[Question #4640] HPV transmission

28 months ago
Hi again,

I'm a straight male in my mid-40's, and my questions revolve mainly around passing HPV to my girlfriend of the last 5 years.

First, some history.

I've been seeing high-end escorts on and off for almost 20 years. Till 2010, those encounters were limited to protected intercourse and some unprotected fellatio. At that point, I had never had any unprotected intercourse at all. However, I then starting having unprotected intercourse over some months with one  escort. When I noticed warts on the shaft of my penis that turned out to be HPV, I had them frozen off, and ceased having any unprotected intercourse. I've never had any other STD symptoms and have always been negative for testable STD's.

In 2013, I started monogamously dating my now-girlfriend, having unprotected sex with her, and stopped seeing escorts. A year later in 2014, she tested positive for HPV, presumably from some remnant HPV on the shaft of my penis; she had no warts on the outside. It cleared, or the doctor cleared it (?). Later in 2015, I started seeing escorts again, but always using a condom. My girlfriend just got a pap smear recently and was negative for HPV.

In the context of all this, I have the following questions:

1. Given my history of exposure to and infection from HPV, will I have built up some immunity to common HPV strains that would limit my infectiousness to my girlfriend? Does she have some immunity too, since she was also infected (presumably by me)?

2. Can HPV be contracted by light skin touching, or does there have to be significant friction?

3. Given my protected sex with escorts over the last few years, is my main risk factor HPV in the groin area? If so, does that limit the potential infectiousness to my girlfriend's groin area as well?

4. Finally, if I currently have HPV, what would be the clearance time frame, i.e. time frame to not be infectious?

Thanks you very much
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Welcome to the Forum.  I'll be happy to comment.  We get many questions about the transmission of HPV so before I get to your specific questions, I'll make a few more general comments regarding our perspective on HPV.  First, for sexually active persons the most appropriate assumption is that they have HPV. Over 80% of the non-vaccinated sexually active adults have or have had HPV and most of them have been infected multiple times (there are more than 200 different HPV types).  While condoms reduce the rate of infection, the reduction is modest and even most persons who use condoms 100% of the time have HPV.  In some people the infections result in visible warts, most often caused by HPV types 6 and 11.  Most infections however are not visible to the naked eye and are caused by a variety of different types.  Even without treatment most HPV infections resolve on their own while a very small proportion advance to cause precancerous changes, of which a still smaller proportion slowly progress to cancer.  Thus, while not meaning to sound glib, most sexually active, unvaccinated persons should assume that they have HPV and not worry about it, other than to follow recommended sexual health screening practices which it sounds like both you and your GF do.  with this background, let's address your questions:

1. Given my history of exposure to and infection from HPV, will I have built up some immunity to common HPV strains that would limit my infectiousness to my girlfriend? Does she have some immunity too, since she was also infected (presumably by me)?
You may have a slight amount of immunity but not so nearly as much as you would have if you got the vaccine.  There is no evidence that HPV immunity reduces transmission of the virus to others.  What it does do is prevent acquisition of new infections.  Also, to assume that your GF got HPV from you may well be incorrect.  Assuming she was sexually active in the past, she likely already was infected and it was just detected at her exam.

2. Can HPV be contracted by light skin touching, or does there have to be significant friction?
Friction seems to be an important factor in increasing the efficiency of HPV transmission.  Thus while I suppose that it theoretically could be transmitted through gentle touchng, friction makes transmission far more likely.

3. Given my protected sex with escorts over the last few years, is my main risk factor HPV in the groin area? If so, does that limit the potential infectiousness to my girlfriend's groin area as well?
HPV is transmitted though DIRET contact.  Thus if you take part in oral or rectal intercourse, those sites could be infected as well.

4. Finally, if I currently have HPV, what would be the clearance time frame, i.e. time frame to not be infectious?
Most infections clear in 6-9 months and typically the rest would clear within 2-3 years.  

A final comment or two.  You and your GF have been sexually active.  Abstinence at this time gains you little.  I would suggest you not worry about HPV -yours or hers. EWH

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28 months ago
Thank you Dr. Hook for your insights.

Best Regards