[Question #2220] Both partners with new HPV.

47 months ago

My husband of 15 years recently had an affair that resulted in us both contracting External Genital Warts.  We are working through this infidelity with a counsellor but I am having trouble accessing the information that I require in terms of our current sexual relationship.  I became symptomatic first with one lesion.  He then had one lesion and then I had an additional 2 lesions.  We are treating with topical Imiquimod which has proved effective in the first 2 isolated outbreaks within a week.  Just recently I have had a third outbreak within 3 months.  This one is more extensive with ~10 labial lesions.  They are all very small.  I understand that sexual contact should be avoided if there is skin trauma due to a medication reaction but should we be sexually abstinent always if external lesions are present.  My primary concern is the introduction of internal vaginal or anal lesions.  What about oral sex?  Also, what about mastrabation in terms of self-spreading of the lesions?  Any guidance on maintaining our sexual relationship (or should we be having intermittent pauses?) 

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Welcome to our forum.  I'll try to help but to do so I will also need to ask a few more questions.  I presume that your warts, as well as those of your husband have been verified warts by an experienced physician (i.e. a dermatologist, gynecologists, etc.)  The reason I ask this is that warts typically take several months to appear following acquisition and that once a person has a wart, sometimes they begin to notice other skin irregularities present in the genitals (the genitals normally have many skin folds, irregularities, and cysts, many of which might resolve with imiquimod. 

As for your specific question, we typically do not urge our clients to abstain from continued sex when HPV/warts are present, even if they are undergoing treatment.  The reason for this relates to the long incubation period between exposure and the appearance of warts and the fact that both partners have typically be exposed to one another's HPV infection on numerous occasions.  Some clients choose to use condoms but we do not fee l that this is critical for managing warts. 

With regard to oral sex, the HPV of concern which can occur in the oral cavity if HPV 16, while the types of HPV which cause visible warts (types 6 and 11) are rare in the mouth.  As for unprotected genital sex, I do not see having oral sex with a regular partner when you both have warts as a problem.

finally, I would not worry about masturbation (by yourself or mutually) as a means of spreading warts.  I hope these comments are helpful.  EWH
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47 months ago

Thank you for your prompt reply.  

We have had a diagnosis made by a physician.  There was approximately a 2 month interval between “the acquisition” and the first appearance of a lesion.  It has proven difficult to get specific answers to these questions so I thank you kindly.  I understand the concept that the virus can lie dormant until, hopefully, clearance is achieved.  I know that we are not passing it back and forth.  I guess my biggest concern is that when an external lesion(s) is present is the virus more likely to spread to unaffected areas (especially internally) or does that mostly have to do with skin trauma (i.e. micro trauma from shaving which I seem to be learning the hard way.)  I can appreciate this is not a well studied concept.  

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Even with the sort of microtrauma you describe there is little risk of further spread to currently uninfected internal areas.  There is a theoretical concern that shaving could spread the lesions however.  EWH
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