[Question #5007] HPV and other findings in my partner

24 months ago
I have recently found out that my gf was diagnosed with HPV (dec 2018).   I have read some of the other questions but i'm still confused about one point and she has several other issues that weren't addressed in my reading of other questions. 
1.  She was diagnosed with abnormal pap and high risk HPV (not sure what number that is)
2. She was diagnosed with yeast infection and bacterial vaginitis

At the time, we had unprotected sex for the first time and i/we noticed a discoloration of skin on my penis and i had some itching and bladder urgency but no burning etc.  Went and got tested at public health facility and no STD's were found for me.  Clinician said the lesion was not syphilitic nor looked like genital warts etc and said the same thing that has been mentioned in previous answers to questions that it takes time for warts to develop.   I saw a dermatologist and the lesion or discoloration has cleared up since addressing the yeast issues.   

My question relates to the following:
1.  with abnormal pap am I at risk for having sex with her with no condom?  (some of previous post answers seemed to indicate there should be NO problem as long as there wasn't an abnormal pap so i wanted clarity on this topic of how abnormal paps can affect male partners - especially if the test says high risk type of HPV)
2. Also, how do I know if her vaginitis and yeast infection have cleared?  should i insist on her getting retested before we have sex without condom? (touchy subject)
3.  Lastly, do condoms protect males from vaginal yeast and or bacterial vaginitis?   I'm asking this because after her diagnosis we had sex with condom and i felt burning on glans of penis during intercourse (kind of scared me because that hasn't ever happened before).   I was using the non-latex condoms as she told me she thought she had a latex allergy.  But it did make me wonder if condoms in general can protect against a vaginal environment that has yeast and bacteria? 

thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Welcome to the forum. Thanks for your question, and for reading other similar ones.

Your situation is extremely common. You can be sure you have previously been exposed to HPV -- that your partner happens to have a diagnosed HPV infection doesn't change the fact that many (perhaps a majority) of all other partners you have had in the past also had HPV, probably including some high risk HPV types like HPV16, 18, and others. in other words, you current/recent exposures with your current partner probably do not elevate your risk any more than before. Second, you can be sure your partner had her cervical HPV infection for a long time before the abnormal pap smear, so you have been repeatedly exposed. Stopping sex now would be like closing the barn door long after the horse was gone. To your specific questions:

1) My opening comments address this. There is no need, and no health benefit to you, from stopping sex or using condoms at this point. As far as we know, abnormal pap smears per se do not elevate the chance of HPV transmission to male partners, and has no effect on the low chance that you'll ever develop warts, penile cancer, or pre-cancerous lesions of the penis.

2) Yeast and bacterial vaginosis are extremely common genital infections in women. If she is having typical symptoms (primarily itching/irritation for yeast, increased vaginal odor and thin gray-white discharge for BV) and those symptoms clear up, that will be the main indication they have responded to treatment. But neither of these is likely to be harmful or to cause symptoms in you and are not reasons to use condoms. Whether or not you continue sex at all depends on her comfort; if she has no pain, irritation, or other symptoms during sex or soon afterward, there's no problem in continuing.

3) As just noted, exposure to yeasts or BV generally isn't harmful. Yeast can infect the penis, as may have happened already -- but if so, an anti-yeast cream for a couple days is all that's necessary. Your sense of penile irritation likely was from the latex -- or if it had a spermicide (especially with active ingredient nonoxynol-9), that can be quite irritating to the penile skin or can cause transient painful urination if it gets into the urethra.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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23 months ago
Dr Hansfield,  

So to clarify on your comments, you don't believe that I should worry about picking up infections from the situation described?  I thought if she had a bacterial infection (BV) that i could get a bladder infection from that?  So my real question is how do i know or how does she know if the yeast and bv have cleared ?  will she need to have another exam?  also,  i think the premise on not worrying about having condomless sex for the hpv virus issue is that based on numbers you are saying that i probably got exposed before her.  What if I hadn't?  should i then be concerned?  and also i forgot to ask about oral sex?  is there a risk of getting hpv in the mouth if she has been diagnosed?  I'm also wondering if the "risk" part has to do with the virus being "active" versus dormant?  ie.  i had epstein barr and i know i will never get rid of it but i don't think my partner is at any risk because it is in dormant mode.  How do we as partners know when our partners virus is in dormant mode?  are there tests for that? thanks for clarifying some of these points.  It seems confusing because in some of the comments it is recommended to get the vaccine but if one shouldn't worry about using condoms etc then why would the vaccine be necessary?  thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
"you don't believe that I should worry about picking up infections from the situation described?" Correct

BV in women does not lead to bladder or any other infections in male partners. I already explained how she'll know the problems have cleared up:  her symptoms will improve. If in doubt, or if her doctor has advised her to return to rechecked, she should do that.

"What if I haven't [had or been exposed to HPV]?" There is no realistic chance of that; you have had it, unless you have been a celibate hermit. And since you've been having sex with your partner, FOR SURE you have been exposed to and probably infectec with the HPV strain causing her abnormal pap smear. In fact, you could have been the source of her infection. And if for some peculiar reason you haven't already been infected, it won't much matter if you are in the future. As for condoms, they don't protect very well against HPV anyway. My answer would be the same even if you and your partmer were regluar condom users.

There is no such thing as truly dormant EBV. You could potentially transmit it to partners by sex or through saliva. But that's true of most people. Similar to HPV, almost everybody has had EBV -- over 90% of people get it in childhood or teen years, certainly by age 20-25. So you can safely assume your partner, like you, also has "dormant" EBV. Such persons are immune to catching it again.

For HPV it is never possible to know for sure whether or not the infection is dormant. It usually is, if there have been no symptoms or signs (warts, abnormal paps, etc) or a few months after these problems return to normal. But there are no tests for dormancy and there is no way to know sure.

There is no conflict between recommendations for vaccine and also not worrying about being at risk for HPV. The vaccine prevents infection with the 9 HPV types most likely to cause potentially serious or inconvenient health problems. But it's still true that most HPV infections, even with those types, don't usually cause serious problems. Without vaccination, probably only one person in a thousand would get measles or tetanus; and most people survive those infections. Does that mean you shouldn't be vaccinated? Of course not. If you are under age 26, for sure you should be vaccinated against HPV; or even if you're older (up to 45) it might be a good idea to reduce your apparent anxieties about HPV.
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