[Question #1646] HPV Kissing on the Mouth/ Lips vs. Deep Kissing (French)

44 months ago
Greetings experts, I hope all is well. I am hoping you can help me find some understanding and peace with HPV. In short, I performed quite a bit of oral sex in my early college years (15 partners over a two and half year period. I am sure that I probably got hpv. I have never had any visual signs (warts or lesions) nor any symptoms that would indicate hpv.  I know that HPV is largely asymptomatic and for males there is really no way to know for sure due to lack of approved test. After learning about hpv, I refrained from any and all sexual and other intimate activities (kissing) for over two and a half years.  After two and half years I entered into a dating relationship with a young lady. Prior to entering a relationship with her I had read on a cdc publication that hpv is not spread through kissing on the mouth. This led me to believe we could safely start a relationship and see where it goes and if we would workout before having to tell her about my past. However, I recently read a publication from cdc and viewed a fox news broadcast that indicated that hpv is spread through kissing. I am so confused and stressed as a result. My girlfriend at the time and I had never been sexual or even french kissed, just kissed on the mouth/lips to greet or say bye. We didn't work out and broke up. However, after reading that hpv may indeed be passed through kissing on the mouth, I have lost the certainty that she was safe from me passing hvp to her because it had been well over two years since my possible exposure and because we had only kissed on the mouth/ lips.  I am now worried I could have passed hpv onto her via kissing on the mouth/ lips. Please can you tell me if hpv is truly not transmitted through kissing on the mouth/ lips. I do understand there seems to be some risk from deep open mouth kissing.  CDC has so many conflicting publications, and I have lost a lot of sleep over it. Thank you in advance and I appreciate your help. 

Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Welcome to our Forum.  I'll try to help by providing some perspective.  Given your sexual history there is little doubt that during your early college years you were exposed to HPV through performance of oral sex since most sexually active persons (including you) will have genital HPV. From there forward however, it is important not only to ask whether something occurred but whether or not it is important to your, or your partners' health.  The answer to the last question is probably not, for several important reasons.  These include:

1.  Your current partner may have gotten the HPV vaccine, depending on her age.  If so, this vaccine is about 99% effective for preventing genital HPV infections caused by the HPV types it contains (the most common genital strains) and the small amount of data available suggest that it is also effective for prevention of oral infection IF you are currently infected (see below).

2.  Even if were infected, most HPV infections are transient and resolve without therapy over a period of six months.  Two years after your last oral sex it is unlikely that you would still be infected.

3.  As a biological process transmission of HPV to the oral cavity is much less efficient than genital contact.  I suspect that it is for this reason that CDC first stated that the infection was not transmitted by kissing and then revised their statement to reflect the fact that oral HPV may, uncommonly be transmitted by deep, open mouth kissing.

4.  Finally and most importantly however, it is important to appreciate that only a tiny fraction of all HPV infections go on to cause the thing that makes HPV infection important, cancer.  Because health care providers are aware of this they look- most dentist now look for evidence or oral cancer or related disease so in the very, very unlikely situation that you or your partner developed an HPV-related pre-cancerous lesions, it would typically be detected and therefore treatable in the course of recommended health care.

In summary, I suspect that HPV can, rarely be transmitted by deep kissing but that small chance is just not significant enough to recommend that you hinder or curtail your relationships with others because of it.  you probably do not have the infection and if you do, it is of little health consequence to your loved ones.  A possible analogy has to do with lightening.  We are all exposed to it, a few people are struck by it, but none of us should worry about going outside because of fear of it.  Media outlets like FOX New and the internet all too often take such information and fail to put it in context.  I hope my comments above will help you to do this and to move forward without concern.  EWH

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44 months ago
Good morning Dr. Hook, 

I hope that all is well. I sincerely thank you for your quick reply, it is of great appreciation and help to me. May I please ask some follow up questions for my own clarity? 

1.  Is oral hpv and genital hpv different? Or, do their respective names come from the infected site?
2. My ex-girlfriend was very affectionate to her nieces and nephews, hugging, and kissing both on the cheeks and a peck on the lips now and then, are either of these efficient ways to transmit hpv (specifically, a quicky closed peck on the lips)? This gives me chills considering I want to someday have children. 
3. While I have never heard of hpv being able to resolve in about 6 months, I can tell you this is a good news and something to look forward to, as I recently had a sexual encounter (oral sex) with a former acquaintance, however I wonder, does age (I am 26), affect a persons ability to push out the hpv virus through their immune system?

I thank you for your time doctor, and appreciate your help. 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Straight to your follow-up questions:

1.  The types of HPV virus that cause genital and oral infections are, for the most part the same.  Thus the designation of oral vs. genital relates to the location of the infection, nothing more.

2.  No these sorts of kisses (kissing on the cheeks, "pecks" on the lips) are no risk events for HPV.

3.  The fact that nearly all HPV infections resolve without therapy, most typically over a period of about 6 months, is indisputable.  There are no data on whether age has a meaningful impact on ability to eliminate infections.  If this were the case, it is people far older than you who might have slower elimination of infection. 

EWH

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