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Transmission of HPV and genital warts
Hello. Your forum is very well-organized, and the answers posted are quite comprehensive. Thank you.
Recently, I exhibited poor judgement. I am a 28yo heterosexual woman with a h/o HPV diagnosed when I was 19 years old, both with an abnormal Pap and with genital warts. Since that time, I have intermittently had abnormal Paps (last 2 were normal, in 6/05 and 6/06), and am currently having my 2nd episode of recurrence of genital warts; I have 3 small warts at the introitus, 2 exterior, one interior. About 3 weeks ago, I entered a monogamous sexual relationship (both vaginal and oral) with a new man; we have used condoms every time we have had sex. Unfortunately, before we engaged in sexual activity, I did not inform him of my diagnosis and active outbreak. Of course, this has, understandably, caused some strife within the relationship. My questions are as follows:
1) Is there any role for vaccination of men with Gardasil in preventing transmission of HPV from infected women to their male partners?
2) Even though he has likely been exposed to and/or is infected with HPV in the past, what is the approximate chance that he will show physical signs of infection (i.e., warts)?
3) I know that the evidence behind oral transmission of HPV is not strong, but do you think he could now have an oral HPV infection as a result of contact with me?
Thank you for your input.
Recently, I exhibited poor judgement. I am a 28yo heterosexual woman with a h/o HPV diagnosed when I was 19 years old, both with an abnormal Pap and with genital warts. Since that time, I have intermittently had abnormal Paps (last 2 were normal, in 6/05 and 6/06), and am currently having my 2nd episode of recurrence of genital warts; I have 3 small warts at the introitus, 2 exterior, one interior. About 3 weeks ago, I entered a monogamous sexual relationship (both vaginal and oral) with a new man; we have used condoms every time we have had sex. Unfortunately, before we engaged in sexual activity, I did not inform him of my diagnosis and active outbreak. Of course, this has, understandably, caused some strife within the relationship. My questions are as follows:
1) Is there any role for vaccination of men with Gardasil in preventing transmission of HPV from infected women to their male partners?
2) Even though he has likely been exposed to and/or is infected with HPV in the past, what is the approximate chance that he will show physical signs of infection (i.e., warts)?
3) I know that the evidence behind oral transmission of HPV is not strong, but do you think he could now have an oral HPV infection as a result of contact with me?
Thank you for your input.
My understanding is that he Merck HPV vaccine (Gardasil) is supposed to vaccinate against the HPV strains that cause 90% of genital warts.
Thank you for your prompt reply. So, even though oral infection is generally asymptomatic, what is the risk of him transmitting this virus either oral to oral or orogenital to someone else? Or is this inconsequential, since most people are already infected?
Incidentally, he ended our relationship today. He is quite upset that I have now infected him with my virus.
Incidentally, he ended our relationship today. He is quite upset that I have now infected him with my virus.
If oral to genital contact a common method of transmission of HPV, even in asymptomatic oral infections?
Wendy I am in the same boat as you and I believe your lucky you broke up because in my opinion - life can dish out some pretty big problems and if he cant deal with something like this- whats he going to be like with bigger things you'll come across in the future? Your better off without him!
MEDICAL PROFESSIONAL
I'll try to help.
1) The Merck HPV vaccine (Gardasil) isn't yet approved for men, but that's only because the research studies haven't been completed. There is no doubt it will be highly effective. But remember it only protects against 4 of over 40 types that regularly cause genital infection. Those 4 are the most common types, but still they cause only about half of all genital infections. Also, as you already understand, he probably has already been infected with at least some of the 4 types covered in the vaccine. He is already immune to catching those types again, and the vaccine won't provide any additional resistance to them.
2) There is no way to predict whether he will develop warts as a result of exposure to your HPV. But your own course of warts is somewhat atypical. If not done, you should see a provider to confirm that your current lesions indeed are genital warts and not skin tags or scar tissue related to previous warts.
3) Yes, he could have an oral HPV infection. But if so, it probably will remain asymptomatic. Oral warts, even in people exposed to their partner's wart-causing HPV strains, are uncommon.
I hope your partner will promptly come to understand that everybody gets genital HPV; that his health will never be at significant risk from exposure to your HPV infection(s) (if indeed you still have an active infection); and that HPV is never important enough to be allowed to stand in the way of a promising sexual relationship.
Good luck-- HHH, MD
1) The Merck HPV vaccine (Gardasil) isn't yet approved for men, but that's only because the research studies haven't been completed. There is no doubt it will be highly effective. But remember it only protects against 4 of over 40 types that regularly cause genital infection. Those 4 are the most common types, but still they cause only about half of all genital infections. Also, as you already understand, he probably has already been infected with at least some of the 4 types covered in the vaccine. He is already immune to catching those types again, and the vaccine won't provide any additional resistance to them.
2) There is no way to predict whether he will develop warts as a result of exposure to your HPV. But your own course of warts is somewhat atypical. If not done, you should see a provider to confirm that your current lesions indeed are genital warts and not skin tags or scar tissue related to previous warts.
3) Yes, he could have an oral HPV infection. But if so, it probably will remain asymptomatic. Oral warts, even in people exposed to their partner's wart-causing HPV strains, are uncommon.
I hope your partner will promptly come to understand that everybody gets genital HPV; that his health will never be at significant risk from exposure to your HPV infection(s) (if indeed you still have an active infection); and that HPV is never important enough to be allowed to stand in the way of a promising sexual relationship.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
