[Question #13053] HPV risk from one exposure and test results

2 months ago

I'm a 36 yo heterosexual married male from Malaysia. My wife and I have been each other's only sexual partners in life, except this one time on my part. May 1, 2024, I had one encounter with a Viet csw( 31yo). Protected vaginal intercourse (condom intact-1min); Unprotected receiving oral-1min. I avoid genital-genital skin contact beyond condom area, but still there's a chance. My full STD panel on Aug 4 all negative.

Me and wife had sex 9 times since May 8, 2024 - Jan 19, 2025, mostly protected, except 2 unprotected on June 13, 2024 and Jan 19, 2025. She had spotting, irregular periods, smelly discharge from Jan 28, but was later diagnosed with polyps and BV. Her HPV DNA test/Pap smear (Feb 27, 2025) both negative. She has since fully recovered.

Feb 19, 2025 I did another STD panel. Urine HPV DNA test. All negative. No symptom.

We both used Seegene Allplex HPV28 PCR

Does my one time encounter pose any real risk for HPV?

Can I trust me and my wife HPV test result?

Can I confidently say I didn't catch and pass on HPV?

Thanks so much!

2 months ago

forgot to add this:

My wife's most recent hysteroscopy and clinical examinations were in mid-April and late May 2025. We received the 9-valent HPV vaccine in March and April 2025 and plan to get the third dose next.

H. Hunter Handsfield, MD

2 months ago

Welcome to the forum. Thank you for your confidence in our services.

There are no data by which to estimate the risk of HPV from a single sexual encounter with a partner who might or might not have an active HPV infection. Oral sex is little or no risk. For vaginal sex, the infection risk without condom protection might be as high as one chance in 10; with a condom, probably under 1% chance, maybe one in a thousand. As I said, there are no data -- these are only educated guesses.

I would have advised against HPV testing for either you or your wife. I have no experience with the test you had, which is intended only for inclusion with a Pap smear for cervical cancer screening -- which is done routinely by gynecologists and not often by STI experts. Assuming your wife had a pelvic examination and her HPV test was taken along with a Pap smear, she can be confident she does not have a precancerous condition caused by HPV. However, it can take months or even years for HPV infections to cause precancerous changes of the cervix or to be detected by testing.

Your wife's symptoms do not fit with HPV or pre-cancer and HPV does not cause bacterial vaginosis or polyps.

Those comments pretty well cover your specific questions, but to be explicit:

"Does my one time encounter pose any real risk for HPV?" Very low risk.

"Can I trust me and my wife HPV test result?" The test results make it unlikely you or your wife have HPV, but because it can take years for HPV to show up with standard testing or to cause pre-cancerous changes of the cervix, the negative results are not 100% proof she doesn't have HPV. However, given the combination of the low risk you were infected plus her and your negative tests, it is very unlikely either of you has HPV.

"Can I confidently say I didn't catch and pass on HPV?" Reasonably confident yes, but there is no way to be 100% certain. Still, I wouldn't worry about it. Even if you caught HIV and transmitted it to your wife, most infections never show up and cause no symptoms. To put it in personal terms, if somehow I were in your situation I would not have had the HPV tests and would not be at all worried. However, your wife -- like all sexually mature women -- should have regular Pap smears according to standard guidelines. This is true regardless of sexual history or known risk of HPV exposure. Your local, provincial, or national health department undoubtedly has such guidelines.

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

HHH, MD

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2 months ago

Thank you very much for thoughtful and reassuring response. I would like to follow up with more about sexual timeline with my wife. After my single encounter, 9 times sex before her HPV and Pap smear. All vaginal.

- 1 unprotected + 1 protected -- she did her test 8.5 months later

- 1 unprotected + 3 protected -- test 6 months later

- 1 unprotected + 7 protected -- test 3 months later

- final 1 time unprotected -- test 5.5 weeks later

And I did my urine HPV test 9.5 months after encounter

- If HPV had been transmitted to my wife- unprotected or protected - would her Pap smear and HPV test likely have detected it by then?

- I understand HPV can sometimes be delayed in detection, but I wonder how much confidence I can have in the combination of our testing and time passed?

- Since we had several sex and her test/my test were all negative, can this be taken as strong evidence that I was never infected in the first place?

Lastly, we both will complete the 3rd dose vaccine by September this year. Would it be reasonable/safe for us to begin unprotected sex and try for pregnancy after we both finish the series?

Much appreciated!

2 months ago

Clarification: my wife only had one time Pap smear and HPV DNA test. I was just showing the breakdown of how many times of sex we had before her test and how long of the time passed.

Sorry if I make any confusion...

H. Hunter Handsfield, MD

2 months ago

I'm sorry but I really can't reply in any more detail than I have. It was nonsensical for you and/or your wife to repeatedly test for HPV. This is the first time in my 50 year career that I have ever heard of anyone testing this frequency in such an exceedingly low risk situation. Anyway, I simply cannot answer your question in the way you want. The exposure itself is the main reason you can safely assume you do not have HPV; the negative test results really do not add significantly to that fact. It can take 20 years for an HPV infection to first show up with testing; and I am unaware of any research by which to estimate the ability of the HPV tests to detect newly acquired infection at various intervals after exposure.

If you and your wife intend conception, you need not wait tune the third dose of vaccine. It would have been fine to try for conception with no immunization at all. In any case, although 3 HPV vaccine doses are advised, protection is 100% a month after the second dose.

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2 months ago

Thank you again for your reply-it really means a lot to someone feeling very anxious about this.

I want to make sure I understand correctly. When you said," I'm unaware of any research by which to estimate the ability of the HPV tests to detect newly acquired infection at various intervals after exposure"- did you mean that this reflects a limitation in the timing of detection in research, rather than our results are unreliable or meaningless?

I understand from your overall message that my exposure was exceedingly low risk, and that even without testing, it's safe to assume I did not catch or transmit HPV.

Also, based on your knowledge and clinical experience, would you generally agree that most HPV infections, if they occur, become detectable by HPV DNA testing within 3 to 6 months after exposure?

And just to confirm- if HPV were transmitted even via protected sex, HPV DNA testing and Pap smear would still detect it eventually, correct?

Thanks again!

H. Hunter Handsfield, MD

2 months ago

It means there has been no research to learn how long it may take for HPV to show up on particular tests. Your test results aren't meaningless, but they do not prove you did not catch HPV. You could have done so and have an infection that will show up in the future. This is unlikely, but not impossible.

"I understand from your overall message that my exposure was exceedingly low risk, and that even without testing, it's safe to assume I did not catch or transmit HPV." Exactly right.

"would you generally agree that most HPV infections, if they occur, become detectable by HPV DNA testing within 3 to 6 months after exposure?" Not really. Most cases of active HPV infection (usually genital warts or an abnormal Pap smear) probably show up 3-6 months later, but it's often two years or more and probably sometimes 20 years. There are no data on time to positive testing in people without symptoms.

"if HPV were transmitted even via protected sex, HPV DNA testing and Pap smear would still detect it eventually, correct?" No, not necessarily. Here again, some infections probably never result in positive test results.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. My closing advice is to concentrate on your "I understand" statement and my reply "exactly right". All the rest doesn't matter, given the harmlessness of most HPV infections.

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