Should I get vaccinated?

Should I tell future partners?

Should she tell future partners?

How long should be rigorously self examining?

In the past three months, I slept with someone else.. should I tell her?

I've read a great deal about most hpv infections being asymptomatic. For types 6 and 11 specifically, are they always symptomatic eventually? How best do I protect future partners if I've never had an out break? If I'm subclinical, what does that bean in terms of exposing others to these specific types of the virus?

 

You are correct that you can't conclude one way or the other whether you were the source of your partner's genital warts. Most of the time the source of any particular HPV infection can't be determined with certainty. I'm not sure it's necessary for you to see your doctor about this. The official advice from CDC, which is also the advice of most individual STD experts (and my own), is that the partners of persons with warts or other HPV infections do not require medical evaluation unless and until they develop warts themselves, or otherwise have symptoms. Since you have not developed warts, having either infected your partner or being repeatedly exposed for almost two years (since 12/15), it probably isn't going to happen. You can safely assume you were infected; and with no warts after this period of time, the infection probably has been cleared by your immune system and will not cause you any problem.

To your specific questions:

1) HPV immunization is not recommended above age 26. And certainly there is no point in being vaccinated now against HPV 6 and 11. That horse is not only out of the barn but galloping over distant hills. 

2) My advice and that of most experts is that nobody has an obligation to inform partners of HPV exposures, only of their own active infections. You have no obligation to inform future partners. But more below about your current partner.

3) Same for your partner, once her warts have been treated and not recurred. In any case, this isn't your business at this point, only hers. If she freely asks your opinion, feel free to render one. But otherwise keep out of it.

4) Stop self examination now.

5) As noted above, in my opinion you have no obligation to tell your current partner anything. OTOH, some couples routinely discuss past sexual lifestyles, past STDs, etc, especially in relationships that have the promise of long term commitment. But this is a relationship issue, not so much one (in this case) of medical necessity or infection prevention.

I hope these comments have helped. There are many other excellent online resources about HPV that can also help address your concerns. CDC has excellent information (www.cdc.gov/std). Also the American Sexual Health Association, sponsor of this forum. Here'a a link (which also happens to include a couple of educational videos:  http://www.ashasexualhealth.org/stdsstis/hpv/

Let me know if anything isn't clear. Best wishes--  HHH, MD

I'm in full agreement that she doesn't have to disclose. She seems pretty devestated and after reading all the material out there, I personally believe it's immoral to subject someone to shame for an ancient microbe that we all essentially have... she is very concerned about passing it on. I understand that and that's her choice but I worry that it will stand in her way of being happy.   I'm going to stay out of it from this point forward, but I certainly don't think it's fair that she has to subject herself to future scrutiny just because she manifested warts when most cases are asymptomatic. It just doesn't seem fair.  My plan is to be diligent with using protection and limit partners

One minor correction: Although true that the large majority of HPV infections are asymptomatic, that's not quite true for the main wart-causing HPV types. Some studies suggest that most people (60% or more) with new HPV 6/11 infections develop overt, recognizable warts.

"Clear" means the immune system has completely resolved the infection to a point at which recurrent warts won't happen and the virus cannot be transmitted. As I use the term, latent (or dormant) means the same thing. But don't get hung up on terminology. The point is that before too long, you won't be a carrier capable of transmitting warts.

That completes the two follow-up comments and replies included with each question and so closes this thread. I hope the discussion has been useful. If new concerns arise, I would suggest you re-read everything above, and perhaps also explore some excellent online resources about HPV, including CDC (www.cdc.gov/std) and the American Sexual Health Association (http://www.ashasexualhealth.org/stdsstis/hpv/). Best wishes.