[Question #1756] HPV & Other STI's

81 months ago

I am a 51 year old man married 20 years.  About 3 months ago, I received deep throat oral sex and deep kissing from another man who is promiscuous.

My wife and I were not getting along and not having sex at the time.  However, our relationship was never to the point that she would accept this mistake I made; it would surely end our marriage if she found out.  We are getting along better and she may start to be interested in sex again.  However, I am worried I caught an STI and could transmit it to her.

I have been closely and frequently examining my genital area and on the lookout for any abnormal discharge since the event 3 months ago.  I have not seen or experienced any symptoms.  However, I am very concerned about HPV.  I have read HPV can be asymptomatic--especially strains that cause cancer.

I have read conflicting information about HPV being transmitted from the mouth or throat to the penis.  For example, I have read on this forum that "transmission of HPV from oral infection to partners appears to be uncommon," while other internet pages make it sound common, if not probable.

Do you think it is safe to resume sex with my wife?  I am very concerned I caught HPV, will now transmit it to her and it will show up in the future as a genital wart or an abnormal pap smear.

If it is possible for you to clarify the chances I caught HPV, it would be appreciated.

Also, since it is 3 months with no symptoms, do you think I'm clear of other STIs like HSV?

Thank you

Edward W. Hook M.D.
81 months ago

Welcome to our Forum.  I'll try to help with my goal being to reassure you that it is safe to resume unprotected sex with your wife and to help you move forward from your misstep without concern that your contact outside of your marriage will lead to HPV infection. In reading your question, I find myself wondering if you have been reading about HPV on  the internet.  If you have, I urge you to stop as much of what is said there is either taken out of context, over stated, or just plan wrong.

There is still much to be learned about HPV and HPV acquisition and transition.  We do know however that while HPV infections do occur in the throat, they are less common than genital infections, that they are poorly transmitted by oral sex and that a single receipt of oral sex, even "deep throat" oral sex, rarely leads to HPV infection.  Genital warts typically take about three and sometimes as long as six months to develop once infection is acquired but as I said above, acquisition of HPV from oral sex is rather uncommon (there are no precise figures on risk of acquisition).  Further, even if your wife were to develop an abnormal PAP smear, the widespread nature and tendency to recur after long periods makes it difficult to determine where infection came from.

My advice, is that there is no need for you to continue to worry about having gotten HPV from the exposure you describe.  As far as other STIs, had you developed other STIs, they most likely would have become apparent through the development of symptoms long before now.  I hope my suggestion and the information I have provided is helpful to you.  EWH

80 months ago
Thank you for the information.  It made me feel much better, but then I had a symptom as discussed below.

Last Tuesday, I noticed a small (smaller than a dime) circular red spot on the shaft of my penis.  I was worried it was the beginning of warts (particularly since I am in the 3-6 month window).  There was no pain, itching, blistering or fluid.

I purchased a magnifying glass with a light to look at the spot.  Under the magnifier, it appeared as though the normal variation in the skin on the penis was inflamed/irritated.   I don't recall any trauma to the skin of the penis that would cause the inflammation or irritation.

I was planning to have it examined by a professional, but by Thursday (2 days later) the red patch started fading and appeared more like dry skin.  By Sunday (5 days later), the patch appeared to be gone and the skin looked normal under the magnifying glass.

I don't recall ever having anything like that before on my penis.  However, if I did, I didn't pay attention to it because I was never on the lookout for issues like I am now.

Do you know what this could have been?  Could it have been related to the unprotected deep throat oral I received about 4 months ago?  Could this have been a precursor to warts or another STI?  Is it safe to have unprotected sex with my wife?

Thank you for this invaluable service you provide!
Edward W. Hook M.D.
80 months ago
What you describe does not sound like a typical wart or any other STI.  It does sounds like local irritation (gym shorts, exercise) or perhaps a fungal infection.  No sTI would resolve over the course that you describe.  My guess is that the fact hat you have not noticed such areas in the past may have to do with the fact that you are now inspecting your penis far more closely than you did in the past.  I really would not worry.

If there are further questions, please don't hesitate to ask however, also please be aware that we close threads after three replies or the passage of two weeks for logistical reasons related to the volume of questions we can manage.  I'm sure you understand.  EWH

80 months ago

Thank you for your response.  The small red patch began fading after 2 days and disappeared after 5 days.  I understand you said no STI would resolve over that course.  So, it could not have been herpes?  As mentioned earlier, there was no pain, itching, blistering or fluid associated with the red patch.  In addition, I did not see any lesions within the first 10 days of the receipt of oral sex.  Could it have been a mild case of HSV?  Or, is that unlikely without blistering, fluid, etc.?

About 5 years after we were married, my wife had an abnormal PAP smear and said it was not high risk HPV.  Similar abnormal PAP smears with non high risk HPV occur about every 5 years with normal pap smears in between.  The most recent abnormal pap smear was late 2016.  I assume these are "reactivations".  Are abnormal PAP smears simply reported as either low or high risk HPV, or are specific strains of HPV identified?  I am concerned identification of a new strain of HPV in the future could raise suspicions.

I know you responded earlier that a single receipt of even deep throat oral sex rarely leads to HPV infection.  So, I know that I just have to move forward and hope I did not acquire any STI--I am working through the guilt I feel.

Thank you again for your patience and all the information you provided.  You provide a much appreciated service.  I understand this question will be closed after your next response.

Edward W. Hook M.D.
80 months ago
the lesion you describe certainly does not sound at all typical of herpes either.  Neither your description nor the time course are at all suggestive of HSV.  As I mentioned earlier, from the sounds of things, you are paying far closer attention to your genitals, inspecting for abnormalities than you would have in the past.  My guess is that what you experienced was either local irritation of a fungal skin infection. 

The way the PAP smears and related HPV infections are reported vary but most often results are simply grouped as "high" or "low" risk.  I presume your concern is being "found out" by the report of a previously unidentified HPV type.  If so, I would not worry.  Even if a specific HPV type were reported, because most people with HPV are infected with multiple HPV types and trying to use a newly detected HPV infection as evidence of infidelity is something that nearly all experts would not do as there is no scientific basis for this.  HPV types may "reactivate" years later in patterns and ways that simply are not understood at this time.  Thus detection of an HPV infection which was not detected in the past should not be used or suggested as evidence of new infection of new sexual partners. 

I urge you to move forward without further concern about having gotten an STI from the dalliance you described.  As you have acknowledged, this thread will be closed later today.  I wish you the best. EWH