[Question #4480] MET SOMEONE WITH HPV AIN 2/3

28 months ago
I'm a male who met someone (another male) who informed me he is being treated for AIN 2/3.
I was tested/swabbed and am thus far negative.
We have not yet had sex.
My question: If we abstain from any form of anal sex/play, am I relatively safe, or do higher-risk strains like his (16 and 18, for example) live "outside" the anus and pose threats across ALL sexual play?
Thanks much.

Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Welcome to our Forum and thanks for your question.  The answers to your question are a bit complex and additional information may help me to help you.  Can you tell me your age, whether or not you have had the HPV vaccine, and your HIV status please.  The reasons I ask are:
1. Your age is related, at least in part, to the likelihood that you already have HPV somewhere.  Most sexually active persons who have not had the vaccine have HPV somewhere (>80%).  In turn,. this may provide a degree of low level resistance (immunity may be too strong a word) to further infection and rarely represents a health problem.
2.  If you have already had the HPV vaccine, you are protected. If you have not, I would recommend that you strongly consider it. The FDA has recently changed its approval level, now approving the vaccine for persons up to age 45.  The vaccine is highly effective and safe.
3.  HIV status. There are continuing concerns that among persons with HIV, HPV infections may follow a somewhat (slightly) more aggressive course than persons who do not have HIV.

With these background statements, let me give you at least partial answers to your questions which may change somewhat depending on what I hear back from you. 

HPV infections are considered to be rather infectious and while not every encounter leads to infection, risk for infection is cumulative and with continuing exposures most persons do become infected if they have not had the vaccine.  While this rarely leads to serious consequences, most persons would prefer to not become infected.  When persons are infected, the infection can occur at virtually any site of infection- if the infection is inside the rectum, it is probably present outside as well.  Thus, virtually any sort of sex play has some risk for infection.  OTOH, so what?  Most people have the infection and the infection rarely progresses to cause problems.  In most persons the infection clears without therapy in months following acquisition.  It sounds to me as though your partner has done a very good thing by letting you now if his infection.  I would not let that stand in the way of the evolution of your relationship.

Sorry if this response sounds convoluted. The matter is complex.  Bottom line however is that even should you acquire HPV, it is just not that big a deal and the sorts of misinformation found on the internet tend to be overblown.  Hope this helps. EWH
28 months ago
Dr Hook
Thank you for your prompt and informative response.
I am actually older, 55, to be exact.
I am HIV-negative.
I have no idea if I have HPV, but assume I must have some strain.
Though I have not had warts, to my knowledge.
No vaccine, though a friend of mine works for the CDC and told me more and more docs are recommending the shot for men of all ages...even if they have certain strains. Apparently, it has shown to slow or stop progression. I am considering.
I want to believe it's not that big a deal, but his recounting of his treatment was not pretty...and I do think he's a bit scared.
The fact that the docs he's visited admit that there are still unknowns is unnerving...especially for those of us who lived through the '80s.
Again, thanks.

Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Thanks for the additional information.  Despite your being somewhat over the recommended age (45), I agree, the HPV vaccine would be worthwhile.  I would take it if I were you.  

At age 55 I agree with you, you likely have or have had HPV somewhat.  As long as you get regular health care checks however, this really should not cause problems for your health.

I also understand both your friend/partner's concerns and yours- it is unnerving that some of our knowledge on this topic is still evolving.  We like to have a clear path forward.  OTOH, I think we have lots more knowledge than we did in the past, we have steadily improving management and detection methods so all is better, much better in fact than it was just 10 years ago. (Glass half full approach)

Finally, I want to complement your friend/partner on telling you of his AIN.  Not everyone would do this.  He did the right thing.  I think that's great, both for him and for you.  I wish more people would share this sort of information.   

Otherwise no changes to my assessment or suggestions.  I hope they have been helpful.  EWH 
28 months ago
Dr Hook,
Thank you again. You have been so kind and helpful...and encouraging.
May I ask, as my final follow up, one last question? Here it is:
Were my partner to pass HPV to me--or if he passed it to someone else before we met--would he be passing on the specific strains that he carries, or just HPV in general? Sounds odd, I know, but I do believe it's one thing to pass on, say, warts, and quite another to know you could be passing on something that could cause someone to suffer with cancer.
Again, thanks a million. You're a good guy.
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
He would be passing on strains that he was infected with.  That said, that certainly does NOT mean that the infection would be likely to progress to AIN or other pre-malignant lesions.  Most (>90%) such infections do NOT progress similarly and instead resolve on their own without treatment.  Thus, to put it another way, if you or someone else were to get his HPV, the most likely outcome of the infection is that it would cause no problems and go away on its on.  

Hope this helps.  As you know this thread will now be closed shortly without further answers. EWH