The sex: Dec. 29th With a Sex worker at massage parlor (could have lots of hpv strains). My first and only sexual experience ever, virgin before this. She was on top of me and our genitals did have some bare contact like some (2-3) taps/touches of bare penis/vagina contact. I don't think there was rubbing. She then got off, put a condom on with her mouth and then there was protected vaginal sex in standing missionary position. idk how much skin to skin contact there was but I had trimmed my pubic hair a few hours before the sex. The sex prob lasted 2-3 mins. I am Worried about the possibility of having HPV now. 

I am Muslim and my future wife will most likely be a virgin, I'm worried about infecting them with HPV. I wont get married for at least 2 years. And I will also not engage in any more pre marital sex.

I'm 25 yrs old I got my first dose of Gardasil 9 in 2015 when I was 17 and my 2nd dose 11 months later at 18. No 3rd dose. Would this have given me enough protection for my encounter?

For how many years is the vaccine effective?

Also, I spoke to the sex worker after our encounter and she said she gets regularly checked and has routine pap smears. And she had a pap smear done in February (1 month after we had sex) where she said there was no signs of HPV, abnormal cells, or any cancer strains or anything. That was her word idk how much to trust it. 

I'm also sorry you didn't reveal in your previous question that you were vaccinated against HPV. It would have made my previous reassurance -- that your penile bumps were not warts -- even stronger than it was.

Although three vaccine doses originally were recommended, it is now known that two doses are effective for at least 10 years, probably longer. The main value of a third dose may be to assure lifelong protection. But at this time (and last December) you were 100% protected against the 9 HPV types covered by the vaccine. Those types cause 90% of genital warts and 90% of cancers caused by HPV. You might consider having the third dose; it probably would not increase your protection level, but you might find it comforting to know you have lifelong protection and would have no worries about HPV if someday you have non-marital sex. (I understand your intentions are otherwise, but you must know that most persons with that intent give in to natural temptations and have other sexual experiences somewhere along the line.)

It sounds like your sex worker partner understands STI risks and takes reasonable precautions. Most people are truthful when asked directly about their sexual health; I think you should be confident she indeed had no active HPV infection at the tine of her last Pap or at the time of your exposure. But even if she did, the combination of your vaccination plus the condom means nearly 100% protection. Accordingly, you can safely assume you do not have HPV. If you succeed in avoiding natural temptations and have no further sexual experiences until committed to your future wife, you should not be at all concerned about transmitting HPV to her.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Unfortunately, we can't say for certain if i was infected or not which does trouble me despite your reassurances.

The thing is I've begun a relationship with someone who I really like and it has potential to lead to marriage. 

I worry because, she has a very weak immune system. She's anemic, she may have vertigo, she has HSV-1, she gets sick easily and often with high fevers, she is susceptible to pneumonia, and earlier this year she was hospitalized due to a very high fever, and she was given IV infusion to help her. Her doctor at the time said she needed the IV or else the fever couldve killed her bc of low immunity, her fever was like 104. 

She also has low red blood cells and was told by doctor pregnancy could cause serious problems for her.

And she bruises easily.

She has a lot of health issues and weak immunity. If there's a chance I have HPV and I infect her with it. I don't know what kind of issues regarding cancer and genital warts could arise in her as her body will most likely struggle to clear the virus.

I would feel very guilty and terrible that I risked her health and she suffered due to my mistakes and poor decision making.

She's also a virgin. 

Given her health history and let's assume I am positive for HPV. Should I not pursue this relationship with her and put her health at risk. I'm at a loss for what to do

I'm sorry to hear of your prospective partner's health problems, but they are less likely to be due to a "weak immune system" than she (or you) think. And even in that case, there are NO known immunodeficiencies known or suspected to increase susceptibility to HPV. The only thing that comes close is that tobacco smoker with HPV have a somewhat higher risk of cancer as a result.

And even if, as you pose in your closing question, it would be really, really dumb to not have a romantic relationship because of a potential risk of HPV. As I said in your previous thread, "Getting and having genital HPV...is a normal, expected, unavoidable fact of being sexually active", and usually harmless anyway. To make such a life-changing (or happiness challenging) decision on the basis if HPV is further evidence or irrational, illogical thinking.

You mentioned tobacco smoking is bad so would smoking Hookah 

Fall into that same category of bad?

Also, should I disclose anything to the girl about my possible exposure to HPV i know i know its a very small chance but is there a logical reason to disclose at all considering we’re muslims?

Really thank you for this service and taking the time to respond to people like me! 

Smoking (or hookah or any other drug use) is irrelevant to your situation. The ONLY known smoking effect is in women with pre-cancerous Pap smears, who have a higher risk than non-smokers of progression.

I see no reason for you to say anything at all about your irrational HPV fears to your partner. Even PROVED HPV infection often does not need to be disclosed to sex partners.

Thanks for the thanks. I'm glad to have helped.