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HPV-Anxiety
First thank you to both doctors for a great job on providing answers in this forum. This past weekend I discovered what appeared 4 small lesions on the bottom of the penis shaft. I had a Doctor look at them but he didn't think it was conclusive and advised me to have them removed just to be safe and he did. A week ago and before I discovered these lesions, I had protective vaginal intercourse twice with a girl I just started dating. The lesions are located in the bottom area of the shaft that the condom doesn't cover well. At least in one of the two encounters, I clearly remember noticing the bottom of the shaft was exposed and that it wasn't covered by the condom. I'm really not sure what to do at this point… I realize from reading other posts that the HPV virus transmission is very efficient and wanted to ask u the following:
- If the lesions are GW, what is the likelihood that the transmission has already occured? I looked at the CDC website and found the following table that talks about “Rates of HPV transmission by source and target site in male-female couples”.
http://www.cdc.gov/eid/content/14/6/888-T2.htm
-Again, if the lesions are GW, and the transmission has not occurred yet, maybe the best thing at this point is to stop all sexual contact with her? Sadly, I prefer this option to risk exposing her or bringing up the topic with her.
Could you please provide guidance? Thank you for your help.
- If the lesions are GW, what is the likelihood that the transmission has already occured? I looked at the CDC website and found the following table that talks about “Rates of HPV transmission by source and target site in male-female couples”.
http://www.cdc.gov/eid/content/14/6/888-T2.htm
-Again, if the lesions are GW, and the transmission has not occurred yet, maybe the best thing at this point is to stop all sexual contact with her? Sadly, I prefer this option to risk exposing her or bringing up the topic with her.
Could you please provide guidance? Thank you for your help.
MEDICAL PROFESSIONAL
At age 29, there is a good chance your partner may not be susceptible to the most common HPV strains (because of past exposure and current immunity). That's why the HPV vaccines are not recommended beyond age 26. But of course there are no guarantees. You'll have to discuss it with her and let her participate in a decision about sexual ectivity with you, and about vaccination.
A final question please . The girl I'm dating is a 29 year old who's had a relatively active sex life since she was 18. What are the chances of infecting her with GW (if that's what they are) for the first time? And if she has already built immunity to the most common GW by now, what are the chances of a new infection? Thanks again.
MEDICAL PROFESSIONAL
I must have misunderstood the question. The risk of transmission from a single episode of sex is not nearly as high as I suggested there. My best guess is that I misread it and believed the questioner had been repeatedly exposed. I stand by my opinion and advice in response to your question.
Thank you for your response. I came across one of your posting from 2008 that seems to indicate a higher probability and certainty of transmission for a single event where condom protection was even more complete than in my case above. You wrote:
"Genital HPV is very efficiently transmitted. If her infection was active when you were together, and if you had not previously been infected with the HPV type she had, then you can be sure you were infected. If so, by now it likely has clear up. If you had been previously infected with that type, you were immune to catching it again. Either way, you remained asymptomatic and experienced little risk to your future health"
http://www.medhelp.org/posts/STDs/HPV-Likelihood-and-Detection/show/538456
Could you please explain why you would give a lower likelihood of transmission to my situation above even though it involved 2 instances instead of one and less complete protection.
"Genital HPV is very efficiently transmitted. If her infection was active when you were together, and if you had not previously been infected with the HPV type she had, then you can be sure you were infected. If so, by now it likely has clear up. If you had been previously infected with that type, you were immune to catching it again. Either way, you remained asymptomatic and experienced little risk to your future health"
http://www.medhelp.org/posts/STDs/HPV-Likelihood-and-Detection/show/538456
Could you please explain why you would give a lower likelihood of transmission to my situation above even though it involved 2 instances instead of one and less complete protection.
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
Even if your penile lesions were warts, the chance you transmitted HPV to your partner probably was low from only two exposure events, with a condoms. The transmission risk wasn't zero, since your wart-causing HPV infection could involve skin above the condom coverage -- but it was probably very low. It is really not possible to extrapolate the results of the Hawaii study to any single couple; there are too many variables that can vary from one couple to another. And the number of subjects in the study wasn't large enough to have much confidence in the precise outcomes.
If the lesions were warts, you should assume you remain infected with HPV and infectious; HPV infection typically involves a much broader area of genital skin than the visible warts themselves. But whether you and she should stop having sex should not be your decision alone, and for sure should not depend primarily on the advice of a distant online source like this one, no matter how expert. Instead, I encourage you to discuss it with your partner and come to a mutual decision. Genital warts are an inconvenience, not a serious health problem, and she may value the relationship with you and the rewards of an enjoyable romantic/sexual relationship sufficiently that she is happy to take some chance of being infected -- knowing she can be promptly treated if warts appear. On the other hand, for some people genital warts carry a serious "yuck" factor; if she is one of them, perhaps you'll decide not to proceed. Or you could pursue the middle ground and continue sex, but only with condoms, taking some chance of infection.
Also, she could be immunized with Gardasil, the vaccine that prevents infection with the 2 HPV types responsible for 90% of genital warts, plus the 2 strains that cause 70% of cervical cancer. Although the full injection series (3 doses) goes for 6 months, there probably is substantial protection a month after the second dose. So you might decide to avoid vaginal intercourse for ~2 months and then go ahead with less fear of transmission.
I hope this helps. Best wishes-- HHH, MD
Even if your penile lesions were warts, the chance you transmitted HPV to your partner probably was low from only two exposure events, with a condoms. The transmission risk wasn't zero, since your wart-causing HPV infection could involve skin above the condom coverage -- but it was probably very low. It is really not possible to extrapolate the results of the Hawaii study to any single couple; there are too many variables that can vary from one couple to another. And the number of subjects in the study wasn't large enough to have much confidence in the precise outcomes.
If the lesions were warts, you should assume you remain infected with HPV and infectious; HPV infection typically involves a much broader area of genital skin than the visible warts themselves. But whether you and she should stop having sex should not be your decision alone, and for sure should not depend primarily on the advice of a distant online source like this one, no matter how expert. Instead, I encourage you to discuss it with your partner and come to a mutual decision. Genital warts are an inconvenience, not a serious health problem, and she may value the relationship with you and the rewards of an enjoyable romantic/sexual relationship sufficiently that she is happy to take some chance of being infected -- knowing she can be promptly treated if warts appear. On the other hand, for some people genital warts carry a serious "yuck" factor; if she is one of them, perhaps you'll decide not to proceed. Or you could pursue the middle ground and continue sex, but only with condoms, taking some chance of infection.
Also, she could be immunized with Gardasil, the vaccine that prevents infection with the 2 HPV types responsible for 90% of genital warts, plus the 2 strains that cause 70% of cervical cancer. Although the full injection series (3 doses) goes for 6 months, there probably is substantial protection a month after the second dose. So you might decide to avoid vaginal intercourse for ~2 months and then go ahead with less fear of transmission.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
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