[Question #3483] HPV Concern

37 months ago
Hopefully Dr Handsfield gets this but I understand Dr Hook also shares the same views on Hpv.  All i really need is clarity, ill try to make this question make sense, sorry if there is any confusion.  Ive been searching the web for what seems like forever about the possibility of catching multiple high risk types of Hpv from a single encounter; and i finally found a thread on Medhelp where Dr Handsfield is answering a mans question who had brief genital apposition and then protected sex with a  sex worker.  He was concerned about hpv and also the possibility of Multiple high risk Hpv infections from this single encounter. Dr Handsfield then said, and i quote, "There might be a very small, theoretical risk of hpv by genital apposition, but too low to worry about; and there is no chance of catching multiple types during a single exposure."  He later then said at the bottom of the thread, "bottom line: you are far too worked up about this non-exposure."  Reading this thread gave me great peace of mind because i have been worried about hpv and  this one encounter i had a long time ago, tested negative for everything, no genital warts, but was worried i could have gotten multiple high risk types from this single encounter. So basically I'm just wanting to make sure Dr Handsfield was referring to any kind of exposure, when he says "there is no chance of catching multiple types during a single exposure"  and not just being specific to genital apposition.  Again sorry if this question is hard to understand i just want to make sure I'm assuming right here and move past this anxiety about Hpv.  Thank You!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum. Thanks for your question. Indeed, you can be assured that Dr. Hook has the same perspectives and would give similar advice as my comments to follow.

We encourage users to scan the forum for question similar to their own before they post a new question, and I thank you for doing so. However, there is a risk in mining the forum too deeply. While we do our best to give absolutely consistent answers, there is often a temptation to slant our advice in a way designed to reduce some questioners fears, especially if they seem particularly anxious. Although I do not recall the specific exchange you quote, it sounds like I was indeed referring to a zero risk of acquiring multiple types of HPV during a non-penetrating genital exposure. Even then, however, perhaps I should have added a qualifier, like "no realistic chance", "no risk for all practical purposes", etc. Because some infected persons harbor as many as three, four, or even more HPV types simultaneously, presumably there is some risk that more than one type could be transmitted during any one exposure. In any case, for any one exposure, the issues that determine transmission risk are the nature of the exposure, the likelihood either partner has active (transmissible) HPV, and susceptibility of the uninfected partner (e.g. vaccinated, or previously infected with the partner's HPV type[s] and thus immune), and so on.

But the larger question, it seems to me, is why you're apparently so worried about HPV anyway. In reading the forum, perhaps you have seen our many statements about HPV as a normal, expected, and mostly unavoidable consequence human sexuality; that almost everyone is infected at one time or another, often multiple times; and that most infections do not progress to cause any important health problem. All young people (under age 26) should be immunized to prevent infection with the 9 HPV types most likely to cause important health problems, and otherwise just not worry about it.

We all have our health related anxities, but among all that exist, HPV should be low on the list of things that keep us up at night!

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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37 months ago
Thank you for clarifying that for me although it is a bummer to hear that i wasn't reading that correctly.  Well let me explain my situation to you and see what you think.  So i had an encounter with a masseuse a few years ago, we had sex for about 5-7 minutes and it was protected, but I'm not 100% sure the condom stayed in tact and didn't check it after.  Given that scenario do you think it is very possible  for her to have transmitted  multiple hpv types to me, if she did indeed harbor multiple high risk types?  Im not sure if this matters  but it seems relevant in determining transmission risk, sorry for the details. She was also very tight down there and dry so there wasn't a whole lot of rubbing or deep penetration going on.    I do understand that Hpv is mostly harmless, and that everyone is exposed to it at some point, i guess my only fear is this encounter.   Because the person i was with has probably been with a good amount of people and i just worry about the exposure to possibly many types of hpv thus putting me at more risk for the bad outcomes of high risk hpv.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
The chance you have any HPV at all from a single episode of non-penetrating sex is low; most likely you weren't infected, let alone with multiple HPV types. However, presumably you have had sex with other people in the course of your life. If so, you can safely assume you have been infected with HPV and could still have an active infection transmissible to future partners.

That the person you describe "has probably been with a good amount of people" is irrelevant. When testing women with 5, 10, 50, or 100 lifetime partners, none would be more likely than the others to have HPV or to be infected with more than one HPV type.

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37 months ago
Sorry if i wasn't clear, we did have penetrating sex, although i did have a condom on, I'm not sure it was intact the entire time.  So say worse case scenario during the 5 to 7 minutes of sex the condom slipped off  or broke, would the risk of acquiring multiple hpv types still be fairly low considering this single exposure.  Also one more thing,  just out of my own curiosity, how is it that someone with 5 lifetime partners wouldn't differ from someone with 100 lifetime partners? I guess what I'm wondering is why isn't that relevant.  Hearing that does give me peace of mind, I'm just curious as to why.  Those will be my last questions, i believe that would have been the two follow ups, thank you again Dr.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Sorry I misunderstood about penetration. But yes, it is true that condom protected sex clearly carries less risk than unprotected. So I still think it unlikely that you were infected during that event, and especially unlikely you were infected with more than one HPV type.

HPV is so common that almost everyone is infected within their first few lifetime partners, and people tend to max out at around 5-10 partners. Second, most HPV infections are transient, cleared by the immune system over time (usually 6-24 months), after which they are immune to new infections with the same HPV type. Therefore, although increasing numbers of partners may mean more frequent exposure, it doesn't necessarily mean more frequent infection. Age also plays a role in ways not fully understood, perhaps partly but entirely through immune resistance. Whatever the reason, new HPV infections are uncommon after age 25, regardless of partner numbers. (That's why the HPV vaccines initially were not even studied in women over 26 years old:  there was no obvious need, or at least the priority for HPV prevention was considered to be lower.)

I hope the discussion has been helpful. Best wishes.

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