[Question #3622] HPV follow up question(s)

36 months ago
To whom it may concern, (I"m a 30+ heterosexual male with 30+ lifetime sexual partners)Dr. Hansfield mentioned, "Over 90% of sexually active people acquire HPV at least once, and with 30+ partners you can be absolutely certain you have been infected, probably with most if not all the most common types. And since HPV 16 and 18 are two of the most common types. It's a good bet you have had them"

My question is: If I'm 33 and I was exposed to HPV-16 when I was say 18-26 (most common time for infection), would I still have built up immunity and therefore not be in danger of contracting if exposed? 

Dr Hansfield also mentions that infections are uncommon after 26 due to probability of exposure and that the vaccine would not be recommended, especially by someone with my sexual history with multiple partners and most likely multiple exposures, which makes sense, but I still have elected to get the vaccine, even at my age and I am currently in between my first and second. YET, my last girlfriend was 24 and although we used a common for the first six months of our relationship, she is mostly likely carrying one of the common types as far as probability goes and therefore I wonder how protected I am from previous natural immunity? 
I had asked about how long natural immunity lasts and Dr. Hansfield mentioned many years, but possibly less than the immunization which lasts 10 years-lifetime (they're not sure I guess), so I'm somewhat conflicted with the information that infections are uncommon after 26, yet natural immunity doesn't last a lifetime? I thought it lasted forever and you were always protected. 

If I'm understanding correctly, HPV 16/18 are very common and that probably means many of us walking around out there have been infected, is that another reason why it is uncommonly transferred after 26? He also said not to be worried and that I do not create any more risk than anyone else, so I greatly appreciate your answers and expertise in this matter.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome back, but sorry you found it necessary. Most of this question seems to be just confirming what we discussed in your other thread.

"If I'm 33 and I was exposed to HPV-16 when I was say 18-26....":  As I said, natural infection confers a high degree of resistance but perhaps not complete immunity. But that's all we can say. There may be a slight chance you could acquire a second (or third? fourth?) infection with type(s) you've had before, including HPV 16 or 18. But there are no data on which to make a numerical risk estimate you might (re)acquire these types in the future. If you go ahead with vaccination, for sure you'll be 100% protected, however.

The next paragraph restates the same concerns in different words. There are no data on which to base a numerical estimate of your risk of new HPV infections, except knowing you'll be 100% protected agains the 9 types covered by the vaccine, at least for many years and probably for life. Immunity after vaccination probably indeed is life long. But that can't be proved:  the vaccines have only been in use for 10-15 years, so no data exist on protection beyond that time.

Last paragraph:  That's what I said last time. The low frequency of new HPV infections after age 25-26 probably is at least partly due to immunity acquired from earlier natural infection.

It seems you're more obsessed with HPV than normal. Humans harbor thousands of bacterial species and viruses. Most are harmless and many are beneficial. Don't freak out about one particular virus that happened to evolve to exploit human intimacy for its own propagation, and that infrequently causes harm. Since roughly half of all humans die of cancer, there's a good chance that's how you will someday leave this world. But the chance it will an HPV related cancer, even if you are harboring HPV 16/18 or other high risk types, is far lower than the risk from other more common cancers like lung, colon, prostate, pancreas, etc, etc. HPV really isn't something to be so worried about!

HHH, MD
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36 months ago
Thank you Dr. Hansfield. And yes, it would seem that I am obsessing over this. I just suspect that I may have been exposed to it again from my previous relationship and having understood STD's as something that could be prevented with condom use, but with learning about HPV it's a brand new consideration that I wish I had known about a long time ago, or never learned about for that matter! I was hoping for a absolution on this matter, which isn't really possible it seems and it's not your job as you have answered my questions very well and with much care and for that I have great appreciation. This is probably something I don't need to say, but either way here goes, I was molested as a young child by a male family member (my mother didn't mean to, but had told me that AIDS is spread from men kissing so I had thought for many years I had AIDS and would die someday from it) and have since come to  deal with it via professional help, but with it has brought up a lot of shame and difficulty accepting my previous sexual promiscuity. However, understanding more about this and myself I have come to more understandings of my current thought process. I tell you this, and others that may hear this and benefit from the understanding so that you may understand why I obsess and others may understand why they obsess more than the average person. I would like to let this go and am working on it. Other than that, I am a well adjusted professional who because of this has not been able to hold successful relationships due to previous intimacy, fear of STD's and inability to connect as well with loved ones, so I've been on a journey to change my thought process and that's just accepting that these things happen and there's no need to worry about future contamination as you said. Honestly, your previous answers on my question from a few days ago were extremely kind, timely and appropriate, it's just the nature of the psychology of someone who has gone through what I have to hang on possibilities. That's not anyone's fault but mine, or maybe the childhood aggressor and I'm not looking for you to solve my psychological issues, I just felt like telling you, as you're a doctor and someone whom I greatly respect. Thank you and sorry for the extra information if that was not appropriate. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Thanks for the additional information. I'm sorry for your traumatic sexual history during your youth and its resultant long term impact. My only disagreement is with your comment "not anyone's fault but mine". This isn't a psychological or counseling service, but I think you'll understand (intellectually) that surely you are not at fault for any of this. But I'll note that you don't mention counseling or other mental health care. If you're not getting such care, I would strongly advise it:  without professional care, you're never going to get beyond these issues on your own, and perhaps never will be successful in forging and maintaining intimate relationships. Factual understanding of the risks (or not risks) of HPV or other STDs is never going to be enough. I think you'll understand that I suggest it from compassion, not criticism.

Thanks for your kind comments about our services. I hope these additional comments also are helpful.

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36 months ago
Thanks Doc, and yes, you are absolutely correct and that advice is very helpful. I have already started that process of counseling and acknowledging and coming to terms with the understanding that it's a common virus that is just part of sex is part of the healing. Thanks a lot for your time and help.