[Question #5708] HPV penis to penis contact.

19 months ago
Hello Dr.

What is the risk of contacting HPV and Genital warts from mutual masturbation and penis to penis contact? I’m 33y/o coming out of a 4 year monogamous relationship. I was sexually active, exclusivity with other men, through my 20’s and the only STI I ever contracted was clamydia. I’ve never had warts before but I’m assuming I was exposed to multiple HPV strains in my 20’s.   I was a bit too old to get guardasil , so I was never vaccinated. 

Thanks. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. THanks for your confidence in our services.

I agree you can assume you have been exposed to and infected with HPV. However, I doubt you are (or were) too old for HPV immunization. The vaccine is recommended primarily at younger ages -- ideally before starting sex, and usually before age 26 -- but that doesn't mean it isn't beneficial later. It is, and recently vaccination was approved by FDA and recommended by experts in some persons up to age 45. Although you probably have been infected with some of the 9 types covered by the vaccine, it would protect you from others. OTOH, since you're now (mostly?) monogamous, you might not benefit very much, perhaps not enough to warrant the cost. But it's something to discuss with your own doctor.

Turning to your primary question, for sure there is no measurable STD risk from hand-genital contact and mutual masturbation, even if genital fluids are involved. I can't say the risk is zero for HPV and perhaps HSV or syphilis on rare occasions, but there are no proved cases acquired in this manner. As for direct penis-penis contact, there has been no research of any kind. It is logical to assume there is some risk for the STDs transmitted skin-to-skin (HSV, HPV, syphilis); and if the urethras come into direct contact, probably for gonorrhea and chlamydia. Given the low rate of HIV even from vaginal or anal sex with ejaculation, the risk from penile-penile contact must be extremely low, but can't say there is zero risk.

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

HHH, MD
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
With apology, at first I misread your comment about monogamy. As you return to the dating scene and are likely to have ongoing sexual experiences with multiple partners, HPV immunization probably would be beneficial.---
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19 months ago
Thank you for the speedy reply.  I’m asking this because I recently attended a masturbation party. I planned to be totally safe, but did some frottaging, rubbing penis and penis together. The encounters we’re short (3 of them less than a minute) and I didn’t see or feel any signs of warts or anything on my partners penis’ I  just worry about STI, especially warts,  and would like to think I was pretty low risk.  I didn’t know the HPV vaccine was available for ages up to 45 now. I’ll definitely get it.  Also, I wasn’t completely honest in my first post. I am in a mostly monogamous relation ship and don’t want to bring anything home. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Thanks for clarifying, but the additional information doesn't change my opinions or advice. The risk of warts is probably low because a) the chance of acquiring those particular HPV types is low for any single exposure, and b) there is a good statistical chance you have previously been infected with HPV types 6 and/or 11, the main wart-causing types, since they are among the most common -- and thus you're likely immune from past exposure. But as I said, there are no guarantees. If you should happen to have acquired warts, they typically don't appear until 2-12 months after exposure. But as I sad, the chance is low from any particular exposure.---
19 months ago
Thanks. That's a relief.  We were also using a lot of lube, would that lower the risk by creating a "sort of" barrier?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
I suppose it is logical that lube might reduce risk, since most such products probably have anti-infective chemicals as preservatives. But there are no data on this.---