials of the immediate past president are SB.  I have known him for 15 years or so and certainly endorse the "very good guy" judgment.  Presumably he too will be at dinner.

It's up to you, but 5 months seems a pretty long time to me. Why not speak with SB about getting your partner immunized against HPV?  One of the two vaccines available in UK includes the 2 types that cause almost all genital warts.  Although it takes 6 months to be fully protected, probably substantial protection exists a month after the second dose, i.e. 2 months away.  Between both your treatment and her immunization, I am confident she would be effectively proected.

[david1234]

Yes, the very same SB!

Thank you very much for your advice I shall speak to SB about that, although he is adamant that I need no further protection.

Many thanks Doctor and i'll bring you up at my next appointment!

Thank you