HPV testing for men

[wondering125]

Hello,

In March I had unprotected sex with a female who had received the HPV vaccine months before.  Shortly after the encounter, she tested positive for high risk HPV (no warts).  Since then, she has submitted to strain typing; the results are not back yet.

I have read about male testing for HPV for experimental research.  I would like to have this done, as I was sexually active with this female for approximately 4 months, only had unprotected sex with her one time, and would like to know if I am carrying the virus.

QUESTIONS:
1) What do you recommend regarding getting the male HPV test.  If it is not yet readily available (I believe it isn't), should I contact the study authors?
2) What are the chances that I am carrying the virus? I had protected sex with this girl approximately 20 times and unprotected sex once.
3) I know the Gardasil vaccine does not protect against every strain of HPV, but how frequently does a female that has been vaccinated have a positive high risk HPV test?
4) How long does the body normally take to eradicate the virus?  What are the chances of viral transmission through sex once the virus is non-detectable - [a]with a condom and [b]without?.  For example: If a female who has tested positive for HPV (+ warts) eradicates the virus as per her most recent Pap smears, can she still pass the virus to her sexual partners.  Should she always use a condom - even with her husband?
5) I do not want to put future partners at risk.  How should I approach this with them?

Thank you very much for your help.

[Edward W Hook, MD]

Yes.  EWH

[tboddin]

Just a question re: that 8-24 eradication. Would you say this is the right time frame for a male with visible genital warts, whether or not there's active treatment against the warts? In other words--would you say that in 8-24 months the body does its own work, eliminating the HPV problem and making it unlikely to pass on (enough to not have to bring this issue up with future partners?)

[Edward W Hook, MD]

Welcome to the Forum.  You asking questions that are frequently asked at our site, some of which really don't have answers that many of our clients find very satisfying.  Sadly (at least from our perspective) HPV testing is available and can be performed on swab specimens from the male penis.  I say this is sad because, as best we can tell, nearly everyone does get HIV at some time in their life and of those, nearly everyone clears the infection on their own.  The problem with HPV testing for men is not only that the infection is so very widespread but also that if a man is found to have a "high risk" type of HPV, there really is not much to be done.  He is not at meaningful risk for developing penile cancer and our advice in terms of protecting his partner is the same whether or not ha has HPV and wants to avoid spreading it or wants to avoid getting it--use condoms.  With this as background, now that you know my perspective on the issue, let's deal with your questions:

1.  See above.  If you need it done, it could probably be done by a local gynecologist (they do most of the HPV testing, much of which is also not recommended, if she had an abnormal pap smear, your GF's situation in a bit of an exception).  Alternatively you might call local urologists to see who might do it.  Before you seek testing, I would still ask, so what will you do if you are positive?  Most therapies are destructive in nature and many are costly.
2.  Unknown.  A single exposure is still not likely to transmit the virus but the precise per exposure risk is unknown (based on your statement that you had unprotected sex with her only a single time)
3.  The vaccine is highly effective, preventing close to 100% of infections once a person is fully vaccinated.  If she was not fully vaccinated, she had some degree of vulnerability, how much depending on where she was in the vaccination process.  In addition, in the studies, some women developed HPV after starting the vaccine due to exposures prior to vaccination.
4.  Typically the virus is eliminated in 8-24 months and in most persons, less than a year..  No virus, no transmission.  condoms, used properly reduce HPV transmission at least 50%
5.  See above.   Everyone has HPV. If you know you have it, you could disclose to partners although many people seem to over react to this fact.  Remember, odds are close to 90% that not only do you already have HPV but so does your partner.  In my opinion, rather than worrying about it, the right thing for women to do is to get the vaccine and have regular pap smears.  To otherwise just sets up paranoia and unrealistic concerns and expectations.  

Hope this helps.  For additional 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)..  EWH