[Question #1037] Guy with HPV

98 months ago

I am a male who was diagnosed as having HPV when I was a participant in a clinical study a few years ago. For over 2 years I was negative, but then for the next two years (tested about every 6 months) I was positive. That's all they would tell me - not what type of HPV it is/was or anything else about the infection, except that the test showed that I had HPV on my head, shaft, or scrotum. They said that HPV is extremely common, but that condoms don't necessarily prevent transmission and I would need to tell any woman about the HPV before we have sex.

About a year before being in the study I had a wart removed from that border area at the top of where pubic hair stops, so I don't know if it was a genital wart or just a regular wart. A couple years ago I talked to the doctor who had removed that wart, and who was also familiar with the study. He thought that the test was just finding the HPV from the wart so it was really unlikely that I had the cervical cancer kind of HPV, and since the wart was removed I wouldn't be transmitting that. In his opinion I didn't have to disclose unless I was planning on it being a very serious relationship.

So now I'm really confused and worried about having sex - I don't want to feel like I'm giving someone cancer or possibly warts, and I don't know how and when to bring it up. Also since I'm a guy I don't think I can get tested again to see if I still have it. I would really appreciate some advice on this. Thanks.

H. Hunter Handsfield, MD

98 months ago

Welcome to the forum. Thanks for your question.

My first comment is to disagree with the advice you had from the researchers about telling future partners about your HPV infection. Most experts would disagree. There is general agreement that there is no need to inform partners of past (inactive) HPV infections. Having done lots of STD research over my 40 year career, I can also imagine that in the context of a research study, the investigators felt obligated to take a conservative stance, or were required to do so by their institutional research ethics board. But in the real world, the fact is that almost everyone gets genital HPV, often several times; thus any future partners you may have are equally likely as you to have past or present HPV; and sex with you therefore would not materially increase their risk of infection or the chance they would have an actual clinical problem, such as warts or an abnormal pap smear. Further, after 2+ years, it is likely your HPV infection is now gone and you are no longer infectious. Finally, all sexually active persons ought to be immunized against HPV; if your potential partner(s) have been vaccinated, there is even less need to inform them of your past infection.

Second, condoms and HPV: It isn't quite true that condoms are ineffective. The risk of HPV is probably reduced 80-90% for any single exposure. Modest risk remains because of skin contact above the condom. However, 80-90% is onlye fair, and with repeated exposure, most people eventually get HPV despite consistent condom use -- which is probably what the researchers meant.

Third, I am inclined to agree with your more recent doctor, that the pubic area wart probably was unrelated to your previously asymptomatic genital HPV infection. (I also have to wonder whether it was a wart at all, since that's not a typical location. But your doctor is in a better position to know.

All things considered, there is no reason for confusion or for avoiding sex at this time. As I said above, you are no more a transmission risk of HPV to your partners than any other partner they might select. Since 90% of us get genital HPV, you can assume 9 of 10 other men they might select also had had HPV at one time or another -- the fact that you happened to be diagnosed through your gallant participation as a research subject doesn't make you any more risky!

You might also consider re-contacting the researchers who you saw several years ago, who probably would also have reassuring advice. They're obviously experts, and I'll bet if you express your concerns and tellthem about this thread (perhaps print it out as a framework for discussion), they would agree with all I have said.

I would also encourage you to get immunized against HPV (if under age 26, the usual cut-off). It will protect you against 9 HPV types (not counting whichever type(s) you had before), which collectively account for 90% of genital warts and 90% of HPV related cancers.

In any case, final advice: plan on resumaing a normal sex life ASAP -- just do it safely (common sense partner selection, condoms for new partnerships). But definitely do not remain a hermit on account of HPV.

I hope this information has been helpful. Let me know if anything isn't clear.

HHH, MD

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98 months ago

Thank you. It's a huge relief to finally get a straightforward answer about this!