I have been following you for many years and i must say a big thanks to what you do!

I have a couple of questions in regards to HPV:

1) I am 44 years old male, heterosexual, had quite a few sexual parners, always safe (protected and long term relationshops and also tested), so that means i already have contracted HPV in the past. Does it make sense to do Gardasil 9 now? Would YOU recommend it for me? The cost is irrelevant. If you believe it would be medically recommended, and provide protection, then please let me know, because i would do it. Please note, that i have been absent from performing oral sex for many years, since i am a bit worried in regards to oral sex and throat cancer. Would Gardasil 9 help if i did it?

2) I am a bit confused in regards to strains. I know there are a lot of different strains of HPV, but what i would like to clarify is, if someone is contracted with, lets say, Genital HPV can this be "transferred" to the oral region? For instance if he touches his genitals and then his mouth, will this be "translated" to oral HPV in a sense? Or is it that oral HPV is only transmitted by oral sex ? (I.e. in my case, cunnilingus)?

3) If someone was contracted with oral HPV and then it was cleared by his body, does that mean that after this, he/she is immune and there cannot be another trasmission of oral HPV?

Thank you very much!

Appreciated!

Regarding your questions:

1.  I agree with you that at 44 years of age and having had a substantial number of previous partners, you almost certainly have had multiple prior HPV infections.  Taking the HPV vaccine really would not add much to your sexual health.  In your situation, I would not pursue it.

2.  HPV infections are local infections- acquired and transmitted by direct contact.  Genital HPV would not spread within your body to other sites, either within the body or by transfer on your hands or fingers.   Oral infections certainly occur but, like HPV at other sites, appears to rarely progress to  oral or throat cancer.  Your dentist likely looks for signs of oral infection when you have check ups.  Other than seeking evaluation if you experience prolonged symptoms, I would not worry about oral HPV and its consequences.  

3.  When persons acquire HPV the immune response typically makes the infection non-detectable.  There is a measurable immune response although the levels of antibodies which follow infection are not as high as the antibody level following the vaccine.  That said, having had HPV in the past does appear to reduce risk for future infections.

You've asked good questions.  I hope that the information I have provided has been helpful.  If parts of my response are unclear, please don't hesitate to use your up to two follow-ups for clarification.  EWH

Thank you very much for the prompt reply.

I only want to ask a follow up for items 2 and 3 and another quick question and close the topic.

So i understand from your answer to question 3 that it is possible (even at a reduced risk) to have aquired, say oral HPV, and then re-aquire it. Correct? Is so, and considering i am a bit anxious with oral HPV (even though i do understand what you say-that i shouldnt, since risks are very low to progress to cancer), is it a good approach to abstain from cunnilingus? Is there any other mode of transmission for oral HPV that i should be worried about, or its just oral sex?

Also on another quick question just out of interest: I never had any issues with HPV that i know of, for instance genital warts. Does that mean a) that i have never been infected, b) that my immune system is "strong", c) a combination of both, or something else? 

Thank you once again! 

You may close this topic post your reply.

Much appreciated!

Statistically, it is more likely than not that you have had HPV in the past which was clinically inapparent and which has resolved.  This is certainly due, in part, to  a healthy immune response.  EWH