[Question #3299] Exposure

Avatar photo
90 months ago
Doctor,

I recently had sex with a condom ( twice same night) and oral sex without. There was the typical floor play, no penis to vagina with out condum. 

I also a week later had unprotected oral sex with a different girl. 

My concern is a few years ago I had gential hpv warts a couple, Doc gave me some medication for at home some liquid. Haven’t had them sine and was told after they were clear I was clear to continue sexual activity. After my second encounter about a few weeks after I was checking down below and fairly confident that I have a couple flat warts on the upper part of my penis near the circumcision line ( which mine has always been darker) these warts are small and darker then the line but fairly confident they are small flat warts my fear is I have exposures these two individuals to Gential Warts. I need to reach out and speak to both of them and was in need of some advice around transmission. I have prayed I haven’t given this to them however after reading more I have learn they are very contagious. 

Can you share your expert opinion on the risk of these encounters and exposure thoughts. I will enocugage both to go get check. 

Thank you.
Avatar photo
90 months ago
Is it unusual for them to come back after 2 year or is it more likely they were never completely gone? 

Also with oral sex, I have read that transmission is less likely is this true.


Avatar photo
Edward W. Hook M.D.
90 months ago
Welcome to our  Forum.  I'll be pleased to comment, first with why I suspect what you have noticed are not warts and then to tell you why this is not something to be concerned about, even if they are.  These are both questions which both Dr. Handsfield and I are asked about regularly so, in addition to reading my response, I would suggest that you return to the Forum and read some of the numerous other exchanges we have had with other clients in the past regarding the issue of HPV infections, their diagnosis and disclosure. 

First, I doubt that what you are describing are warts or, if they are, that they are recent.  The location of the lesions you describe is the place where pearly penile papules regularly appear.  Pearly penile papules are bumps that are normal and typically appear close to the circumcision line.  They are often mistaken for warts.  Further, if they are warts, I am confident that they were not acquired from recent sexual encounters as it typically takes 2-3 months following exposure for visible warts to be detectable. 

Now regarding issues of transmission and the need for disclosure to sexual partners, these are things that we typically do not feel is necessary.  Our reasoning on this is that there are now many studies show that when persons become sexually active they acquire HPV very rapidly and that within three years of a person's first sexual encounter over 50% of persons, even those who have had only a single partner, have HPV.  It is now conservatively estimated that over 80% of sexually active Americans have or have had HPV.  Thus it is in no way surprising that you were found to have had warts in the past, and it is likely that, unless your partners had received the HPV vaccine that they had the infection as well, whether they know it or not.   Thus, for all practically purposes HPV are part of being a normal, sexually active person which only very rarely lead to complications or problems.  At the same time because these infections sometimes generates disproportionate concerns and reactions, often based on misunderstanding of the science behind the infection and often fueled by mis-information commonly found on the internet, we see little to be gained in most instances from disclosure to sexual partners.

I hope this information is helpful.  The best way to find if the lesions you describe are warts are to have an experienced sexual health clinician or a dermatologist to take a look.  In the interim however, I would not worry.  If any of this is unclear or you need additional information, please feel free to use your up to two follow-up questions to seek clarification, hopefully however AFTER you have looked at our responses to other, related questions.  EWH.
---
Avatar photo
90 months ago
Thank you. After reading your previous post! Sounds like transmission is very easy.  After reading your post. I suppose I don’t know the correct terminology for the dark line around my penis it’s below the circumsison line is suppose around the shaft. 

In reading your post in the past, there seems To be limited research on transmission and risk associated with Gential Warts and some difference in studies. When warts are present does this increase the transmission rates I have seen and would it very with oral and vaginal protected. Do you think there will ever be a cure for these viruses? Are there anything in the works? I understand that most people will acquire hpv but does that mean most people have the strand that cause warts?  
Avatar photo
90 months ago
If transmission occurred of the warts strain. How long would it be if they were to have symptoms being warts. I saw that some people who acquire the wart strain never have warts and some do. 
Avatar photo
Edward W. Hook M.D.
90 months ago
It is difficult to determine how "easy" (that is, what is the chance of infection after a single exposure to an HPV infected partner) it is to get HPV.  Rather the important consideration is that most people have HPV and thus most of the time you have sex, your partner has or has had HPV unless they were vaccinated. 

The lesion you describe still does not sound much like HPV but again, my advice is to have a knowledgeable, experienced clinician take a look.  I cannot make a diagnosis over the internet.  Further I would warn you that because HPV is so common, all too many clinicians think that any sort of irregularity they see on the genitals is HPV.  this too is usually incorrect.  Most genital lesions that people note when they examine themselves closely are not HPV.

Did you look at other posts?  If you have, you will see our explanations that most HPV infections are controlled by the body and over time become non-detectable.  People quibble over whether this means they are still infected or not.  The fact is that the virus is likely somewhere in the body but not detectable and not causing problems. 

It is hard to say just how common the HPV type that causes warts are.  At least 10-15% of sexually active persons will have detectable warts and less than half of persons infected with the types of HPV associated with visible warts will actually have visible warts. The remained of the persons have the infection but it is not manifest as visible warts. 

I hope tis helps.  My sense is that you may be worrying all too much above HPV and warts.  The are primarily a nuisance, nothing more.  EWH
---