[Question #14035] WTD post bowenoid papulosis/positive high risk
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6 hours ago
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51m/ married, monogamous 10 years, wife vaccinated in past couple years. what I thought was stubborn wart turned out to be a bowenoid papulosis after biopsy, had it removed, but is close to edge. Also presence of high risk 16,18,26,31,33,35,39,45,51,52,53,56,59,66,68,73,82. Derm has me using imiquimod for 4 months as precaution, but what do do regarding sex now? any point in abstaining since wont know going forward what my status is?
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H. Hunter Handsfield, MD
2 hours ago
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Welcome back to the forum. But please understand we STI experts do not diagnose nor care for patients with bowenoid papulosis and similar situations; this is pretty strictly a domain of dermatology. (Or of many genitourinary medicine experts, if you're in a country with GUM training and specialty practices, such as the UK.)
There are no specific data on the transmissibility of late recurring warts, BP, and similar problems. You can assume you are infectious for your sex partners for the HPV types detected, except for partners who have previously been infected with the same types or have been vaccinated. However, in your previous thread a couple weeks ago, it seems your only partner is your wife and she has had the HPV vaccine -- correct? If so, you can safely assume she has been repeatedly exposed to your HPV infections, certainly since the warts/BP appeared and perhaps for years before that. And since she has been vaccinated, she is immune to the HPV types that you have that also are included in the vaccine (HPV16,18, 31, 33, 45 and 52). Accordingly, she is at little or no risk and at this time there is no point in abstaining sexually and no need to alter your sexual practices together.
If you are likely to have other partners until your BP is gone, it would be a courtesy to advise them of possible risk. But all in all, you probably can entirely ignore the potential for sexual transmission of your HPV infections.
I hope these comments help a bit. Let me know if anything isn't clear.
HHH, MD
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