Welcome to the Forum.  Thanks for your confidence in our service.  I'll do my best to help although there are not solid scientific answers to some of your questions.  Further, as I read your question, I found myself wondering about your age.  As you move forward on your plan, there is much to recommend seeking vaccination against HPV.  The current vaccine is now recommended for persons up to age 45 and even for those who might be a bit older, the vaccine may have a good effect, greatly reducing the risk for acquisition of the two HPV types which cause most visible genital warts, as well as the 7 most common HPV types associated with pre-malignant PAP smear changes, including HPV 16, the HPV type which causes nearly all oral HPV infections. 

Further, I would suggest that you look at other posts regarding HPV risk on our site.  There is much information on our responses to those, earlier questions which is relevant to your concerns.  With this background, I'll go to your specific questions:

(1) If I were to acquire HPV orally through cunnilingus with a new partner, how likely would that be transmissible to my wife via the same route when/if we resume our sexual relationship?

There are not good data to inform us on how often HPV is transmitted through oral (or genital) sexual contact.  What we do know is that most single exposures to infected partners do not lead to infection.  Overall, the prevalence of oral HOV in women (about 3.5%) is about 1/3rd of the prevalence in men (10.5%). 

(2) If someone acquires an HPV strain that causes warts, how long until warts typically appear? 

Typically, warts take about 3-6 months following infection to occur.

 (3) If someone acquires an HPV strain that causes cervical cancer, how long before a Pap smear would become abnormal for a female?

Pap smear changes following acquisition of HPV can take several months to occur.  Please remember that even when such changes occur, most changes then go on to resolve without therapy over the next 1-2 years.

I hope this information is helpful.  EWH

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Dr. Hook, thank you very much for your response. My age is substantially higher than 45 (unfortunately)...more than 10 years so. Regarding my Question #1, I guess I'm asking about the likelihood of HPV transmission from me to my partner (wife) via cunnilingus -- my performing mouth to vagina. Thanks again and I await your clarification.

Dr. Hook I think you’ve already addressed my follow up question by saying there’s no clear answer. So if I may let me approach from another angle. Regarding HPV vaccine, I know it only covers against the most dangerous strains and does not protect against previously acquired infections. So let’s say my “new” partner had the vaccine a few years after becoming sexually active. Is it correct that the vaccine would be protective against those strains not already acquired? Also, if she had a previous infection but cleared, would that make those strains non-transmissible? I guess my strategy if moving forward would be no oral or penetrative sex with someone who has been vaccinated, but women in mid-30s for instance didn’t have access before sexual activity. And at my age, I’m not exactly into college girls. I appreciate your response.

* not been vaccinated

Several additional comments.

1.  At your age, should you chose to, you could still take the HPV vaccine, you would just have to pay for it (about $600.00) and convince your doctor to give it.

2.  The likelihood that you have oral HPV and would transmit it to an unvaccinated person through cunnilingus is relatively low but clearly not zero.

3.  Your are correct, the current HPV vaccine does not have a known effect on HPV infections which were present prior to vaccination.

4.  If a person has had HPV in the past and it has clears, they are unlikely to transmit infection to new partners.

5.  Most sexually active persons in their mid-30s will like have or have had HPV but if they have been seen recently by their GYN or sexual health specialist they should have some idea of their own HPV/PAP smear status. I think this answers your final question made in f/u.)  EWH

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Dr. Hook,

Straight to your questions:

1.  Consensus is that most persons who have had HPV infections which went on to clear no longer have transmissible infection.  A small proportion of persons who have cleared may have reactivation but those people are generally considered to have less transmissible infections.

2.  The vaccine should protect against re-acquisition of an infection which has cleared.

this is my 3rd response to your questions.  Hence, as per Forum Guidelines, this thread will so be closed without further responses.  I hope the inforamtion provided has been helpful.  EWH

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