[Question #11217] HPV warts
16 months ago
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My question surrounds the moral obligation to disclose of HPV warts when diagnoses have been uncertain and different opinions have been given from multiple different clinicians.
I was first diagnosed with genital warts in 2021 by a nurse, however I am certain I had those for at least 3 years prior without realizing they were anything. I had those treated with cryo as aldara and podophyllin creams did not work. Since then, i have had reoccurrences, I have had two doctors on different occasions at an STI clinic tell me they weren’t sure they were even warts but treated anyway, one doctor tell me they were and removed them and lastly about 5 months ago a doctor flat out told me they weren’t warts and to forget about them. There were maybe one or two bumps that I didn’t get to show that doctor as he was certain there was nothing to worry about.
I recently had protected sex without disclosure with a >30 yr old. Those lesions that were checked by the doctor are still there, and the ones I forgot to show him have not changed in size (I have also had these for approx 1 year). There has also been no other lesions that have popped up. One lesion is in my pubic area and one small one on the scrotum.
My understanding after reading previous answers is that disclosure is not necessary once warts have been removed. However, I find myself riddled with guilt for not disclosing due to there being lesions present whether they are warts or not. My question is, did I have a moral obligation to tell her about them, should I now tell her after the fact or should I continue and follow the advice of my physician and forget about them? Thanks!
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Edward W. Hook M.D.
16 months ago
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The short answer to,your question is that we do not feel that you have a moral obligation to disclose that you may have or have had HPV infection to present or past partners. There are many reasons I say this, some of which I will outline below and which have been mentioned on many previous posts which are available for your review by looking through our site. We make past threads available for this purpose. Some of the reasons include:
1. From what you say, it sounds that you do not know for sure that you have had warts. If you are not sure, “ disclosure “ will only be confusing
2. Unless a person has been vaccinated against HPV, if they are sexually active, they probably have HPV infection, whether or not they know it r not.
3. For over 95% of persons with HPV the infections are self-limited processes which resolve without therapy. For the very small proportion of infections which are at risk of progression, there are excellent, widely accepted and highly effective methods for detecting these problems early, allowing intervention and prevention of progression
Bottom line, we see no need for routine disclosure and, in your case where you have received conflicting input as to whether or not you even have HPV, for you to disclose will only confuse things. EWH
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16 months ago
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Thank you very much for your reply.
I suppose it doesn’t matter whether I currently have/had warts or not I should just follow the advice of the physician who most recently examined me. It’s confusing with all the information and opinions people tend to have with STIs, but rather than listen to people with no expertise on the internet I should focus on the expert opinions such as yourself as the best advice. All clinicians who examined me have all said there is no need to disclose regardless of whether I have HPV or not for similar reasons as you have listed. I just want to to the right thing by myself and any partners I may have.
You have eased my mind thank you!
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Edward W. Hook M.D.
16 months ago
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I understand both your concern for future and current partners. You have summarized our sense regarding disclosure and HPV/genital warts very well. Please remember, the internet is not your friend here. EWH---
15 months ago
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Hello again,
After reading your first reply I was relieved and managed to even see and sleep with the recent partner again. However, since then I seem to have fallen down another rabbit hole of guilt. I'll use my last reply to ask a couple quick questions to ease my mind and moving forward I will be seeking therapy for this issue and no longer thoroughly examine myself as I am obviously overreacting and want to live a normal life without anxiety;
Assuming that I have had warts previously and these lesions aren't warts, would it be fair of me to say that disclosing to my last partner after the fact would be unfair, confusing and cause unnecessary stress to her given the fact I was told by my last examining physician that they weren't warts?
And similarly, since the lesion that I didn't show looks very similar to the one that I was told was not a wart, I can safely assume this isn't a wart either?
Lastly, assuming I have had these small lesions for over a year and they have not changed in shape or size, and one has a hair in it, this supports the physicians diagnosis of not a wart?
Also out of curiosity, what is the usual reaction of your patients when diagnosed with genital warts? I assume since it's so common and I don't hear about it at all outside of the internet, the general consensus is it's not a big deal and the minority such as myself are the ones to become stressed and take to the internet?
Thanks for the help, I understand that feeling guilt is unproductive and not reasonable in this situation as I was following expert advice and even then, guilt is an unnecessary emotion even if it was HPV.
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Edward W. Hook M.D.
15 months ago
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Straight to your follow-ups
1. Assuming that I have had warts previously and these lesions aren't warts, would it be fair of me to say that disclosing to my last partner after the fact would be unfair, confusing and cause unnecessary stress to her given the fact I was told by my last examining physician that they weren't warts?
Correct. Further, please aware that HPV infections/warts are widespread and most adults (over 80%) have or have been infected. Your recent partner is >30 years of ag. and thus almost certainly has had or been infected by prior partners. "Disclosure" of something you do not even know you have would only cause problems.
2. And similarly, since the lesion that I didn't show looks very similar to the one that I was told was not a wart, I can safely assume this isn't a wart either?
Correct. Review my earlier answers.
3. Lastly, assuming I have had these small lesions for over a year and they have not changed in shape or size, and one has a hair in it, this supports the physicians diagnosis of not a wart?
Warts, like many, many other benign dermatologic conditions can persist unchanged for long periods of time.
People handle the diagnosis of warts in a variety of ways. Some over react as appears to be your tendency. They are just not that big a deal. Health care providers do NOT consider them a big deal at all.
As you know, this reply will complete this thread. I encourage you to continue to work with your therapist to address your well intentioned but misplaced concerns. Take care. EWH
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