[Question #4462] Oral HPV question

27 months ago
I had visible warts from an HPV infection that were treated but I got another one recently that I’m seeing a dermatologist about next week.    I have been abstinent while I’ve had any visible wart but temptation got the better of me recently.

I am a bisexual man and another man and I performed oral sex.  There was no anal sex and no genital to genital contact.  I started getting nervous after this incident and went online and read that HPV can be contracted orally, though how frequent is a subject of debate.  I feel nervous that I’ve condemned this man to get throat cancer.  What are your thoughts? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome back to the forum. Thank you for your question and your continued confidence in our services.

Oral HPV has had a lot of media attention in recent years and is a common source of anxiety and questions like yours. It is true that there is uncertainty about the frequency of oral HPV. But for sure it's a lot less common than genital or anal infection; the single most respected study found it to occur at roughly 15% of the frequency of genital or anal HPV infection. Most oral infections are asymptomatic and remain that way, and are cleared by the immune system. Of the 100+ types of sexually transmitted HPV known to exist, only a single one, HPV16, accounts for almost all throat cancers due to HPV. Even in people with oral HPV16, a small minority -- probably under one in a thousand -- go on to develop cancer. Also, 85-90% of genital warts are caused by HPV6 or HPV11, so its unlikely yours are due to HPV16. Finally, your partner undoubtedly has performed oral sex on many other men over the years, so undoubtedly his mouth and throat have been repeatedly exposed to HPV, perhaps including HPV16. So any small risk of oral infection from the event with you does not further increase his small risk of throat cancer someday.

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

HHH, MD
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