I’m a  mid 40 male. 11 years ago I had scrotal wart. I must have transmitted it to my wife. She tested positive for high risk hpv (not 16 or 18) twice (at 5 and 7 years later). Mine never recurred. For the most part of my life I’ve forgot about this. Now I’m entering a new long term relationship with a new partner (mid 30) who told me she tested negative for hpv and was not vaccinated. From what I read here it seems most hpv cleared within 2 years but can always reactivate for no reason. So it’s inevitable that at some point I would transmit to my new partner if it’s a long term relationship assuming she never had it before? Asking her to get vaccinated now would seem suspicious and I doubt vaccine will have 100% protection for a long term relationship. I also have neurodermatitis on my scrotum that I have to apply topical steroids once 2 or 3 days for the itch. Would this increase the chance of my hpv reactivation and thus become transmissible?

As that implies, I scanned your previous thread 5 ½ years ago. As you undoubtedly recall, it was a very detailed discussion with Dr. Hook about HPV epidemiology, your wart, and your former wife's Pap smear results.

It isn't necessarily true that you infected your wife back then. The multiple HPV types identified in your wart might be due in part to cross-reactivity of the DNA tests across various HPV strains. And by this time, another five years later, the possibility that you have active transmissible HPV from back then is very unlikely. It isn't impossible, of course, since 90% of all sexually active people acquire HPV -- often several times -- and may carry them indefinitely, with the possibility of reactivation. But exactly because of this, your new partner is no more likely to acquire HPV from you than from any of her past sex partners or from any other partner -- aside from you -- with whom she might have a new sexual relationship. In any case, this many years later, it is by no means "inevitable that at some point I would transmit [HPV] to my new partner". If she ever has an abnormal Pap smear, there would be not the slightest reason to assume it came from you rather than some other past partner.

HPV should be viewed as a normal, expected, unavoidable consequence of human sexuality. Having it means nothing in terms of health risk, at least no more risk than that experienced by any and all sexually active people. Also recall that the large majority of genital HPV infections are harmless, causing no symptoms or disease.

All things considered, I really don't think you have anything to worry about. I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Thanks a lot. I have a follow up question: does it make sense to ask my new partner to get vaccinated now? If I’m only contagious during my reactivation period then vaccine may still protect during these limited reactivation periods. Vaccines will take 6 months to finish but it seems it’s already quite effective after only 1 dose. It doesn’t seem vaccine is recommended during pregnancy (we are planning) but it also seems studies have also found no harm for those inadvertently get pregnant in the course of vaccination. If she get vaccinated now, should we at least abstain for some time after the 1st dose to wait for the protection effects to kick in?

Looking back at your previous question five years ago, it seems you have been living with an inflated perception of your role in transmitting HPV. I am confident your wife's ASCUS Pap and positive HIV test back then had nothing to do with you. You were not the source of her HPV and you are not likely to still have active infection or to infect your new partner.