[Question #337] HPV exposure

35 months ago
I believe I may have intra-anal HPV. I am a male and recently had receptive anal intercourse. I did not realize at the time that I may have HPV. The sexual intercourse went somewhere I wasn't really wanting to go, but basically here is my question: if my sexual partner engaged in unprotected anal sex with me while I may have an intra-anal HPV infection, and then he inserted his penis into my mouth (following possible contact with HPV), is there a likelihood that the HPV could now infect my mouth? In other words, if exposed to HPV are you quite literally capable of transmitting it immediately? (I see my GP Monday.)
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Welcome to the Forum.  I'll try to help by trying to convince you that whether or not you have rectal HPV, or for that matter, if your partner had penile HPV, it really does not matter.  The fact is, most sexually active people have HPV at sites of genital or rectal exposure but that these infections are most often self-limited and resolve on their own without therapy.  Less is known about the precise frequency of oral or pharyngeal HPV although the available research DOES indicate that infections of the oral cavity are substantially less common than infections of the genitals or rectum, probably because transmission to the oral cavity is less common than to other sites.  Further, there are no good tests for HPV in men.  As a result, I, along with most other experts would suggest that a single exposure of the sort you describe is not a major concern.  Further, the best way to approach such concerns is to have your doctor evaluate any lesions you might develop and, if rectal intercourse is a regular activity, to consider periodic rectal Pap smears (how frequently is also a matter of controversy.  Certainly no more than once a year and many think every two years is sufficient.)

Finally, the fact that most single exposures do not lead to transmission should reduce your concern about infection even further.  My advice is to not worry about having gotten oral HPV from the exposure you have described.
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35 months ago
Thanks. On the off chance that I have not been exposed to all strains of HPV, I assume there is no harm in getting the vaccine? I'm over 26 but I assume that just means I will have to put for an off-label prescription. 
35 months ago
Does HPV have burning or itching sensations as a symptom? 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago

Certainly there is no harm to receiving HPV vaccine when a person is over 26.  The  age recommendations are based on estimates of benefit for the entire populations vs. cost.

Most HPV is asymptomatic.  Burning or itching would not be typical symptoms.  EWH

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