[Question #11293] Follow Up

Avatar photo
15 months ago
Hello Doctors,
I am sorry to come back and ask for your advice again but I honestly do not know what to do. I cannot get tested in the UAE as if on the chance I am positive I will lose my house and my job as well as my partners. I am debating flying back to my home country to test which would be expensive or waiting for 3 months when I would go back normally. I would have time on my visa to sort out everything when I returned.
I have HPV, I  found out from my urologist. I went for an ultrasound scan that showed nothing related to STI's two weeks after our last chat, just a slightly swollen lymph node infront of the pubic bone. I have read HPV increases the risk of HIV. I know that 1. One off incidents are not normally tested. 2 Never been a proven HIV case from insertive oral sex. 3. 1 in 20,000 chance. 

I am trying to focus on the facts, the medical and scientific data and I know I have a very good chance of not having it. But I am scared that I would give it to my long term partner. We have been having protected sex since the incident. Please give me some advice on what to do and I will do the following. Thank you.
Avatar photo
15 months ago
I forgot to mention that I have a few HPV warts on the shaft of my penis. That have been there for sometime. I did not know they were warts until my urologist told me. I want to try and move on from this and I will fly home if needed to test, or wait to test in 3 months. What would you do if you were in my situation? Thanks

Avatar photo
H. Hunter Handsfield, MD
15 months ago
Welcome back, but I'm surprised you found it necessary.

It is really, really dumb to not find a way to be tested for HIV. There is absolutely no chance you have it, assuming the oral sex event you described last time was your only possible risk. Do you really imagine you might be the world's very first case of catching HIV from oral to penis exposure?

You have misinterpreted something you found (online?) about HPV and HIV risk:  HPV is the only common STD that does NOT significantly elevate the risk of HIV if exposed. There were some reports years ago that the two infections might be linked, but that has long since been disproved by more recent and more valid research results. Therefore, having genital warts makes no difference in your concerns about HIV. There is no way you acquired the HPV during the oral sex event; warts cannot show up sooner than 2 months after exposure, and mostly they appear much later than that. You acquired that HPV infection sometime in the past, not from the oral sex event you had a couple months ago.

Your partner needs to be evaluated for genital warts, but that has nothing to do with HIV etc. And there is no point in using condoms now:  she was repeatedly exposed to your warts long before you started using condoms. (And condoms aren't very effective in preventing HIV anyway.)

Just bite the bullet and get tested for HIV. It will be negative. (I do not suggest testing because I believe there is any chance you have it -- only because you obviously the negative test result in order to move on with your life! (And yes, that is exactly what I would do if personally I were in your situation.)

One more fact that might help you to know: In the 20 years of this forum and our previous one, with thousands of questions from people worried about HIV, not one has yet turned out to be infected. You will not be the first. If and when it finally happens, I am confident it will be from a genuinely high risk exposure, not a trivial exposure like yours!

HHH, MD
---
---
---
Avatar photo
15 months ago
Hi, Dr. HHH,
Thank you for your great advice, I feel a lot better and based on the medical and scientific data I am going to live my life as normal. I will test when I go to my home country in the summer. 
On the HPV, is there anything I can do about the warts or should they reduce over time? I feel like I have one or two for about 6 months and can see small ones coming. And yes my partner probably already has the strain as we have been together for a while.
Finally, I still have a dull pain above my penile area. The left and right of my pubic bone, gets better and worse depending on the day. My bloodwork  and urine came back fine and when I went for the ultrasound they said everything looked normal bar a swollen lymph node. Maybe it is gastro? I will check to see with my urologist but would just like your input.

This will be the last time I contact this service and thank you for all your help.

Avatar photo
H. Hunter Handsfield, MD
15 months ago
Genital warts generally are cleared by the immune system over time, but that time is long; it can be years. Why not get them treated? There is at least one excellent STD clinic in Dubai. Or, since you apparently have a urologist, s/he can advise treatment.

Your suprapubic pain is not a symptom of HPV or any other STD. Beyond that, I have nothing to add; we deal with STDs and HIV, not not other genital (or genital area) health issues. Seeing your urologist makes sense.
---