[Question #3585] Genital hpv questions

37 months ago
Thank you for your time, my main question is- If you haven't had any anal contact during heterosexual activity, is there any reason to be concerned with genital hpv infection in that area?  I have tested twice for oral and genital hpv DNA through a reputable lab as part of a study and both times results were negative. I opted not for that test because I didn't think it would be a concern, and neither did they. 

Also, it was stated that with one time condom use, hpv is reduced by 90%. If you have sex once per week or every other week with a condom, is that similar to "one time" exposure? 

If I tested negative for those results, and they were 2-3 months after last exposure (assuming accuracy), would you say that there is Minimal chance I contracted anything? Is there a window for testing for hpv (when does it show up for people?)  I would think that once you've been exposed and if you were going to be infected it would show up in DNA rather quickly? They recommend time tables for other std's...I just haven't seen that for people for genita hpv, with the realization that no FDA test for hpv exists for men. Thanks so much. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome back to the forum yet again. (I was logged in when your question arrived. Most users should not expect nearly real time replies.)

Repeated forum questions are discouraged, but this one is sufficiently different than your others to warrant a reply. However, by coincidence, the question immediately before  yours (#3583) covers exactly the same issues about anal HPV infection. It is an excellent example why you and the your lab advisor made the right decision not to have anal HPV testing. (It's also very questionable whether you should have had genital or oral testing. Probably not -- but what's done is done.) Anyway, read my reply to the other thread and then let me know if anything remains unclear about anal HPV.

The roughly 90% protection with condoms is for each exposure. That means that if unprotected exposure carries a risk of, say, 10%, using a condom would reduce the risk to 1% for that exposure. That's for each and every exposure. So after 10 exposures, the chance of catching HPV would be around 10%; and after100 exposure, you could expect at least a 50:50 chance you would have been infected.

The "window period" for HPV testing isn't known. There has been no reported research on this and we have no data on how good the available HPV tests are 2-3 months after exposure. As discussed in the other thread, all tests miss some infections; and probably 2-3 months is too early. Some HPV infections may not be detectable until many months or even a year after acquiring them. And as also discussed in the preceding thread, there's not much to be done when a test is positive. These unknowns are the main reason that CDC and other experts and agencies generally recommend against asymptomatic persons being tested for HPV.

I hope this information is helpful. Read the other thread as well, and let me know if anything isn't clear.

HHH, MD

---
37 months ago
Sorry for the repetition as I have refrained from reading other questions due to increasing worry/anxiety/theoretical possibilities. So I haven't read it for that reason- for that, I apologize if this is taking your time, but I really appreciate your expertise to help me understand as it's just the way my brain works on these things and I trust your responses. 
If you don't have anal to genital activity, it is unlikely you would have anal hpv, especially in the absence of penile hpv? 
Thanks again for your time on some of these questions that probably seem a little ridiculous, but the answers are helpful
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Sorry, I'm not going to do your homework for you. There is no reason that reading other messages should increase your anxiety. Read it and then let me know if you still have questions.---
37 months ago
I see what you're saying and your comment regarding self inoculation as the most likely potentiator of anal infection makes sense, for heterosexuals who have not had anal contact, so if there's no genital infection than there isn't  a reason to worry. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Generally that is true.

Please note the forum does not permit repeated anxiety driven questions. This will have to be your last one; future new questions on these topics will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

I do hope these discussions have been helpful. Best wishes and stay safe.

---