[Question #11985] HPV Exposure

11 months ago

Dear Dr. Handsfield, I had sex with a commercial sex worker in early April. The condom slipped out and the motion continued for about 30 seconds until I noticed. What is my chance of contracting HPV from this incidence? My wife is pregnant and is scheduled to get a pap smear in early October. How likely is she going to contract the virus from me? And how likely that she's able to clear the virus if she caught it in April? So far she has not shown symptoms. Many thanks!

H. Hunter Handsfield, MD

11 months ago

Welcome to the forum. Thanks for your confidence in our services.

You should not be at all worried about HPV in this situation. First, almost everybody acquires genital HPV somewhere along the line, often several times. If you and your wife have had average sex lives, with at least a few different sex partners, you can be sure you both already have been infected. Therefore, any single new exposure does not significantly raise the risk of being infected. Second, the chance of infection from this single exposure probably is low anyway -- although there are no data on which to base an actual risk estimate. Even if you caught HPV and transmitted it to your wife, most infections never cause symptoms or show up on Pap smears. And even if that happens, typically it is a few months or years before being detected. If and when your wife ever has an abnormal Pap smear or other evidence of genital HPV (like genital warts), there will be no way to judge when and by whom she was infected.

I hope this information is helpful to you. Let me know if anything isn't clear.

HHH, MD

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11 months ago

Thank you for your quick response and analysis. My wife and I have been together for over 10 years. I’m her only partner. But I’ve occasionally had extramarital sex and used condoms all the time.

1. Assuming we’ve been both infected, does that mean we have acquired natural immunity to some extent?

2. Can the virus be dormant for over 10 years and reactivated during pregnancy?

H. Hunter Handsfield, MD

11 months ago

1. Yes, indeed: People are immune, or at least highly resistant, to any HPV types with which they have been infected.

2. Also yes, unfortunately (and often disconcertingly). Some experts believe all HPV infections persist indefinitely, or at least HPV DNA permits. The immune system is generally effective in keeping it suppressing and undetectable, usually for life. However, breakthroughs are not rare. Indeed, most abnormal Pap smears in women beyond age 30 are due to reactivation of prior infection, not tnewly acquired HPV. However, reactivation during pregnancy isn't common, to my knowledge.

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10 months ago

Thank you Dr. Handsfield. I know it might be difficult to quantify but would appreciate if you could expand on the transmission mechanism and why the probability of contracting the virus through one brief exposure is low. I’ve read somewhere on the internet that the probability to contract HPV with an infected partner is around 20%. Does that mean repeated exposures would be required to facilitate transmission?

H. Hunter Handsfield, MD

10 months ago

I can't say the source of you 20% estimate. I suppose it coulee about right. Twenty percent seems consistent with the data that half of all people acquire HPV within their first three lifetime sex partners.

With no visible evidence of active infection in 10 years -- no warts and assuming your wife's Pap smears have been normal -- there's probably under 1% chance of reactivation that would cause either of these problems. And if it happens, both these are minor health concerns when properly and promptly treated. Give your sexual histories, you should not losing a moment's of sleep over HPV.

That completes the two follow-ups included with each question and so ends this thread. I hope the discussion has been helpful.

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