[Question #1673] HPV

46 months ago
After genital warts are removed, do I need to let my future partners know that I have had them? I have read different opinions and there doesn't seem to be a consistent answer to my question.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question. 

There are varied opinions on this because there are no firm data. It just isn't known exactly how long HPV may persist in transmissible form, a potential risk for future sex contacts, after warts clear up. However, most experts agree that a few months after warts clear, either with treatment or on their own, transmission risk is low. I usually tell people 6 months, but that's just an educated guess.

However, I really don't think it matters much. Let's say you meet an attractive person and the two of you get it on. Let's further assume that both of you have had several other sex partners. For sure you have both had HPV; and if you're age 20-35, there's a 50% chance either or both of you is infected right now and can transmit HPV to the other person. You don't know, so you don't worry about it. But if one of those persons has had genital warts in the past, it really makes no difference:  the partner's chance of having HPV or genital warts is no higher on account of this particular exposure. So why say anything?

When couples form committed relationships, some discuss their past sexual lifestyles and STDs. In that setting, you might tell your partner you've had genital warts in the past. But that's a relationship issue, not one of disease prevention.

This is why there are only two effective strategies to prevent HPV problems:  vaccination, to prevent infection with the 9 HPV types that cause 90% of genital warts, cancers, and other HPV health problems; and pap smears in women (and maybe someday routine anal pap smears in gay men) to detect pre-cancerous lesions before they become dangerous. No other strategies have any signifcant value, including informing partners of past infections.

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

HHH, MD

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46 months ago
Your response is helpful, thank you.  I did not get the vaccine and didn't really understand what HPV was until recently.  I know the vaccine is provided to people up to 26 years of age. I'm 27 and wanted to know if paying for the vaccine myself is worth it. I don't care so much about the warts as I do cancer. I've been told it isn't but figured I'd ask.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
There are three main reasons HPV vaccine isn't recommended over age 26: First, new infections are uncommon after that age. Second, by their mid twenties, most people have already been infected with the most common HPV strains covered by the vaccine, and therefore the vaccine won't help much. Third, because of these facts, the vaccines have not been formally studied in women older than 26, and therefore are not officicially approved or recommended.

However, the vaccine almost certainly works well in women your age, and some such women remain susceptible to vaccine-covered HPV types. For example, if you have had few sex partners but expect to be dating and will have several more in the next few years, getting vaccinated may be worthwhile, even if you have to pay out of pocket. But if you have had an average sex life, with several partners over the past decade or so, it is unlikely you will beneift from the vaccine and I and most other experts would not recommend it.

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