Human Papillomavirus (HPV) Community
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Detailed Compilation about ORAL-GENITAL HPV Transmission: 2018

This is a comprehensive compilation about what I have researched about HPV Transmission. This isn't a substitute for proper consultation but this is what I have found and compiled so far about what is known about HPV.
This is something I did for my personal use, and you may not find it useful but if you are in a scenario like me. This could maybe help you. You might not have to go through what I had. Best Wishes to the readers.

HPV Transmission

Genital to Genital: EFFICIENTLY spread in genital to genital sex with or without condom since there would be a lot of contact in areas that are not covered such as the scrotum or the base of the penis that is below the condom.

Oral to Genital/ Genital to Oral: INEFFICIENTLY since oral infections are rare & from a biological perspective the transmission is inefficient with only occurring in a small fraction of people. So it is POSSIBLE- nothing is impossible but it is RARE. Below are compilations from the most recent replies of EWH and HHH in asha asktheexperts forum (2016-2018 data) to support this claim.

**BTW these 2 doctors are claimed to be experts in the field of STDs. The following were from what they replied to their clients over a series of different questions. I just so happen tried to compile what they said in different scenarios, exposures and times.

Statements from EWH:

*HPV is VERY RARELY acquired from oral sex but it can happen sometimes.
*Warts RARELY result from oral sex and condoms should EFFECTIVELY PREVENT warts on the penis
*HPV DO OCCUR in the throat but they are POORLY transmitted by oral sex and a single exposure would RARELY lead to infection.
*Acquisition of HPV from oral sex is quite uncommon and there is no precise figures on risk acquisition

Statement from HHH:

*Oral sex ALMOST NEVER transmit warts.
*Most oral exposure to HPV doesn't result in infection, and oral warts are RARE.
*There are no data on the risk of oral HPV from a single episode of sex.
*First, oral warts are RARE, even in people who regularly perform oral sex on partners with genital warts.  It is VERY UNLIKELY you will ever have a serious complication of oral HPV or that you will be a risk to future sex partners.
*There are no data, but I think the chance you have oral HPV from a single episode of performing fellatio is EXTREMELY LOW. And who cares? If you had it, it will have gone away by now; and oral sex DOES NOT FREQUENTLY transmit HPV.

So in conclusion, we can say that oral transmission in either directions is RARE, VERY UNLIKELY, DOESN'T FREQUENTLY, ALMOST NEVER, EXTREMELY LOW..

4 Responses
Avatar universal

So yeah we know that they cant say NEVER or 100% IMPOSSIBLE since they are doctors and their words on public website could sue them in the case it ever happens but as per communication with another member in this site that has his own experience with his doctor, he states that its 100% impossible but the doctors here couldn't say it publicly. For my account I would also say yeah, so it is then that this route of transmission is so rare that is less than 1% chance in happening..

Also from a post by HHH during 2010.https://www.medhelp.org/posts/STDs/Protected-Oral---Risk-Factor-HPV-Herpes/show/1313159

In this post a similar guy have the almost exact exposure as I do and almost the same concern. To summarize the key points from the conversation between him and Dr HHH regarding his HPV and Herpes risk factors.

Dr HHH said:

*Oral sex is very low risk even without a condom.  With a condom, it isn't just "low risk", but zero.  No STD can be transmitted through an intact condom membrane.

- Zero Risk is a dangerous statement to say online, but I think this is what is his personal opinion based on his 30+ years of experience. BTW HPV had always been there since long ago. Nothing much has changed in 30 years, I also tried to get his most recent statement regarding this. Though his tone has changed by saying its extremely rare or almost zero and things like that. If you would read between the lines it means that even in the span of 8 years nothing much has really changed in the discovery of how HPV and other STDs are transmitted.

*Zero risk for HPV, which is generally not transmitted by oral sex even without a condom.  Even people at highest risk for STD, and those with genital HPV infection, usually don't have the virus present in their mouths.

In the following reply the forum user started to using his research and asked about what the CDC says about HPV being passable via oral routes and that condom only lowers the risk and he sees a potential disconnect with what HHH and CDC has stated. This would have probably be my reply if Dr. HHH said something like that to me. It seems that his over confidence over this issue was questioned by the user.

Dr HHH replied saying: There are lots of uncertainties about HPV and its epidemiology, and research could make some aspects of today's knowledge wrong.  And in the absence of definitive data, alternate opinions are easy to find.  The harder you search for information, the more likely you will find potentially conflicting replies. There are lots of uncertainties about HPV and its epidemiology, and research could make some aspects of today's knowledge wrong.  And in the absence of definitive data, alternate opinions are easy to find.  The harder you search for information, the more likely you will find potentially conflicting replies.

*** Recent replies from EWH and HHH regarding HPV also made mentions of this, as if the in the span of 8 years nothing much has changed. Though it is probably also a good thing since what the CDC states here is possibly on a theoretical basis POV vs the doctors who has first hand experience. The CDC has to be careful in what they are saying though.

The way HHH replied speaks about the truth of the information known about HPV- still not much is known. There  aren't data available yet even as of recent. Then also the part where there are potentially irreconcilable differences since not much is really known. But for me, IMO i believe what these doctors say are more realistic since they have been in the field. They are old and they have tons of experience- compared to what the other websites state.

***So what he says is Any risk of HPV transmission from mouth to genitals is theoretical.  I am unaware of any reported proved transmissions by that route, even without a condom. Probably it doesn't make much difference whether or not the oral partner is "careful" to avoid contact above the condom.  Only a few percent of people with genital HPV have the same infection in their mouths, and usually in small amounts that may not be transmissible.

