[Question #6568] HPV transmission

12 months ago
Has there been any updated information about HPV transmission following clear pap smears for several years?  What does having subclinical HPV really mean? HPV has been a detriment to my life for fear of transmitting the virus to future partners.  Any updated information about the ethical necessity of telling partners of distant past HPV?
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago

Welcome to our Forum and thanks for your question.  Your concerns are questions which are widely shared.  I hope that my responses will be helpful. 

From the sounds of things, it sounds as though you have been diagnosed with HPV through a PAP smear in the past and that following detection subsequent tests were negative for HPV.  This is similar to the course of HPV infection in the great majority of persons who become infected. Following resolution of detectable HPV, most experts agree that in the majority of persons this resolution reflects true resolution of infection and that for those in who infection "persists" although HPV DNA may be detected with very sensitive, research-based methods, the risk for transmission is very low.  Studies have now shown that the amount of residual virus present following resolution of infection which is detectable using standard methods is lower than when the infection is detectable and for that reason is far less likely to be transmitted.  While I cannot provide a specific percent decrease in the likelihood of transmission as this is not known, most experts do agree that the chance of transmission becomes substantially lower and that transmission is uncommon following resolution of detectable infection. 

Thus, considering that fact that any unvaccinated current or future sex partners that you may have are likely to already be HPV infected and that you are unlikely to transmit your clinically resolved infection, I would urge you not to worry about future transmission and to merely continue to follow sexual health practices and screening at recommended intervals.  Further, integrating the facts that I have mentioned above, I would not feel the need to disclose regarding your past infection to current or future pastners and if you do choose to, to use the past tense.  They are no less and perhaps more likely to be HPV infected than you.  EWH

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12 months ago
Thank you. My last partner has had a girlfriend for the last 4 years.  She showed up with a positive HPV test soon after they got together. Her husband had also been cheating on her.  Is it likely that I gave him HPV and then he gave it to her?  He has had numerous partners.  I know its hard to speculate. Thank you so much Dr. Hook, for your informative answers. 
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago
In answering questions of this sort is an exercise in futility.  Well constructed, high quality scientific studies show that within 6 months of beginning to have sexual intercourse, over 50% of women are infected with HPV.  Trying to determine who transmitted HPV to a partner is just not possible.  As indicated above, the likelihood that you transmitted HPV to your partner who, in turn transmitted infection to his partner is very, very low and not something to be worried about.  EWH---
12 months ago
Good afternoon, 
Do you think getting the HPV vaccine is a good idea for me at 49 years of age?  I have been celibate for 4 years and want to do everything I can,  not to get HPV again. Are there any health risks for someone my age?
Also, your answers are reassuring but why do so many other health professionals advise a person to share past HPV? Why is there so much disagreement among doctors?  You and Dr. Handsfield seem to very knowledgeable in this area as you have had extensive experience with patients and in the field of STDs. Why would anyone disagree?
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago

Thank you.  The CDC's Advisory Committee on Vaccines now has broadened its acknowledgement that there may be benefits for HPV vaccination of persons up to age 45 and to my way of thinking this age cut off is a bit arbitrary.  In your situation, unless there are barriers I have no concern safety-wise about suggesting the vaccine for you and it may well provide protected form future infections.  I should warn you however that your health care insurance is probably unlikely to pay for it and the vaccination series may cost as much as $600 to cover the cost of the vaccine plus the cost of administration.  There are certainly no health risks.

Regarding statements by other health professionals, I don't have a great explanation.  The area is one which is relatively fast moving and as you point out, it is an area of specific interested for Dr. Handsfield and me.  For others who do not specialize in the sexual health field, catching up can be challenging and it is easy to be out of date or have misconceptions. 

As you know, we provide up to three replies to each client. This is my 3rd response.  Thus this thread will be closed shortly without further re0plies.  Take care. EWH

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