[Question #4942] HPV and partner back and forth?

27 months ago
 first met my husband 5 years ago. He did disclose to me that he had anal warts removed 4-5 years beforehand, so I knew he had a prior HPV diagnosis.  Long story short, yes we started having unprotected anal sex a year or so after dating. We have been exclusive outside of a few mutually shared experiences (3 other partners that we both were with). I was fairly inexperienced prior to him. About 12mos ago, I noticed the first appearance of what I figured to be anal warts. After the initial embarrassment, I finally pursued a referral with my doctor, who gave me a referral to a dermatologist...was then referred to gastro...who then referred me back to my PCP for another referral to colorectal surgeon for a hi res anoscopy. Have not been yet, as I have been a little frustrated by the merry go round of referrals since summer and how perplexing apparently this issue is to my doctors. So far, i have one visible wart still present after these 12 mos (unsure about within though), and at least do have lab work confirming low risk warts HPV types but negative on the high risk cancer causing types. But that is the only headway I’ve made - I have Kaiser and thus very little choice in who I see, and am basically trapped in this seemingly never ending referral circle.

Because of the presence of the warts, we have not had anal sex in about a year, and we both are getting a bit listless and depressed in the relationship as our sex life has stagnated.

I am extremely certain the infection is from my current partner’s previous issues from way back. What are the chances of reinfecting him via exposure to my current wart symptoms and causing him warts if he has already been infected previously by the same HPV strain?
Is he at risk of developing warts from exposure to my warts, or would it be pretty much benign and not of concern if he has indeed already had that same type previously? I know outside partners are probably a no go, but what about him...Thank you for any help.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome to the forum. Thanksfor youf question.

From your username and context, I'm assuming you're male, which you don't state directly -- although most of my advice below will pertain if you're a woman.

Until a year ago, my reply would be that once people have had HPV, they are immune to new infection with the same type. And that's probably still true for the most part. Recent research indicates that past infection may not be as protective as previously believed. The immune response to an HPV infection, as measued by measurable antibody, is actually less strong than immunity from the vaccine, and probably some recurrent infections with the same HPV type are due to new expoosures. (In contrast, vaccination is 100% protective lifelong -- at least for 10 years -- against the 9 HPV types covered by the vaccine.)

Still, such reinfections probably are uncommon. When both partners in a couple are infected with the same HPV type, they probably do not "ping pong'" the infection back and fofth -- or at least not more than once. For those reasons, your current anorectal warts -- assuming the diagnosis is confirmed with your upcoming diagnostic tests and surgery -- probably are not due to reinfection or reexposure to your partner, but a recurrence of your own past infecition.

My advice always has been that people in your situation need not restrict their sexual exposures and pratices with their current, probably infected partners. Whatever the origin of your infection -- i.e. if caused by a type your husband is not known to have had -- undoubtedly he has been repeatedly exposed to and likely infected from you. Either way, he already has it and/or is highly resistant (maybe totally immune) to re-catching it (despite the newer research). Your infection might dictate caution for fear of irritating the warts, or because of comfort -- if these are issues, of course act sensibly. But otherwise, and assuming I correctly understand the facts of the case, I see no need for any restriction on the type or frequency of anal sex or any other sexual practice that give you mutual pleasure.

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

HHH, MD
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