[Question #51] HPV transmission risk

100 months ago
Dear Dr. Handsfield
I am a male 37 years old , Two weeks ago I had the following exposure:
receiving unprotected oral sex  from High risk HPV infected married woman with upnormal pap smears .  the woman performed oral sex on my penis till I ejaculate in her mouth , my questions are :
1-what is my real risk to be infected from her mouth as she performed oral sex till my ejaculation on me ONE time ?
2-does she have the virus in her mouth ?
3-if she has the virus in her mouth what is the risk of transmission from  her mouth to my penis ?
4-what is the risk of french kissing in this case?
5-I feel so guilty and i convinced my wife to take the first shot of HPV vaccine ; can I resume normal sex with my wife?
6-is my wife  protected by taking only one shot of vaccine , ( she will take the second in two months)?
7-referring to the infected married woman , whose also her husband is infected , does this make possibility that she also have Oral HPV which increase my risk?
8-I lost my sleep and feel so guilty , whats your expert  advise for me ?
thanks in advanced , i am really waiting your best reply which hopefully will release my stress.
Edward W. Hook M.D.
100 months ago

Welcome to our site.  Your question reflects a common concern but one for which there are not a great number of good answers.  As a 37 YO male who has probably had other sex partners and a variety of different types of exposures over past years, it is highly likely that you have been exposed to HPV many times in the past and probably have already been infected with HPV (over 80% of sexually active persons have or have had HPV)..  You state that your partner had abnormal PAP smears but this fact is not known to change the likelihood of HPV transmission if you were even susceptible.  Further, while there are no good estimates as to the probability of transmission following any sort of single sexual exposure your risk is low -only a few percent at most.  Further, risk of infection from receipt of oral sex tends to be lower than the risk of STI acquisition from participating in genital or rectal sex.  Thus, in answer to your specific questions:

1.  See above. The risk is very low, probably less than even a few percent.  That you ejaculated does not change this.

2.  The probability that she has oral infection at her age is low.

3.  Repetitive question- see above.

4.  Virtually zero.

5.  I see no reason for you to not have normal, unprotected sex with your wife at this time. 

6.  Following a single injection of the HPV some but not all persons are protected from HPV. The amount of protection increased substantially to nearly 100% following the second injection.

7. These facts in no why change my assessment.

8.  Your guilt is related to your infidelity and can best be addressed through being honest with your own wife.  Many of our clients do not feel they can do this and just have to wait for the passage of time for their guilt to decline.

I hope these comments are helpful. Overall your risk for infection is very, very low and not something for you to worry about.  EWH

100 months ago
Thanks doctor for your reply . Just to make sure that risk is understood properly . My exposure was fellatio . Means that my gf put her mouth om my penis ? Have the virus been transfered this rout?
Dose her cervix hpv 16 is restricted to her cervix area or can be on her mouth . Her age is 26 ?
Is vaccination good option for me?
Is there any hpv test for me to role out the infection?
Many thanks in advance?
Edward W. Hook M.D.
100 months ago

You were clear on your exposure.  My answer is unchanged. this was a very, very low risk exposure for all of the reasons I mentioned (and will not repeat).  there is no effective way to tell if your partner had HPV in her mouth but, even if she did, the exposure remains low risk. 

At your age there is little meaningful benefit for you to take the HPV vaccine. 

Just as for your partner, there is no good test for oral HPV for you.

My advice remains to do your best to not worry and to try to get over the guilt that you feel over your infidelity.  What is done is done.  EWH

100 months ago
Am sorry if I am disturbing you but you know it's my anxiety . My last post .
Have you or Mr. Hands field in your long experience face mouth to penis hpv infection?
If I am infected from her mouth .will  The virus infect my penis ? I heard about Some test using PCR ?
Does very very low risk means RARE?

Edward W. Hook M.D.
100 months ago
I understand that you are anxious but repeating your questions does not change my answer.  Transmission o HPV through oral sex is RARE and you are not at meaningful risk.  thus there is also not a meaningful risk that you would infect your wife through having unprotected sex with her.  Similarly, my response that there was no reason to test, nor a useful test for you in this situation included use of a PCR test.  EWH