Hand-genital contact might transmit HPV, especially if genital fluids were used as lubricant and if, as you sort of imply above, one or both persons handles their own genitals as well as their partners'. But even so, the efficiency of transmission undoubtedly is a lot lower than through intercourse. There are no data on which to base a numerical estimate of the transmission risk, but probably over 95% of genital warts result from direct genital contact and a small minority from other kinds of exposures, like oral sex or mutual masturbation.
There are conflicting data on the proportion of infected persons, with the wart-causing types (primarily HPV 6 and 11), who develop visible warts. The best data suggest that at least 50%, and more likely 60-80%, get warts they can notice without special examination or testing.
Sorry! One last question, if you don't mind: What are the chances of developing visible genital warts if infected with one of the strains that causes visible warts? Do 100 percent of those infected by those strains go on to develop warts? I hope my question makes sense.
Thank you for the response, Dr. Handsfield. I appreciate the information. I hope you do not mind if I ask a brief follow-up question.
I understand what you are saying about the likelihood that he has already been exposed.
Just to satisfy my curiosity, what would you think is the relative risk of transmission via mutual masturbation as I described? I have read a lot of conflicting information on that point. Suppose a person were to engage only in mutual masturbation and abstain from other types of activity when warts are present? What would be the chance of transmission be, in your opinion/experience? Thanks again.
Welcome to the forum. Thanks for your question. I think I can help.
My first advice is that you not assume your self diagnosis is correct. Even with a similar appearance in a similar location, recurrence of warts after 10 years isn't very common, and you need to have a professional diagnosis.
But let's go ahead and assume it's a wart. If so, the HPV infection causing it has probably been active in your genital tissues for a few months, maybe a year or more. Therefore, you can assume your husband has been repeatedly exposed through both intercourse and all the other sexual practices that you and he participate in. It is pointless to worry about any particular event, such as the recent mutual masturbation contact.
Condoms help reduce HPV transmission, but do not entirely prevent it. 100% condom use by women reduces their risk of new HPV by about 50%; so over multiple episodes of sex, you can assume your husband has been genitally exposed -- if you have HPV at all. (For that reason, I generally do not recommend condoms to prevent HPV in couples in which one person is infected.)
If and when you are confirmed to have a wart, the proper step for your husband is to just be on the lookout for warts of the penis or elsewhere in the genital area; and if something shows up, to see his doctor for examination and treatment. If nothing shows up that he can see, then no worries.
In the meantime, don't be worried while you wait for diagnostic confirmation. Genital warts are an inconvenience, not an important health threat. If and when you are confirmed to have a wart, the proper step for your husband is to just be on the lookout for warts of the penis or elsewhere in the genital area; and if something shows up, to see his doctor for examination and treatment. If nothing shows up that he can see, then no worries.
I hope this has been helpful. Best wishes and happy holidays-- HHH, MD