[Question #465] HPV Transmission Understanding

80 months ago
Doctor, I was hoping you could answer a few questions I have about HPV transmission. After studying other posts, I was able to gather a general understanding of how this transmission works. I need a little clarification after a particular night and need to hear it from you to know whether or not I'm out of the woods.   

From what I understand, HPV is transmitted in two ways. One is through a break in the skin or a mucous membrane with varying degrees of risk depending on where we're talking about.   

I was with my friend and we were dry humping, so limited sexual contact concerning only the penises but absolutely no friction whatsoever. So I don't believe HPV could be transmitted through a break in the skin, assuming my friend has it in the first place, because no hard rubbing occurred and it was more like our penises were just tapping one another.  

My main concern is through the mucous membrane, taking in the information from above, with just this limited tapping assuming my friend has HPV, which he may not.   
     Is it possible for HPV to be transmitted through the opening at the tip of the penis or the glans of the penis itself (the head)? I've recently learned that the glans of the penis is also considered a mucous membrane so this information has gotten me all worked up. Logically, I would think that if my friend had HPV and his infected penis was touching the glans of my penis, transmission is likely. However, what I understand from other posts this may not be the case. But I need a direct opinion from you because I don't feel like this question has been posed this way, so I would really appreciate a detailed response explaining whether or not this is a likely case of HPV transmission. Thank You. 
Edward W. Hook M.D.
80 months ago

Welcome to our Forum.  Before I comment on your questions, a bit of context.  Questions which include statements like "is it possible...." cannot be answered with certainty, other than to say anything is possible.  Here in this Forum we provide information which is based on the combination of scientific study and data, along with out combined over 70 years of experience doing research and providing care to persons with and at risk for STIs.  New information is generated on a nearly daily basis and things that have never happened before happen.  Thus, you will find that the information that you will receive has more to do with probabilities and likelihoods than "possibilities".  While it is "possible" that you will be struck by a meteor falling from space while reading this, I can assure you that it is most unlikely.

Second, an error that many of our clients make is the assumption that all or even most exposures lead to transmission of infection.  That is not the case. In fact, STIs of all sorts, including HPV are only transmitted in a minority of exposures.  So, following any single exposure to a partner whose infection status is unknown, it is unlikely that the infection will be transmitted, both because of the FACT that most people do not have STIs and, even if they do, most exposures do not lead to infection.   While the per exposure risk for HPV infection is not well defined, I am confident it occurs with less than 20% of exposures.  Thus, the odds of infection following any single exposure are very low.

Now let's return to your question.  The activity you describe was VERY low risk for infection, mostly for the reasons I mentioned above.  HPV transmission is facilitated by friction and does not require open cuts or abrasions to occur.  The more friction, the more likely transmission is to occur even though that likelihood remains quite low.  This statement (about friction) related to both regular skin and mucous membranes.  The skin of the head of the penis tends to be thinner and more sensitive than skin on other parts of the body (including the shaft of the penis) and in uncircumcised men this skin is still thinner than in circumcised men but in both cases this is not a mucous membrane. For the male penis, the mucous membranes begin on the inside of the opening of the urethra as it enters the penis.  Tapping of the sort you describe is a very, very low risk event and should not worry you in terms of risk for HPV.

Finally, I would add that as you know, most unvaccinated persons will get HPV at some point in their sexual lifespans.  This is sot something to fret about- most such infections go on to resolve themselves over time (typically months) and even when they persist, they rarely evolve to become cancerous.  We urge our clients to put their (often internet-fueled) concerns about HPV aside, other than to get the HPV vaccine which is safe, highly effective and dramatically reduces the risk for HPV infections.  If you should get HPV, likewise, at present it is not something to worry about.

I hope these comments are helpful to you.  EWH

80 months ago
 Thank you for your reply, I have a few other questions to further understand HPV transmission that also has been bugging me. 
What about HPV transmission in an oral situation-
 What are the chances of receiving HPV if you give oral sex to someone who may have it? 
 What are the chances of you getting it if someone is giving oral sex and they have it?  
Can HPV be transferred indirectly-
 Can HPV be transferred from hands to genitals? 
 Can HPV be transferred from an object?   

Edward W. Hook M.D.
80 months ago
Oral HPV infections to occur but they are much rarer the genital infections. This is true for both giving and receiving oral sex.

Similarly transmission of HPV through transfer of infected material on a person's hands or inanimate objects is very very rare and is not a meaningful concern.  EWH