[Question #2519] HPV transmission

Avatar photo
96 months ago
41 year old female, diagnosed with HPV 9/16. (HPV test in 9/11 was negative, 3 partners since then, incl. current). Colposcopy done in 9/16 showed benign healthy tissue.   No sexual activity from dx til  6/17, then vaginal intercourse with new male partner using a condom each time except the last time.  Male partner, 45, has no hx of genital warts/cancer. If I were to receive or give oral, what is my risk of oral HPV infection since we have now had unprotected vaginal? What is his risk of same? Can he reinfect me thru unprotected vaginal sex down the road if I am HPV neg. at next test,  if we remain active with each other only?
Avatar photo
H. Hunter Handsfield, MD
96 months ago
Welcome to the forum. Thanks for your question.

In general, I do not advise altering sexual plans, exposures, or practices on account of genital HPV infection, except for warts. Warts tend to have a "yuck" factor, with many people put off by them, so it often makes sense for someone with new warts to avoid sex with new partners until their warts are gone. However, for non-wart causing HPV types, I generally advise that there are no certain ways to avoid transmission other than avoiding sex entirely -- and usually sex and romance are too important to be so drastic about it. I would encourage the two of you to enter a fully expressive sex life: the determinant of your specific practices should be mutual pleasure, not prevention of HPV.

Despite your partner's lack of diagnosis or awareness of prior HPV, almost certainly he has been infected, since over 90% of sexually active people have HPV at one time or anohter, usuallly several times. Recent research shows that 50% of adults have HPV in the genital area, so there's a good bet he's already carrying it. Sex with you, even given your recent diagnosis, will not significantly raise his risk of having an HPV problem someday. Whatever HPV type you have, there's a very good chance he has already had it and is now immune to new infection with that type. (And for that same reason, couples are believed to not "ping pong" HPV back and forth. If you infect him, and your HPV then goes away, you will not re-catch it from him.)

Would oral sex reduce his risk of acquiring the particular strain(s) you have? Maybe, but not for sure. Many people with genital HPV have it in their mouths. Oral sex rarely transmits HPV, but it happens sometimes.

Be clear:  I'm not saying there is no chance your partner won't catch HPV from you. He might. However, the vast majority of HPV infections never cause symptoms, and his risk will be no higher from you than it was with his other past sex partners. He can be sure that most of them had HPV, even if never actually diagnosed. And some of those women probably were diagnosed with abnormal paps etc and didn't tell hiim.

So my advice is to discuss all this with your partner to make sure both of you mutually understand the pros and cons of unrestricted sexual expression. And most likely proceed without restriction.

I hope this information is helpful, but I understand it's a complex topic. So let me know if anything isn't clear.

Best wishes for a rewarding and romantic relationship!  HHH, MD

---
Avatar photo
96 months ago
Thank you so much for this incredibly informative and stress-reducing response! To follow up, do you recommend the use of monolaurin or herbal combinations/ dietary supplements with anti-viral properties? Is HPV specifically  known to be  responsive to something like that? Or is it simply that it boosts the body's immune response which is beneficial to overall health? Thank you again for your time.
Avatar photo
H. Hunter Handsfield, MD
96 months ago
Being generally healthy with an effective immune system of course is a good idea, but has no known influence on HPV clearance, disease progression, etc. It can't hurt, but there is no evidence it helps. (Whether the supposed immune boosting items you mention actually have any effect is a separate and controversial issue, but of course many people believe them to be helpful.) The single lifestyle factor known to have an adverse effect on HPV is smoking, which is associated with higher rates and perhaps faster progression of pre-cancerous lesions like dysplasia.

---
Avatar photo
96 months ago
Thank you again, Dr Handsfield, I appreciate the time you took to respond.