[Question #13209] STI

1 months ago

I had approximately 9 small genital warts on my penis. I had them treated over the last year and the dermatologist said they are no other visible ones however I see some very small bumps but I am unsure if they are warts (upper 1/3 of shaft). 3 of the initial 9 warts were at the base of the penis and pubic area. Those have been removed approximately 1 year ago and no visible warts in that area. If I plan to have intercourse using a condom that covers the area where the possible small bumps are but obviously doesn't cover the base and pubic area (treated 1 year ago) with no visible warts in that area, what are the possible chances for transmission to my potential new partner? Is the skin at the base and pubic area likely still infectious?

Also, if do have an active infection (the small bumps) what are the chances of transmission of remnant viral particles on my hand to a baby when changing diapers? I read that soap and common disinfectants are not effective against hpv.

H. Hunter Handsfield, MD

1 months ago

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

I can't really comment on whether or not the "very small bumps" you still perceive are continuing or new warts. It would be best to return to the dermatologist for their judgment about whether the new "bumps" are warts. If they are, then you likely will be able to transmit the HPV causing them to your sex partner(s). Condoms are not very good protection against HPV. You should think of genital warts and other genital HPV infections like an "iceberg": the warts are the tip ("above water") but the infection is much more widespread than that. Condoms probably have little benefit in preventing transmission just because they cover visible warts. In other words, the answer to your question "Is the skin at the base...likely still infectious?" is possibly yes.

This doesn't necessarily mean you should not have sex with your regular partner: if she is an ongoing partner, she likely has already been exposed or infected (or maybe the source of your HPV/warts?), and now possibly immune to catching the same virus strain again. But if this is a new partner, you should consider discussing the situation with her then decide together whether or not to have sex.

There is no risk for HPV in children or others in the household, even when changing diapers etc. Genital warts or other HPV infections never occur in household members of infected persons, regardless of diaper changing, shared toilets and towels, etc.

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

HHH, MD

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1 months ago

Thank you for your response. I'm trying to understand. If I have one small possible wart on the foreskin, that makes the entire skin on my genitals infectious? If I do remove the one small possible wart on my foreskin that is tip of the "iceberg", would that help in making the skin at the base of my penis less infectious?

Also, how safe is mutual masturbation?

Thank you for your time.

H. Hunter Handsfield, MD

1 months ago

The "iceberg" analogy doesn't necessarily mean your "entire" penile skin is infected, only that infection is often more widespread than the visible warts. Experts have long believed and advised that wart removal probably reduces the likelihood of transmitting HPV to partners but does not completely eliminate the risk. As I said above, it's also one reason that condoms are less effective in preventing HPV transmission than other STDs.

Hand-genital contact rarely if ever transmits HPV or any other STDs. Nobody can say the risk is zero, but busy STD clinics rarely if ever see infected persons whose only possible exposure was masturbation by a partner.

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