[Question #12226] Disclosure of newly diagnosed warts

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9 months ago
I am a 59F who was diagnosed last week with GW.  My sexual history is that I had one partner at age 18, another at age 23-24 and then I was with my ex-husband for 33 years. I got divorced last year and in August, I had sex a couple of times with one partner, one time (Aug. 20) unprotected. Then, October 1-5, I had unprotected sex 5 or 6 times with a new partner (57M) That turned out to be a short fling and now we are just friends. 
On Oct. 22, I noticed a white bump near the rear of my vulva. I thought it was a pimple or cyst, but then on Nov. 2 I looked at it again and it looked more like a wart with the cauliflower appearance. I went to the gynecologist and they diagnosed GW and gave me imiquimod. I'm guessing I got the virus from the encounter in August, and the timing is right - about 2 months for the wart to appear. 
My big concern is whether to tell my partner from October about the GW. I don't know if I was contagious at the time or what the chances are of him getting warts. I am really worried that it will end our friendship, but I want to do the right thing! I don't want him to ignore possible warts and maybe infect someone else. I don't know anything about his sexual history except he's been divorced 4 years. I'm going back and forth with this because telling him won't change anything and he can't get tested for it. He can be on the lookout for warts, but that could cause him stress for months. Help - what should I do? 

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Edward W. Hook M.D.
9 months ago
Welcome to the Forum.  Thanks for your questions.  I'll be glad to comment.  Your post makes it clear that you have a good understanding of the issues around HIV.  We do not feel that disclosure of the presence of HPV infection to others is crucial in most instances but it is always a personal decision.  I'll summarize the basis for this stance below but I also would encourage you to review some of the many, many other interactions addressing this issue on the Forum.  We make them available so that clients can review the information that we provide to other clients.  To summarize:

One of the things we tell clients repeatedly that trying to determine the source of HPV (wart) infections is very difficult, if not impossible in persons who have had more than 1 prior sex partner.  The reason we say this is twofold- First nearly all (over 80%) of non-vaccinated sexually active persons will have acquired HPV at some time in the past (over 60% of persons with a single sexual partner have acquired HPC within 2-3 years of the onset of sexual activity.  Secondly, while most HPV infections go away without therapy, the infection may recur- sometimes years later.  Thus, newly recognized HPV infections may well be due to the recurrence of infection which was acquired years previously.  

In addition to the facts summarized above, assuming your prior partners may well have had HPV infection  in the past which can result in transmission of infection.  Finally, HPV infections are innocuous for nearly all infected persons making the importance of disclosure less important. 

Thus, while disclosure is always a good thing, if it will jeopardize a valued relationship, in our opinion, disclosure is by no means essential.  

I hope that this information is helpful.  EWH


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9 months ago
Thank you for your response. I did read as many of the HPV disclosure questions as I could find, but none seemed to fit with my timeline and issue, which is why I submitted the question. 
I'm still confused as to what I should do. I know it's a personal decision, but these are my main concerns.
1. In the future I plan to disclose to any potential partners, at least for a year or two, but since this exposure already happened, what are the benefits of disclosing, since he can't go get tested for it? 
2.  What are the chances that the exposures 3 weeks before I first noticed a bump will lead to him getting warts? I have read 66 to 75% likely that he will get it if I had the wart when we had sex. If it's that likely, it seems like I should tell him. Then again, how will that help him?
3. I am feeling really guilty about this whole thing! I'm dreading telling him (even though he made the choice not to wear a condom or ask me any questions about sexual history), but if it's the best thing to do, I will just have to bite the bullet. 
What are the pros and cons here? 

Are you able to give me any more clarity? I guess I just want an expert to tell me what to do. 


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Edward W. Hook M.D.
9 months ago
I can't tell you what to do- that is a personal decision.  I'll do my best to provide some information.  It would help if you could answer the questions I asked above. before my final response

1. In the future I plan to disclose to any potential partners, at least for a year or two, but since this exposure already happened, what are the benefits of disclosing, since he can't go get tested for it? 
I agree with assessment that there is nothing of benefit to come from disclosure to him at this time.  

2.  What are the chances that the exposures 3 weeks before I first noticed a bump will lead to him getting warts? I have read 66 to 75% likely that he will get it if I had the wart when we had sex. If it's that likely, it seems like I should tell him. Then again, how will that help him?
I'm not sure where you got the information you mention.  You did not mention the "bump".  Most visible genital warts are not due to HPV 16 or 18.    Exposures in the absence of lesions is unlikely to transmit infection

3. I am feeling really guilty about this whole thing! I'm dreading telling him (even though he made the choice not to wear a condom or ask me any questions about sexual history), but if it's the best thing to do, I will just have to bite the bullet.   
Personally I think your guilt is misplaced.  Disclosure is a personal decision.  EWH
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9 months ago
Just a couple more questions to close out this discussion.
You asked about the "bump". I mentioned it in my original question. I first noticed a white bump on Oct. 22 on or in my posterior fourchette.  On Nov. 2, it seemed to be bigger (about 5mm) and on closer examination, looked like the photos of genital warts I found online. 
My questions about this (and I know there may not be answers) are:  How long would it typically take for a 5mm lesion to develop? I'm trying to determine if I did have the wart a month earlier, but I realize it's probably impossible to tell.
Is it correct that warts can develop as little as 3 weeks after exposure? Or is 6 weeks the minimum? 

Next: During the time that I have warts and am treating them, how careful do I have to be about spreading the virus? If I touch my genital area with my hand, is it enough to wash with soap? What about laundry - underwear and towels? Is regular washing good enough? Any special precautions? 
Thank you for all of your help! 




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Edward W. Hook M.D.
9 months ago

final Responses:
You asked about the "bump". I mentioned it in my original question. I first noticed a white bump on Oct. 22 on or in my posterior fourchette.  On Nov. 2, it seemed to be bigger (about 5mm) and on closer examination, looked like the photos of genital warts I found online. 
It sounds as though this is growing faster than might be anticipated.  A wart would not double in size in just 10 days and photos can be misleading.  You may have a cyst of some other non-HPV lesion.  Cysts are common in the region you describe.

How long would it typically take for a 5mm lesion to develop? I'm trying to determine if I did have the wart a month earlier, but I realize it's probably impossible to tell.
Is it correct that warts can develop as little as 3 weeks after exposure? Or is 6 weeks the minimum? 
Warts typically take at least 6 weeks/2 months do develop.  See my comments above.

During the time that I have warts and am treating them, how careful do I have to be about spreading the virus? If I touch my genital area with my hand, is it enough to wash with soap? What about laundry - underwear and towels? Is regular washing good enough? Any special precautions? IF THIS IS A GENITAL WART (please be sure it is) touching the wart does not lead to transmission through transfer on your fingers.  Washing your hands will provide prevention of transfer.  Warts are not transferred by contaminated clothing.

Finally, let me comment once again about disclosure, particularly if you are not sure you have a wart.  As I said earlier- "First nearly all (over 80%) of non-vaccinated sexually active persons will have acquired HPV at some time in the past (over 60% of persons with a single sexual partner will have acquired HPV within 2-3 years of the onset of sexual activity).  I feel that at your age, most future partners will have already had HPV and are unlikely to become infected, IF you do have warts.

This completes this thread.  I think you are worrying more than you really need to.  EWH
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