[Question #10633] HPV question
 |
21 months ago
|
+About 2 months back had dermatologist take a look at a tiny (very tiny) bump around rim of penis. Asked him to biopsy it. It came back as condyloma/wart.
+Typing test was done. Results said that the wart was NOT hpv 6/11, NOR was it hpv 16/18. No further detail beyond that.
+Wart basically removed via biopsy; over follow-ups every 2 weeks or so, had some other possibly suspicious little areas treated with cryo-freeze treatment. Also used imiquimod 5% for about 6 weeks.
+I had Gardasil vaccine about 8 years ago.
Given all this, I'm trying to form a battle plan re: proper disclosure with future sexual partners. My wife and I are non-monogamous. We *always* practice safe penetrative sex with other partners.
+Wart basically removed via biopsy; over follow-ups every 2 weeks or so, had some other possibly suspicious little areas treated with cryo-freeze treatment. Also used imiquimod 5% for about 6 weeks.
+I had Gardasil vaccine about 8 years ago.
Given all this, I'm trying to form a battle plan re: proper disclosure with future sexual partners. My wife and I are non-monogamous. We *always* practice safe penetrative sex with other partners.
My questions:
1. Let's say at the next follow-up there's zero active warts visible, etc. How long should I feel compelled to disclose this history with future sexual partners? Conversations around the issue have gone well so far, but I also feel like I'm already being 100x more diligent than the usual person, and don't want to cause undue stress and anxiety for myself more than I need to.
2. If my wart was not 6, 11, 16, or 18, I'm assuming i might be an outlier here--in that I probably have a strain of HPV that doesn't normally cause warts, but is doing so in my case. If someone were to contract this strain of HPV from me, what are the chances that *they* would develop warts? Is it true that many/most/____ of people with HPV strains that could cause warts don't ACTUALLY manifest visible warts?
3. In general, I want to be doing my due diligence & being a moral person, but also not going overboard and crippling my sex life due to paranoia and guilty feelings. So I'd truly appreciate some common sense advice re: disclosure that would help me thread that needle!
1. Let's say at the next follow-up there's zero active warts visible, etc. How long should I feel compelled to disclose this history with future sexual partners? Conversations around the issue have gone well so far, but I also feel like I'm already being 100x more diligent than the usual person, and don't want to cause undue stress and anxiety for myself more than I need to.
2. If my wart was not 6, 11, 16, or 18, I'm assuming i might be an outlier here--in that I probably have a strain of HPV that doesn't normally cause warts, but is doing so in my case. If someone were to contract this strain of HPV from me, what are the chances that *they* would develop warts? Is it true that many/most/____ of people with HPV strains that could cause warts don't ACTUALLY manifest visible warts?
3. In general, I want to be doing my due diligence & being a moral person, but also not going overboard and crippling my sex life due to paranoia and guilty feelings. So I'd truly appreciate some common sense advice re: disclosure that would help me thread that needle!
 |
Edward W. Hook M.D.
21 months ago
|
Welcome to the Forum. Thanks for your thoughtful questions and for your concern for future partners. While I appreciate your forthright and honest approach to future partners, I do not see the need for future disclosures. About 10% of visible genital warts are caused by HPV 6 or 11. For the remainder there are a variety of types which have not been all that well characterized. In general we do not feel that disclosure to future partners is essential for persons diagnosed with HPV. The infection is close to ubiquitous in unvaccinated sexually active persons and for the majority of persons when (not if) they become infected there is little reason for concern. With regular sexual health check ups HPV infections can be reliably detected and managed before they, on rare occasions, lead to complications. When you can discuss your prior HPV infections with future partners, that is a good thing to do but it is by no means essential. The key to addressing the threat and any concerns about HPV is to get vaccinated and get regular sexual health check ups. In response to your specific questions:
1. Se above. I do not feel that specific discussions about HPV is needed. I trust that with partners you discuss both your and their STI histories and when they were checked last. This is important and appropriate. Your HPV may come up in this discussion.
2. There are no data to answer this question. Even those infected with HPV strains which cause the majority of visible warts (i.e. types 6 and 11) do not cause visible lesions in many infections.
3. Please see my comments above. If there are questions or any part of our perspective is unclear, please don't hesitate to use your up to two follow-ups for clarification. EWH
--- |
21 months ago
|
Thank you, Dr Hook! This makes me feel much better. My only confusion is that from prior online research I had come across responses you and Dr Handsfeld gave re HPV wart disclosure and the verdict seemed to be "disclose for 3 months,maybe 6"...so just wanted to make sure I was "doing the right thing" by future partners...
|
Edward W. Hook M.D.
21 months ago
|
Thanks for the opportunity to clarify. I think that IF you felt it was important to disclose ( and, as you know, we do not feel it is important) following resolution of visible warts, then disclosure would be important for three or, at the very outside, six months following resolution and no longer. EWH ---
|
21 months ago
|
Makes total sense!
So in conclusion, essentially -- if this was your decision to make, based on medical knowledge, you'd determine there was no need to disclose at this point to future partners...
|
21 months ago
|
Dr Hook, so just to summarize--
+Last visit at dermatologist a few days ago, zero new or unresolved warts spotted.
+As a result, I will not feel a need to inform future partners of this HPV wart infection.
+Why? Because disclosing this--as far as I can glean--is not considered essential. And also because a future partner is just as likely to pick up a wart-causing HPV strain from any other sexual partner, including someone who has a wart-causing strain without visible wart symptoms.
+Also, the advice I've seen you & Dr Handsfeld give in other forums re: disclosing for 3 months, or 6 months--this is only in the case of time frames IF someone chooses to disclose. Whereas from your medical POV, disclosure in these cases, and my case, would NOT be essential or even very helpful.
Does that all sound accurate? Thanks!
|
21 months ago
|
Also just want to confirm that your opinion on not needing to disclose would apply as soon as visible warts are gone -- not that it needs to have been 2 months since last visible wart, etc! Before my most recent all clear visit at dermatologist, I had had some spots cryotreated two weeks prior. But everything looked good or had resolved at recent visit so I'm hoping im all good to move forward without feeling obligated to disclose to new.partners.
|
Edward W. Hook M.D.
21 months ago
|
Thanks for letting me know about your dermatology follow-up. I agree with your decision that disclosure is not necessary. We see so many instances in which well intended disclosure is misunderstood.
I agree with your summary. No need to disclose once the warts are gone. The data are that if warts were going to recur, most would do so within 3 months of therapy. That said, there is no real need or benefit to partners for disclosure even at this time.
As you know, we provide up to three responses to each client's questions. As this is my 3rd response, this thread will be closed shortly. Take care. Please don't worry. EWH
---