I recently tested positive for HPV16 on my pap smear, and I have been given a lot of conflicting information on best practices to avoid spreading the virus to future partners. My main question is: should I assume that I have an oral HPV infection as well? My last sexual encounter was four years ago, and could have exposed me to oral HPV, but online resources / Planned Parenthood had different takes on my oral HPV status. Any information is helpful! Thank you, and have a good day.

It can be alarming to be diagnosed with HPV, especially one of the high risk (potentially cancer causing) types like HPV16. However, HPV in general and even the high risk strains usually are not dangerous at all. The chance you'll have any sort of serious outcome is very low, and virtually zero if you follow your doctor's advice about follow-up evaluations.

Oral HPV is a lot less common than genital. Not rare, but on average about 15% as frequent as genital. And most oral HPV, including HPV16, causes no symptoms and is cleared by the immune system over time. Although you don't ask about transmission by oral sex, that's generally believed to be rare:  almost all genital HPV infections are acquired by genital contact, not from oral sex.

Having said all that, it is true that HPV16 is the type that causes most squamous cell cancers of the throat -- of the several types of oral cancer, that's the one caused by HPV. However, the cancer statistics tell a lot:  last I checked, in the US there are around 16,000 cases of such cancer per year, compared with millions of people who have had HPV16 infection. In other words, even in infected persons, the cancer risk is low. What should you do about it? This is an evolving area of science. Many otolaryngologists -- the primary specialty that deals with throat cancer -- would advise periodic examination to detect early lesions when most treatable. However, it's probably equally effective to simply remind your dentist to examine your throat when you have routine dental care. But all things considered, your cervical HPV16 is (or was) a higher risk -- but still very low risk, as noted above -- than potential oral infection.

Finally, after 4 years, it is likely your cervical HPV16 -- and oral infection, if you ever had it -- are gone by now.

I hope these comments are helpful. Let me know if anything isn't clear or if other issues about HPV16 are on your mind.

HHH, MD