- This again would confirm what he said recently in 2017 when EWH or HHH like when they say that it can happen sometimes- but I guess these are just careful statements.  Only a few percent of people with genital HPV have the same infection in their mouths, and usually in small amounts that may not be transmissible. When HHH said its theoretical and he is unaware of this transmission means that in his vast experience in over 30 years he hasnt seen anything like this. He might probably see it recently but if basing on the replies he made last year, he still use the words ALMOST NEVER, RARE and VERY UNLIKELY.

The user also made this comment. Closing issue for anyone who reads the thread on a search:

To double cover, went to both free clinic in city and my general practiciner in the city to talk about my exposure and my symptoms.  Both heard the same account as Dr. HHH and said the same thing.  Any risk was, at most, THEORETICAL and I was cleared medically and ethically to pursue normal sexual relations with my partner.

And Dr.HHH stopped replying to that thread.

So the thing that we can conclude here in his post during August 2010 with the most recent available data in 2017 in his replies at the other forum, strongly suggests that its in the low risk category of ALMOST NEVER.

So we can conclude that by TRANSMISSION FROM ORAL ROUTE it is VERY LOW RISK. But given the chance transmission does occur what are the consequences then?

They state there are 3 possible types of HPV:
1. Low Risk- Warts causing
2. High Risk- Cancer causing
3. Other Types- neither of these

So all in all what they say is that these infections do clear up and are usually treatable and doesn't really cause any serious problems.

*The chance you will someday have oral cancer due to HPV is 1.6% of the risk of all cancers (in males in the US, 14,000 pharyngeal per year versus total 850,000 for all cancers  
- this is good news since its more likely by 60x to get other forms of cancers than from HPV.

*The good news is that, as noted above, the large majority of HPV infections are never clinically apparent and cause no harm. Nevertheless, it appears you are obsessed by all this. I encourage you to do your best to gain a new perspective on HPV as an expected, unavoidable, most mostly harmless consequence of human sexuality. Young people should be immunized, women should have pap smears, and everyone should have any unexplained genital lesions or sores professionally examined. Otherwise, just forget HPV and go on with life.
- pretty straightforward

*Most HPV infections are cleared by the immune system, and surgery for HPV problems also helps clear it and reduces transmission risk. Someone who had HPV 11 years previously, and had surgery, is unlikely to still be infected now.

*Almost all HPV infections clear up on their own, and that certainly would include any infection your husband acquired from you. Penile cancer is very rare, even with HPV, and almost always easily curable without drastic treatment. It's really nothing to be worried about.

*-The VAST majority (well over 95%) of all genital HPV infections, including those associated with cancer, resolve without leading to cancer.  The concept that if you slept with someone and they were to get HPV and go on to get cancer (a process which takes years or even decades) is too linear.

So if we try to summarize what EWH and HHH answered, its is said that most infections are usually treatable and they resolve.
So if you had a protected oral sex- which is very low risk exposure event compared to unprotected vaginal, protected vaginal or unprotected oral.

and you had an oral transmission- which is also very inefficient, rare and almost never happen as compared to genital to genital transmission that is frequent in protected/unprotected vaginal.
**Protected oral would still be considered safer than Unprotected oral since the area of exposure is reduced significantly.

So.. The mathematical result of Low Risk Exposure * Low Risk Transmission * Low Consequence of Infection= Lowest possible combination of the what could happen.

This is as far and as low as it gets unless you abstain. There is always a possibility since there are no absolutes in the math of probabilities.
* IF you get vaccinated. The risk also drops lower
Avatar universal
Thank you for the compilation.

I hope it's true.  Unfortunately, I think I have oral hpv.  Unprotected oral is the stupidest thing in the world...I didn't get crap out of it except for regret and a lifelong disease.  Don't do it people!

Hi Dumb Decisions 17,

I feel the same way as you. I have lots of unprotected oral sex with my husband and my gyno confirmed that I have HPV 16. I am terrified. Worried sick. Any advice? They have that orarisk test but it is not fda approved. I’m sure I have it so what’s the point. I am scared to death.
If i may ask. how did the Gyno confirm you have hpv 16? did the doctor find something on your mouth?
At this point, knowing the potential for Cancer the only thing I can think to do is:

1. Get checked maybe twice a year by a dentist and ENT, basically oral cancer screening.  I plan to have my throat scoped as well.

2. Healthy life style, get sleep and take immune boosting vitamins that will help the virus remain dormant.

3. Try not to stress or worry. It makes things worse.  Tough bit it really does make things worse.

4. Pray - for no cancer, for a cure to be made available soon, and other good things lol!

Honestly, the mistakes have been made.  All we can do is take better care of ourselves and hope for the best.  

Take care and best wishes to you!
There is also an Oncalert Oramark test that is supposed to detect cancer, but it's not in the US yet.

There seems to be some promising things on the horizon, but who knows if or when they will be available, and with the vaccine I'm not sure it is top priority to do anything about HPV.
I asked my doc, he said we are more likely to get other forms of cancer from worrying too much.

i think we are all anxious here
I did get warts on my lips and I think it is very likely from unprotected oral sex.  The dermatologist told me it could have been from touching something and then touching my lips,  or from sharing a cup or towel.  I did have oral sex about a month and a half ago,  and it is something I haven’t practiced much.  Really dumb decision.  I just wonder how there is people that do this all the time and they don’t have break outs.
Avatar universal
Righhhht  isle39  I’m right there with you
Avatar universal
I believe there is a risk from giving oral ..  how could it not be ??  Doesn’t even make sense !
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