[Question #6881] Hpv/Sti concern

11 months ago
Just got back from gyno visit and I had a concern. Started to look online which led me to your site. Went to a new dr today for a Pap smear and exam.  Couple things now have me a little concerned. Hoping you will say they are not a concern for hpv or any sti infection. 

1.) took a sample with a nonsterile Swab (my previous dr office used sterile ones I think because they were individually wrapped). These were just in one giant box.

2.) nurse helping dr handled speculum container where they put used ones before giving dr cream so he could inspect inside me with his fingers. Concerned if any hpv or sti was on outside inside of the can. 

I’m not sure if you can get hpv or sti this way. Dr also said my cervix looked a little red/inflamed so don’t know if that would heighten risk for sti or hpv infection? I have had hpv in past but am currently negative. 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Welcome to our forum as for your question. I’ll be glad to help although, I must say in the beginning this reply that it is difficult to judge or evaluate another clinician’s  practices using verbal descriptions.

You are clearly quite observant regarding the activities of the clinician who you were seeing. In contrast and with all due respect, I believe that the practices you describe are a bit overly casual. That said, I suspect there is no meaningful risk for contamination or misdiagnosis related to the practices you described above.  With regard to your specific questions:

1.  Specimen collection swabs collected packaged in the manner you describe ( in a large box) are typically sterile and clean at the time they are packaged. There is little likelihood of contamination through handling of swabs in the manner you describe.

2.  The activities of the nurse as you describe them do carry a very small risk of contamination with transfer of genetic material which might be detected through the testing process.  To be honest, it is unlikely that the used speculum container was contaminated or that she picked up any contamination on her gloves at the time she handled the container, however there is a very low possibility that this occurred. In my estimation, I anticipate that your test will be negative. If they are, believe the test results.  If they are not, my advice would be to point out the problems that you observed and to request repeatTesting before you go any further in terms of more invasive evaluations.

Bottom line, I suspect that your test will be negative and there is little risk that the procedures you observed, while sub-optimal, will lead to incorrect information. I would await the results before you make any decisions or take any action. I hope this information has been helpful to you. 

If their questions or problems regarding my responses, please feel free to use your up toTo follow up questions for clarification. Take care. EWH.
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11 months ago
1.) The box actually said non-sterile on the side. I didn't think anything of it initially because did not think they would be used during exam so I did not say anything. So dr is just reaching in each time to grab one during each exam and they are not sterile. 
2.) Worried about getting infected with hpv/sti/hiv/blood disease becuase container was handled before he did the finger exam. Not so much worried about inaccurate results.

I am worried that these two incidents could possibly led to be being diagnosed with hpv or sti or hiv or blood disease in the future. is that a likely outcome?

Also, since I have had hpv in past, can I contract same type again? After being infected with hpv, I got the vaccine. Does this offer some protection from other strands?
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
1.  The term “sterile” refers to bacteria.  The swabs are clean and not contaminated.  I would not be concerned with any danger of,infection from the swabs.

2.  Transmission of infection through transfer of infectious material on hands, gloves or inanimate objects has not been demonstrated.  I would not worry about this.

There really is. It a concern about you getting infected from the events you describe.

I’m glad to hear that you have received the HPV vaccine.  I the vaccine offers protection over and above the immunity induced by naturally occurring infection.  You should not be at risk for re-infection from any of the HPV  types included in the vaccine, including the type of HPV that caused your past infection.

Hope this clarifies things.  EWH
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11 months ago

1.) in 1st response you said was small risk of contamination. was this referring to the sample collected or his fingers infecting me with a sti? Bit in 2nd response you said  “There really is. It a concern about you getting infected from the events you described . “ did you mean there isn’t a concern from events described?

 realize splitting hairs with words but want to be safe before having sex w/ husband. also breastfeeding 3 month old. Esp b/c cervix was inflamed during exam & occasionally have bleeding. 

