Hello again. Thank you to all three of you for your work here and elsewhere. I ask for your patience. I can't believe I am now a repeat poster - but here I am. I am trying to come to grips with the likelihood that I contracted HPV in my only sexual experience outside my marriage (I am her only lifetime partner). I was previously unaware of its ease of transmission and ubiquity. I had a one time encounter with a CSW in her mid/late 30s (only my second partner); over the last six months, also five erotic massages, one involved any vaginal fluid. We had protected oral and vaginal sex, followed by prolonged hand-genital-hand contact with vaginal fluids. I know my questions are likely generated by guilt and fear - but in order to address this adequately, I need to get further clarity about whether I should expect that I contracted HPV.  HPV+ would end my relationship – this is why it is a major concern for me. I hope you can empathize. Dr. Hook was helpful in answering my questions about risk. He guessed that my risk was lower than a 10% chance that I was contracted HPV from this CSW encounter, with the caveat that this was a conservative guess and it could be much lower. Also, on MedHelp, when responding to a very similar context (including some condom slippage), Dr. Hansfield guessed the risk to be "probably under 1 in a 1000." Does the variance come from the fact that there are "guesses" – and so I should not take them as overly comforting or reassuring? 10% still *feels* high to me, not that it feels like Dr. Hook overestimated, but that 10% did not feel overly reassuring; it does not feel 'very, very low' as he suggested, but perhaps that’s because I don’t understand likelihood/probabilities when it comes to STDs. Can you explain this to me? When it comes to STIs, especially HPV, should I be encouraged by a 10% likelihood, given that this assessment has built into it all we know about HPV? Can you talk me through this a bit more?  

 

It's been over six weeks now and there are no visible warts. How much longer do I need to be looking for them? Is it likely for GWs to occur, but not be visible, even with very careful weekly inspection? In closing, is it safe to assume that I did not get HPV? Or, would that be too sugarcoated? I just don’t know how to proceed with the next year, waiting every week to see if my wife gets warts, or gets an abnormal pap. 

Welcome back to the forum. But I'm sorry to see you remain so concerned and so unnecessarily.---

Dr. Hansfield, many thanks - both for your help here and your work elsewhere. It has been very helpful as I have worked through my questions and concerns. Your responses here were reassuring and clarifying for me. It really does seem as if condoms really work - even against HPV. A few things I'd like to follow up on, while I have you here. (No tortured 'what ifs' are coming, i promise!) *Quick clarification: I did not have anal sex, only oral and vaginal, in case that matters*

1) HPV sometimes is found in people who are true virgins. It't not certain how this occurs, but the information about you and your partner's sexual histories doesn't change my opinion or advice.---

Dr. Hansfield, thank you. You have been very kind to me. I think you are absolutely right about the underlying cause of my fear here. Something I'll need to look to in the future if my anxiety about this continues to be so high about this in the coming weeks. One thing is for sure _  I need to get off the internet.  

Oh, and one more quick thing: it's sometimes hard to know whether to take your point that I ought not to worry about this as either (a) an implication of your belief that HPV is ubiquitous, normal, and will happen to everyone whose sexually active at all (and so why worry about this specific encounter), or b) I really shouldn't worry b/c you really don't think I got infected in this single encounter b/c of the specifics reasons associated with it (one time, condom protected, only my second lifetime sexual partner) and b/c of what you know about HPV in the US! My guess is that it's both (but I hope its heavily weighted towards (b) !! :) ) - confirmation or correction is welcome here. All the best. 

Yes, the 1% chance is a conservatively high estimate; and yes, it applies to any apparent health problem of any kind, i.e. warts, abnormal pap in your wife, or anything else. I would add that in the unlikely event an HPV related problem appears in either of you, there will be no reason to attribute it to the sexual exposure described above. I agree (b) is the main reason you shouldn't be worried, but (a) also applies to some extent. Finally, I certainly agree that you should stop searching online about any of this. Like many or most anxious persons, you are being drawn to information (often inaccurate) that inflames your fears and not "seeing" the reassuring bits. As the famous statistician Nate Silver wrote in his book "The Signal and the Noise", "Give an anxious person a computer with an internet connection, and he'll soon be mistaking his cold for the bubonic plague" (approximate quote, from memory).---