[Question #2207] HPV risk

46 months ago
Hello Dr.
This is a follow up to question 2135, and it is related specifically to HPV.

As a quick background summary I am a male and had a regrettable one night stand with a colleague 5 months ago. I've been with my wife for close to 10 years and I an worried of the effect that this misstep could have on my marriage.

Could you please help me clarify the following?

1) What are the overall chances of getting HPV for an unprotected vaginal encounter.  From what I have read, I understand that there may not be accurate data to estimate this, in this case an estimation based on your experience would be more than enough for me.
2) Given the case that my partner were infected, how likely is that I could have got infected if we had sex 2 times that night?
3) In the case that I am infected, how likely is that I can transfer it to my wife and how easily could it be identified or related to an encounter in the last 10 years?
4) From a health perspective, should i disclose this with my wife? Is she at any risk?

Thanks in advance.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome back. But sorry to see you remain concerned despite the reassuring replies you had from Dr. Hook.

As for HPV, this is never something to worry about in this situaiton. You can assume you already had HPV before this event. We know that at least 90% of all humans acquire genital HPV, even if they have had only a small number of sex partners. In addtion, a newly published research study shows that at any point in time, HPV DNA is present on the penises of 50-60% of all males age 15-60. It is similar in women, and these figures apply equally to currently monogamous persons as well as those with multiple partners.(Probably not all these are transmissible to partners, but it reflects how common HPV is.) Therefore, any single sexual exposure does not significantly raise the risk. So in the event your wife were ever to develop evidence of an active HPV infection, such as an abnormal pap smear, it will not necessarily be the result of your sexual exposrue 5 months ago; you would never know where it came from.

To your specific questions:

1) There are no data on risk of new HPV from any one sexual exposure. It is probably quite low, I would guess under 1% and for sure less than 10%.

2,3) Also no data. Probably a low chance after only two exposures, but of course the risk rises with ongoing, repeated sexual contacts. See my comments above:  if your wife develops HPV someday, there will be absolutely no way to trace it to any particular sexual exposure, either by you or her; and no reason for her to suspect you had other partners during your marriage.

4) From a medical or risk perspective, in regard to HPV or any other STD, there is no reason to tell your wife. Some men would still tell their wives, to help get beyond their remorse, guilt, shame etc. But this is a relationship issue, not a medical one. Only you know whether it might be right for you.

My last general advice is to separate your guilt and shame over a sexual decision you regret from the medical consequences of that event. They are not the same. Deal with the former however you need to (perhaps with professional counseling if you cannot shake it). But you can disregard the latter. It is not an issue for you.

I hope this has been helpful. Best wishes--   HHH, MD

45 months ago
Hello Dr,
Thanks for your reply, yours and Dr. Hooks comments helped me a lot to put my mind at ease while I am dealing with the guilt factor.

There have been some changes in my situation that brought back some of the concerns.  My wife is now pregnant from the single encounter I described on my previous question and I have again big worries about her health  and about my indiscretion being discovered.  In order to put my mind at ease again, I wanted to ask your help with some additional information so that I could put my mind at ease back again.

1) The Chlamydia test I had was performed using an "Inmunochromatographic" method.  How likely it is that this has failed to detect a possible infection? And, in case it has failed,  could you please provide a rough estimate on how likely for a Chlamydia infection to heal in the course of 5 months with no treatment?

2) I have not been tested for Gonorrhea.  Any estimated % or any information on how likely is for an infection to heal on its own in 5 months?

3) Also not been tested for Trichomonas.  As with questions above, could you please provide an estimated probability of this to be cleared in a period of 5 months?  And how likely is it to be infected from a one night stand kind of encounter?

Any additional recommendation?

Thanks in advance

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
1) That is a highly reliable chlamydia test. You can be sure you don't have it. There are no data in men about how long chlamydia can persist without treatment, but my guess is that it usually is cleared by the immune system within 3-6 months.

2) Almost all men with gonorrhea develop obvious symptoms that you would not miss. Even without testing, there is almost no chance you were infected. Without treatment, gonorrhea in men usually is cleared by the immune system within 6-12 weeks.

3) No males ever are tested for trichomonas; there is no proved test for use in men. The chance of trich infection in this circumstance probably is near zero.

Most pregnant women are tested automatically for common STDs, and your wife probably has already been tested by her obstetrician for HIV, syphilis, chlamydia, and gonorrhea, and perhaps trichomonas as well. There is no test for HPV in women without symptoms, except as part of a pap smear. Anyway, if something had been detected in your wife, she would have been told and undoubtedly would have discussed it with you.

All things considered, the chance you have any STD from your adventures with your co-worker are very, very low. You really need not be worried.