[Question #6676] Past HPV 16/18 Exposure

12 months ago

In Jan 2015 right after me and my girlfriend at the time had slept together for the first time, she got her papsmear results back which said she tested positive for HPV 16/18. She took the test PRIOR to us having sex. There had been some oral sex and her rubbing her outer vagina on my penis, weeks before she was tested. I had never heard of HPV and had an appointment with a Dr who was also an infectious disease specialist. My #1 concerns was disclosure to future partners. Dr pretty much said that HPV is incredibly common and that there was no need to disclose (unless I ever got lesions/warts), that pretty much anyone active gets it. That disclosure doesn't change anything and it only creates unneeded hysteria. He said even if I was exposed to it through my gf, that it wouldn't necessarily mean that I would be a carrier or transmit it in the future. He said that worrying about HPV is like worrying about getting hit by a meteor when i'm walking on a sidewalk. Essentially that it was no big deal and to relax. Me and my ex stayed together until Nov 2017, with no other partners. I read that HPV generally clears from a man within 2-3 years. Newly single, I still felt a bit unsure about future sex, since disclosure seemed so divided online. I asked my female dermatologist. She said that HPV never leaves the body but that my exposure was so long ago that there probably wasn't a need to disclose. I'm pretty sure my ex even said she cleared it, but cant remember for certain. I decided to listen to what the two doctors said, plus it had been over 3 years since my ex tested positive. I didn't sleep with anyone until april 2018. I've had 5 partners since then. The other day my uncle was telling me about his friend that had recovered from throat cancer that they said was caused by HPV. That really scared me and made me concerned for my own wellbeing and second guessing the doctors advice. I wanted to ask you if you agree with that those Doctors, how to proceed with future partners, and what screenings should I do if i'm at risk?

H. Hunter Handsfield, MD

12 months ago

Welcome to the forum. Thanks for your confidence in our services.

I agree exactly with the advice you had from the ID specialist. I couldn't say it better than he did:

"HPV is incredibly common and...no need to disclose (unless I ever got lesions/warts), that pretty much anyone [sexually] active gets it. That disclosure doesn't change anything and it only creates unneeded hysteria. He said even if I was exposed to it through my gf, that it wouldn't necessarily mean that I would be a carrier or transmit it in the future. ...worrying about HPV is like worrying about getting hit by a meteor when i'm walking on a sidewalk. Essentially that it was no big deal and to relax." PERFECT!

I also agree with your dermatologist:

She said that HPV never leaves the body but that my exposure was so long ago that there probably wasn't a need to disclose.

I can quibble about "HPV never leaves the body". Probably it does in some persons. But it is true that HPV DNA persists in many, with a possibility of future recurrence. But most of these events carry little health impact either for the infected person or his or her sex partners.

As for you uncle's friend with throat cancer, it can be frightening when someone you know has a problem like this. But even though the frequency of throat cancer due to HPV (almost always HPV 16) is rising, it remains an uncommon cancer compared with malignancies like colon, lung, prostate, breast, etc. The vast majority of people with oral HPV 16 infection, which is quite common, never get cancer.

Also, you never had proved HPV infection yourself. It's likely you have or have had genital or even oral HPV. But that's true for 90% of all human beings. Nobdy is ever obligated to tell future partners about a past partner's HPV infection. If we all did that, every sexual partnership anywhere would start with a discussion of HPV, since it's universal. There's just no point in disclosing what everybody has or has had, including any of your future sex partners.

Don't get me wrong. When entering a new relationship, especially one that may have long term promise, couples often discuss past STD experiences, exposures, etc. But this is primarily a relationship issue, a mark of commitment and caring. In regard to HPV prevention, it is unnecessary and makes little or no diference.

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

HHH, MD

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12 months ago

Thanks for the thorough explanation, Dr. That makes me feel relieved knowing that I do NOT need to disclose, especially since I don't know if I even have it. I had really started fearing that HPV was far more serious than I had been told and that I was a terrible person for past non disclosure. I had a few more questions.

How common are the High risk cancer strains of HPV compared to other HPV?

Does the high risk kind ever cause genital warts?

Are there any screenings recommended for men since there's no actual test?

I've had recurring warts on hands and feet over the past 12 years. Since my body is struggling with hand/feet warts, does that mean that my body is more likely to not clear the sexual kind of high risk HPV virus?

I've struggled with getting sick with colds easily in the past. Although lately i've been sick far less. Does getting sick with colds frequently mean that my immune system is weaker and that therefore I am in more danger or the HPV becoming cancerous or not clearing?

I have always tested negative on all STD tests. However if someone directly asks me if I am STD FREE, is it dishonest to say yes. Because I technically don't know if I have HPV and never had any symptoms or warts. I think if they asked me specifically about HPV then I would address it.

You said the frequency of HPV throat cancer is rising. What is the cause of that? Could it be from people having more casual encounters due to the use of dating apps?

H. Hunter Handsfield, MD

12 months ago

"How common are the High risk cancer strains of HPV compared to other HPV?" They are among the most common HPV types. Happily, the large majority of infections with these strains don't lead to cancer.

"Does the high risk kind ever cause genital warts?" Maybe sometimes, but rarely. Nearly 90% of genital warts are caused by HPV 6 snd 11, which don't cause cancer.

"Are there any screenings recommended for men since there's no actual test?" No tests are recommended for males, at least not by the most reputable agencies, such as CDC. With currently available technologies, a positive result doesn't usually indicate high risk for either disease or transmission, and a negative result doesn't prove HPV is absent.

"I've had recurring warts on hands and feet...." I doubt it. Other skin conditions can mimic warts. If not professionally diagnosed, you can safely assume you don't have had warts. See a dermatologist.

"Does getting sick with colds frequently mean that my immune system is weaker...?" There is no evidence of this. People with recurrent or persistent HPV have never been reported to be at increased risk of other health problems. Frequent colds are not an indicator of weak immunity, and most people who believe their immune systems are weak in fact have no immune impairment when evaluated by testing.

"...if someone directly asks me if I am STD FREE, is it dishonest to say yes"? Personal preference. If I were in that situation, in reply to a direct question I would say something like " Yup, I've had HPV. So have you, probably, and most other human beings. So what?" (I might not be that glib, depending on the situation. But such a reply would not be wrong or unethical.)

"You said the frequency of HPV throat cancer is rising. What is the cause of that?" Not completely understood. Probably increasing frequency of oral sex in the past 30 years is part of the reaason. The rising frequency predates modern social media and dating apps, but conceivably they could be part of it.

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