[Question #4566] Risks of getting carcinogenic HPV from infected woman, and passing on

28 months ago

I’m considering having sex with a woman with whom I’ve been getting involved who still tests positive for an HPV strain that has already caused her to develop precancerous cells, which have been removed. Am I a complete idiot to do this when the chances of this really becoming a long-term, serious relationship are very uncertain? 

I’m a 45-year old non-smoker. She is 27 and first learned she had HPV in 2014; in Jan. 2018 she had an abnormal pap and precancerous cells were found, removed in Feb.; she was still testing positive for HPV. 

Is it correct that 90% of people clear the HPV infection within 2 years? Including the carcinogenic strains? Does the fact that she has not cleared HPV in 4+ years have any bearing on whether I’d be able to clear it? If I am likely to “clear” HPV, would I no longer be at risk to develop cancer from it, but would I remain a carrier that will transmit HPV to future partners? 

Does it make any difference if I use a condom, or am I virtually guaranteed to get it either way? If I perform cunnilingus (no dental dam), am I virtually guaranteed to get it? Will I be at high risk for penile and oral cancer? Is there any issue with fingering her? 

If I have a future relationship with someone else, can I pass it to that future woman by performing cunnilingus? If she performs fellatio on me? Simply by kissing? Whether by the above or by vaginal sex, will I be virtually guaranteed to pass HPV on and put her at high risk for cervical or oral cancer?

Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Weicome to thr Forum.  I'll be glad to comment.  You are asking good questions.  Before I get to them, let me provide a little background information.  At age 45 and assuming that you have had other partners, it is more likely than not that you have already acquired and cleared one or more cancer associated HPV infections.  This fact is provided to help demonstrate that well over 95% of HPV infections clear without persisting or progressing.   That your potential partner has persistent HPV infection does not change the likelihood that you will clear the infection. 

 The precise efficiency of transmission of HPV infections is unclear however we do know that the infection is transmitted readily between sexual partners and through all sorts of sexual contacts including cunnilingus.   Thus, there certainly is the risk of infection through sexual contact with your potential partner. Correct and consistent condom use will reduce that risk for infection by more than 50% but the risk of infection going forward is still considerable, even with cunnilingus.

 Men are at a lower risk for developing genital cancer's from HPV infection than women. Even if you were to acquire your partner's HPV it is highly unlikely you would develop penile cancer.   The best preventative measure for prevention of penile cancer is simple observation and seeking dermatologic advice should a persistent (I.e. One that persists for several months) lesion appear.   If such a lesion is a wart or a pre-cancerous lesion it could then be easily treated. 

 In answer to your final question if you have HPV, sexual activity including Receipt of fellatio could potentially transmit your infection to an uninfected, unvaccinated sexual partner. 

 Having answered your questions, the final comment. In general, the presence of HPV infection in a sexual partner is not a good reason to not pursue a relationship.  The infection is so widespread, progression is so uncommon, and treatment  is so readily available that the threats related to HPV infection are easily managed.   I hope you find the information I provided and my comments helpful. If there are further questions I would be happy to address them in up to 2 followup questions.  In addition, if you look at other posts on our forum you will see that Dr. Handsfield and I have provided many answers to similar questions in the Padres. Reviewing them may prove informative and helpful.  EWH