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Advice on HPV as a man

Hi there

I have a situation and neither professionals or Google is offering any realistic guidance.

I'm in a happy long term open relationship. Around a month ago a friend performed oral sex on me.

Yesterday she told me she has had a smear test and tested positive for a high risk strain of HVP.

As a man, what do I do at this point? I've spoken to a doctor, he wouldn't give me any information on realistic chances of having contracted hvp from a one off, oral encounter.

He told me my obligation is to inform future partners. I'm fine with this of course, but for how long? Given there is no testing for men, forever? He sort of just shrugged and let it go.

So some questions that I've really struggled to find answers for online/from my doctor. Any insight would be very much appreciated.

1. What is the likelihood of contracting HPV from a single oral encounter vs say penetrative sex? I found studies that suggested in 6 months of vaginal sex, with an average of 4 sessions a week, only 20% of people managed to pass HPV on to their partner. I've read that oral chance is even lower, can anyone add to this data?

2. Presumably a smear test only checks for HPV present in the genitals? And HPV via oral sex is only transmissible via oral if present in the mouth?

3. Does having no active oral HPV symptoms also lower the chance of transmission? I know symptomless transmission is possible, but how does it affect chances?

4. How does having the HPV vaccine help post possible transmission. Does it help the body clear the infection faster?

5. I understand that 90% of people with the high risk strain clear it within 2 years with no health problems. Of the 10% that remains, how likely are these people to contract cancer?

6. I'm reading that 42% of Americans have HPV, but only 7% have oral HPV. I assume this means the chances are much lower of contracting it in this encounter.

What are the chances of getting HPV from *receiving* oral? Lower or higher than performing it?

7. I'm trying to understand my moral obligations. I want to do right by future partners, but given I can never test to ensure I'm clear what do I do?

Given that I have a fairly active sex life with new partners, do I tell every new partner that I have a small chance of potentially having HPV?

My doctor suggested I do this, but for how long? 2 years when it's cleared on average? Forever? At what point do I sound a little crazy explaining a brief encounter years before that provably resulted in nothing? Any thoughts?

Any help you can offer would be really wonderful, as I'm feeling a bit bewildered by the lack of guidance out there for men who have come into contact.

Thank you ❤️
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207091 tn?1337709493
COMMUNITY LEADER
So I will do my best to answer your questions, but from the start, let me say that it will be a lot of guessing because her pap smear only tests her cervix. We have no idea if she has it in her mouth. We also don't know if your friend was infectious a month ago.

So your questions -

1. What is the likelihood of contracting HPV from a single oral encounter vs say penetrative sex? I found studies that suggested in 6 months of vaginal sex, with an average of 4 sessions a week, only 20% of people managed to pass HPV on to their partner. I've read that oral chance is even lower, can anyone add to this data?

We don't have stats on this, and I'm not even sure about the accuracy of your PIV stats. There is no accurate way to test men, and if they are only going by symptoms, that's not a great measurement. Were condoms used?

Generally speaking, oral sex is lower risk for all STDs than vaginal or anal sex. We do know that much.

2. Presumably a smear test only checks for HPV present in the genitals? And HPV via oral sex is only transmissible via oral if present in the mouth?

Yes, a pap only tests the cervix for the presence of HPV, and HPV from oral sex requires the presence of oral HPV.

3. Does having no active oral HPV symptoms also lower the chance of transmission? I know symptomless transmission is possible, but how does it affect chances?

No, most oral HPV is asymptomatic.

4. How does having the HPV vaccine help post possible transmission. Does it help the body clear the infection faster?

There's no real good evidence for this, but it sure doesn't hurt. If you've not had the vaccine, and you are this worried about HPV, you should get it. HPV is incredibly common - it is estimated that upwards of 90% of us will get it at least once in our lifetimes. You may have already had it and not known it.

5. I understand that 90% of people with the high risk strain clear it within 2 years with no health problems. Of the 10% that remains, how likely are these people to contract cancer?

Not likely. In the US, HPV causes 3% of all cancers in women and 2% of all cancers in men. (https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer#cancers-caused)

6. I'm reading that 42% of Americans have HPV, but only 7% have oral HPV. I assume this means the chances are much lower of contracting it in this encounter.

Yes, that's accurate.

What are the chances of getting HPV from *receiving* oral? Lower or higher than performing it?

Depends on who you're performing it on. If you only perform it on vaginas, it's lower than if you perform it on men.

Receiving oral is probably lower risk than if you have a vagina than if you have a penis.

This is true for all STDs. Most STDs reside in the throat. The penis enters the throat during oral sex. The vagina doesn't.

7. I'm trying to understand my moral obligations. I want to do right by future partners, but given I can never test to ensure I'm clear what do I do?

Your doctor is an alarmist. You received oral from someone who has genital HPV, and who was kind enough to tell you.

If you are using condoms for vaginal and/or anal sex, I see no reason to mention this. I would recommend getting the vaccine for your own protection, though.

And find a new doctor. I wouldn't want him in charge of my sexual health. It's like he's never had a patient with HPV before.
Helpful - 1
3 Comments
I didn't mention this in my original post, but the report she got back on her smear test was " low dyskaryosis" rather than a positive result for any particular strain.

I know that dyskaryosis is usually caused by high risk hpv but is that always the case?

If it does indicate she has high risk hpv, does that change your view on disclosing etc?
Also I'd like to thank you so much for taking the time to give me such a long answer ❤️
So she hasn't tested positive for HPV?

It sounds like she probably had HPV, or maybe has it, but unless she was tested and got an actual result, it's hard to say whether it's active for sure.

It doesn't change anything. You still only had oral sex with her, and we have no way of knowing if she has oral HPV. Everything still holds true.

And you're welcome.

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