[Question #4430] Past Partner Disclosure - Genital Warts

30 months ago
Hello-

Had a few questions based on my past genital warts disagnosis that I hope I can get some help with. I was diagnosed around 22 months ago and had my warts removed by a Dermatologist. I had to get a second opinion because the first doctor basically said it was all of my fault and I would have to tell every person I’ve ever been intimate with because I could give them cancer. I was really upset and only told my current partner at the time because I was ashamed. They were appreciative and not upset. The thing is I had noticed wart like growths a few years earlier, not knowing what they were, and had just dismissed them as skin tags, hair bumps, or something else. They got worse and I eventually had them looked at. 1. Should I be going back to alert sexual partners I’ve had 20 months-7 years ago to tell them I could’ve exposed them to genital warts? 2. Could someone get genital warts from touching your penis that had warts on it? 3. After I had the warts removed, I thought it was clear to have sexual relationships without letting partners know about my past genital warts, as I wasn’t told otherwise. Should I be going back to alert those partners from a year to 16 months ago about my past warts even though they were gone? Everything I’m reading says that you must always tell partners, but I feel like I was never told the right information, I would’ve told everyone had I known the risk and now  I am really struggling with this morally or what to do. 
30 months ago
I should follow up with the fact that I have OCD, and the fact that I didn’t know I had warts for a while and could’ve been passing it to people is making my life extremely difficult. Any help is appreciated. Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
Welcome to the forum. Thanks for your question.

I'm sorry to hear your initial physician was so naive and misinformed about HPV. Telling someone it's their "fault" they have HPV is wacko. At least 90% of all humans acquire genital HPV at least once, and probably 20-25% are diagnosed with genital warts at one time or another. HPV is impossible to avoid, other than through lifetime celibacy; and genital infection is no more common in people with multiple partners compared with one or two lifetime partners. (HPV is the reason that all women require pap smears, not only those at special risk.) All sexually active persons should be vaccinated against HPV, which prevents infection with the 9 types of HPV that cause 90% of cancers and genital warts -- but even that doesn't prevent infection with the 100+ other types that commonly involve the genital area and are sexually transmitted.

You don't say whether your new crop of genital area bumps have been diagnosed as warts. If so, it's not all that unusual:  although delayed recurrence of warts isn't usual, it's not rare either. When it happens, it's not an indication of any serious underlying health problem, i.e. not an indicator of immune system deficiency. Most HPV infections, whether causing warts or not, are cleared by the immune system over several months to a couple of years. HPV DNA can persist in tissues longer, perhaps for life -- but active infection is gone and is generally not transmissible to sex partners.

So I strongly disagree with whatever you read "that says you must always tell partners." That's reasonable for current, active infections (new warts, newly diagnosed abnormal pap smear). But not older, resolved infections. Because all HPV infections are cleared up, and all sexually active people are going to be exposed and infected anyway, there is no need to inform distant past partners of earlier infections. In other words, whether or not you say anything to your past partners will make absolutely no difference in the chance they have HPV themselves, develop complications (warts, abnormal pap smear), or transmit HPV to their own current or future partners.

Those comments cover questions 1 and 3. As for transmission (question 2), hand-genital contact rarely if ever transmits any STDs, including HIV. Without intercourse, there is little chance of transmission.

For expanded information, see information provided by CDC (www.cdc.gov/std) and the sponsor of this forum, the American Sexual Health Association (http://www.ashasexualhealth.org/stdsstis/hpv/). In the meantime, I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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30 months ago
Hello Dr. Handsfield. I appreciate the quick response. To clarify, the occurrence in the second question of hand to genital contact occurred with the same warts, but it was at the very end of treatment when only a scab was left over the warts. They have never come back since they were removed around 19 months ago. I’ve read that you say to inform partners within 6 months after removal, I didn’t have that information at the time and therefore I was seeing if I should now contact those individuals within that 6 month window of time. And finally, I am now aware that 2+ years ago I did have warts without me knowing at the time of intercourse, therefor the partners would have been exposed. With these clarifications to my questions, would you still not recommend contacting past partners AND without any reoccurrences moving forward, is it safe/ethical to assume the infection has cleared and disclosing is not needed unless my warts returned? Thanks for your time! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
First, 6 months is an educated guess, not at all a firm deadline. After that time, ongoing transmission undoubtedly is uncommon, but might sometimes occur; and often transmission potential is gone within a couple of weeks. I would not inform any partners exposed only by hand-genital or oral-genital contact, even with entirely untreated warts, and certainly not after they had been treated and healing was underway.

Your second question already is answered above. I would definitely not inform partners sexually exposed to your warts 2+ years ago. Doing so will do them no good whatsoever and will have no effect on the chance they'll have HPV now or will ever have a problem with it in the future.

Do you best not to obsess about your potential for having HPV that you could transmit to partners. Since most people have multiple infections, even if the wart virus is long gone, it's a good bet you have other, undiagnosed and asymptomatic HPV infection(s) as well. So does everybody else. Just accept HPV as part of the normal complement of billions of viruses and bacteria carried by all humans. It's part of life. Just let it go.
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30 months ago
Ok thank you, just 1 last clarification. If I had sex with people within that 6 month period, not just oral genital or hand genital, which is over 1 year ago, should I also not inform them as well? That is all. Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
Correct. Don't inform anybody. 

That concludes this thread. I hope the discussion has been helpful.

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