 

2.) to further clarify. after nurse touched speculum container where put used ones (can with a lid) she opened gel envelope & held it open for dr to put his fingers in the gel envelope for finger exam.

Don’t believe their fingers touched. Both obviously wearing gloves. He then put his fingers inside my vagina. Does this change answer?  If their fingers did touch before finger exam still no risk? if he touched envelope where she had touched it?

(I’ve read some of your old posts & it would seem would be no since you have said Sti don’t live on surfaces & can’t be transmit that way even with fingers being put inside vagina. Just worry some vaginal fluid/STI was on can even though wasn’t likely as you said. Or if dr put his hand inside can when putting speculum inside even though that’s not likely either b/c he opened it with a foot pedal before doing finger exam)

 

3.) Does where vagina fluid come from inside body increase sti risk (ie from deep inside the body vs lips of vagina)? If an sti was in a can not exposed to air would it still be infectious? 

 

4.) more I think about it more worry. If you tell me not to will try to put this behind me at this point I’m very worried. I’m also worried that carried sti out of office with me on belongings or gloves was wearing (covid 19) or clothes due to fact dr handed me box & paper at end of exam or on skin & want to wipe all my stuff down which hoping don't need to do. mom says don’t need to & won’t catch sti from inanimate object or someone’s skin  even with it being on something if you put fingers in your mouth or inside your vagina or anything. (guess would be indirect contact & ok?)  Does how fresh the body fluid is increase risk?  I've read same sex couples can transmit sti on hands or sex toys during intimate acts. ( husband thinks they transmit STIs through scissoring 

& not from fingers in vaginas but don't know if that's accurate?) Does any illnesses or vaginal infections a person may have increase risk of contracting a sti? Very concerned about STIs but mainly about my hpv coming back if get diff strand. Or reinfected with same (no one I spoke with seems concerned about this incident but me so I am hoping I am wrong & not them. They insist an STi is exactly what it sounds like but fingers in a vagina or other private or mouth seem like would carry some risk)

 

6.) Also once you have a type of hpv you are saying that means you can not be reinfected with same type again from someone else?

And what did you mean by "the vaccine offers protection over and above the immunity induced by naturally occurring infection"?


I feel like I am overreacting but I am very scared about STIs, and especially HPV since that's the only STI to lead to cancer (as far as I know). 

 

 

 

Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Thanks for your follow-up.

1.  Let me apologize for the typo in my last reply. The phrase you mention should have read “there really is little to no concern about you being infected from the events you describe.”  (I believe I noticed some typos in your reply above as well.  It happens to us all when a person is typing.)

2.  No, no change in my answer or concern that you might have been infected by the procedures you describe.  STIs are just not transmitted from person to person on someone’s hand.  Not in doctor’s offices and not even during mutual masturbation when partners typically get each other’s genital secretions on there hands and each other’s (note.  This is offered only as an example of the fact that STIs,are not transmitted from person to person on by transfer on someone’s hands.)

3.  No.  It makes no difference.

4.  I urge you not to worry.  Transmission of COVID 19 is through to occur differently than STIs.  Most COVID 19 is transmitted by inhalation of aerosols but a small amount may also be acquired by transfer of virus to the eyes, nose or mouth on the hands.  This does not happen with STIs.  How fresh the  fluid is makes no difference, still no STI risk.

5. I do not see a question number 5.

6.  The immunity resulting from the HPV vaccine is stronger than the immunity resulting from naturally occurring infection.  This is part of the reason the vaccine works so well.

I hope these final comments are helpful.  Please don’t worry.  I suspect that, like most people, you think that STIs and infections are easily transmitted and that any exposure leads to infection.  That is not the case.  To use an example away from STIs, remember that you have been around lots of people with the flu and didn’t get it.  These infections are not casually or easily transmitted.  Please don’t worry.

This is my third reply. His per forum guidelines this thread will be closed shortly without further replies. I hope the information I have provided is helpful. EWH
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