High risk HPV transmission

[wonderingabout0]

Hello Doctors,

I’m a 26 year old male. I was with an older lady who was diagnosed with cervical dysplasia.
There was no sexual intercourse but she used her thong to masturbate me. I wasn’t wearing a condom.  The thong had contact with my penis, scrotum and mouth.  We did this same thing on 15 occasions. Sometimes the thong was fresh off her body, sometimes it was a thong from the laundry that hadn’t been washed. After ejaculation she would use the thong to wipe off excess semen on my glans.

Here are my questions.

1. Is it possible that high risk HPV may have been transmitted to the parts of my body that the thong touched

2. I have read that 70% of cervical cancer is related to HPV 16 and 18 is it right to conclude that 70% of dysplasia is caused by these strains

3. I read that the body’s ability to clear the virus has more to do with the strain type than the immune system. If I have HPV 16 then will it be certain that I will get cancer

4. If high risk types have no symptoms, then how is there so much information saying that most people don’t develop health problems. Isn’t it possible that all people with high risk strain develop dysplasia or cancer

5. I noticed tiny (1mm diameter) spots on the inside of my prepuce They look similar to this picture I found on the internet. Are these warts? Tyson’s glands?  Here is the link it is series 61 http://cme.medcomasia.com/cmequiz/quiz.asp?id=2  (I do not have as many as on that picture.)

6. I read that menopausal women have high estrogen levels which could cause cervical dysplasia?  Is it possible that this woman does not have the virus

Based on what I read, both of you are quite certain that skin to skin contact is needed for transmission.
I have found posts from you that contradict this notion:
In the links below there are mentions of transmission other than sex
http://www.medhelp.org/posts/STDs/HPV-and-oral-cancer-risk-in-male/show/1181303
http://www.medhelp.org/posts/STDs/HPV-Throat-Cancer-Risk/show/599528

[Edward W Hook, MD]

Hepatitis B immunization ir recommended for all Americans.  It is highly effective an safe.  It is inconceivable that you would get hepatitis B through "thong masturbation"  EWH

[Edward W Hook, MD]

You are being repetitive.

1,  HPV 16 and 18 are SLIGHTLY slower an less likely to clear than other HPV types.

2.  Yes it is definite.  Well over 90% clear within two years of acquisition, and most of the remainder clear subsequently.

3.  There is less virus present on clothing than lesions, the virus is less likely to be alive having been exposed to the environment and the kind of abrasion/friction is different, among other things.

4.  HPV infections are regularly cured, both by persons own immune systems and by current treatments.

I will not address your "hundreds of questions".  For whatever reason, your fears about HPV appear to be far, far out of proportion to any real risk of serious problems relating to the behaviors you describe.  You need to figure out how to move forward.  EWH

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to address your questions however, having read both this post and your other posts on our Community sites my impression is that you are more concerned than is appropriate.  You are correct, HPV infections have been spread through indirect contact however this occurrence is rare- very rare.   Further, in the unlikely circumstance that you were unfortunate enough to acquire HPV in this way, the chances are very, very high that your body would eliminate the infection with the passage of time.  I'll address your specific questions below:

1.  Possible, yes, just as it is possible that you will fall while walking today and break a bone.  I presume neither is likely however and I know that it is unlikely you got infected.

2.  No, dysplasia is caused by both other types of HPV and other processes, including the inflammation related to infection.

3.  Incorrect.  Most HPV infections resolve on their own including infections due to HPV 16.  Most HPV 16 infections resolve without therapy and only a small fraction go on to cause cancer.

4.  No, research studies show without a doubt that most HPV infections resolve without therapy and without consequence.

5.  Sorry, we do not view pictures on this site. If you want to have these bumps evaluated, you should see a physician, probably a dermatologist.

6.  Yes.

I hope these comments help.  As I said, I think you are over reacting to these exposures.  I urge you to not worry.  Please, no follow up "what if" or "has it ever" follow-up questions. EWH

[Edward W Hook, MD]

LAst answer. You are worrying entirely too much.  No reason to be worried about HSV either.  EWH

[wonderingabout0]

Hello Doctor Hook,

I don't know if you will answer me after 1 month.

If you refer to my original post, on question 5. I did see a dermatologist and he was not sure what the bumps were. When I asked him if they might be Fordyce spots he said "Oh yeah, probably that".

However, I am now worried that these are HSV 2 lesions. I read that in HSV 2 an outbreak usually clears up in 3 to 14 days. But these spots (which do seem fluid filled) have been there now for at least 39 days. I also noticed more of them upon further examination but do not know if they are new ones or overlooked ones upon my initial examination 39 days ago.

The whole HPV scare caused me a lot of anxiety and I know that HSV outbreaks usually follow stress. All the puzzle pieces seem to fit; including burning during and after urination and ejaculation.

Do you think this can be Herpes?

[wonderingabout0]

Thank you Doctor Hook for your answers.

Last question.

I just received a call from the secretary of my STD doctor.

She said I have to come in for the Hepatitis B vaccine.

When I asked her how I could have contracted Hepatitis B, she said I didn't and it's just a precaution... but i am now in a monogamous relationship so why do I need immunization?

Could it be I have Hepatitis B based on the "thong masturbation" events of a few years ago?? And the secretary just did not want to tell me?

[wonderingabout0]

Thank you Dr. Hook for the quick response. It is truly appreciated.

I have a few more questions. (At risk of sounding repetitive)

1. Is HPV 16 or 18 more difficult for the body to clear than other high risk types?

2. Is it proven that the body can clear the 16 and 18 strains? Based on studies that have been done, would you be able to give me an approximate percentage of infections with these strains that are cleared by the body?

3. What makes transmission via clothing less likely than transmission via skin to skin contact?

4. Do you know if there is any hope for a cure for HPV in the near future? I read a story about the AAV-2 virus that has the potential to kill HPV and other cancers without harming healthy cells.

I'm sure I have hundreds of other questions.... I just can't seem to be comforted ...

[wonderingabout0]

For question 5, I also want to mention that i have only had sexual intercourse with one woman in my life. And it was after the encounter with this older woman.