[Question #13508] HPV safety, health, and new partners

4 days ago

So I’m sure you get this question below often. While I can’t say that I’ve found it on the forms yet, I did want to reach out for my own piece of mind. I was originally vaccinated for HPV around twenty. Unfortunately, I was diagnosed with genital warts in late June. I’ve since had them all frozen off via cryo and revaccinated. I’m a male in my thirties. And I can honestly say the diagnosis regardless of it being extremely common initially left me depressed and dismayed.

I’ve heard so many different perspectives on this, but I still wanted to reach out for as much clarity as possible. Once the warts have been frozen off what is a good rule of thumb in terms of viral clearance or dormancy and future partners. Is this something I should be disclosing with new partners for life? Is there ever a time when it becomes unnecessary? If so, how long should one wait? I just want to see what overall consensus on this is, and follow what protects people and keeps them the healthiest and safest possible as this is new territory for me.

Thanks so much of your help.

H. Hunter Handsfield, MD

4 days ago

Welcome. Thanks for your question.

The HPV vaccine is 100% protective against the two HPV types that cause 90% of genital warts (HPV 6 and 11). Your warts might have been due to a different HPV type, but not necessarily; it is at least equally likely they resulted from reactivation of an HPV 6 or 11 infection caught before you were immunized. In other words, this experience does not imply the vaccine hasn't been effective; assuming an average sexual lifestyle, it may have prevented infection from I'm sorry you were "depressed and dismayed", but glad to hear they have cleared up. Revaccination probably hasn't helped, but it certainly isn't harmful.

There are no good scientific data on the time HPV may persist and remain transmissible to partners after successful treatment of warts. Most experts with substantial experience treating genital warts believe that transmissibility is significantly reduced once the warts are gone; and usually not transmissible at all 3-6 months later if there have been no visible recurrent warts.

In general, nobody is obligated to inform partners of distant past HPV infections. Once 6 months have passed, in my view you should say nothing to future partners. Remember that 90% of sexually active people have been infected with HPV, often many times; and any new exposure does not significantly raise their risk of HPV any higher than it otherwise would be. Of course many people discuss their past sexual lives and STD histories with new partners when they expect the relationship to become committed and to continue over the long term. But the reason is primarily for mutual respect and caring, and not because it is necessary for health protection.

A bottom line is that having genital HPV and sharing the infection with partners is a normal, expected, unavoidable aspect of human sexuality. Happily, the large majority of infections are harmless and usually remain asymptomatic. And of course the odds are further improved by vaccination. And if you initiate a relationship with a vaccinated partner, the worries are even lower.

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

HHH, MD

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4 days ago

Hi Doctor, thanks so much for getting back to me so quickly. And for the kind words. This does indeed put my mind at ease, and gives me a lot to think about. This has very much been a learning experience in my health. Just to make sure I understand, after the 3 to 6 month mark with no wart recurrence, that would be considered clear? Given what is known about the virus, resuming normal sexual activities would also be considered safe from transmission at that point since the virus is considered negligible? Are there any sexual activities at that point that present a higher risk than others? (oral for example, though it sounds like oral transmission of gential warts maybe somewhat rare to begin with.)

Truly. Thanks again for taking the time.

All the best

H. Hunter Handsfield, MD

3 days ago

There is no guarantee you are clear of the virus and cannot transmit it after 3-6 months. Or ever; most or all persons with HPV, i.e. 90% of the population, have a lifelong potential for reactivation. (This explains the majority of abnormal Pap smears in women, for example.) But in general after that time the likelihood of either recurrence or transmission clearly is significantly reduced.

Correct that oral sex is inherently safer than vaginal or anal sex in relation to HPV transmission. Some cases are transmitted orally. However oral HPV is even less likely to cause warts, pre-cancer, or cancer itself than genital or anal infection; the large majority of cases are entirely silent and never cause any health problems.

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