[Question #6905] HPV risk assessment

11 months ago
Male 44, have had hpv, wife 40 also had hpv a nd at least one abnormal pap a few years ago. In 2013 I had an exposure with a high end csw. She did unprotected oral on me for 5mins and I did unprotected oral on her for 6-7mins. Those were the only activities we engaged in. She assured me she was clean. My wife and I did not have sex again till July of 2015 21 months after my exposure  it was not due to this just we were not having sex for almost two years. Since 2015 we have been more sexually active. She had her annual pap the other day and it came back abnormal and has to go back and have another one done, this is not her first abnormal, had at least one a few years ago here is my concern.

That I became reinfected with hpv and passed it on to my wife and that has caused the new abnormal pap. I have read that the possibility of me getting hpv from this would be low. But is it possible that one I could of gotten reinfected from this exposure and two passed it on to my wife when we did not have sex again until 21 months later?

Thank you 

Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Welcome to our forum and thanks for your question. I’ll be glad to answer it. One of the most common questions we get regarding HPV infections is have I been exposed, or, if a partner is discovered to have the infection, did I give it to them.  Because HPV is so very common and because it can occasionally recur long after initial resolution, these questions are nearly impossible to answer. Having said that, it is far more likely that your wife’s Pap smear changes are not the result of your having acquired the infection from the single exposure that you described above and then having passed it on to her. For that scenario to play out the following would be necessary:

1.  Even before we address the possibility of you are having acquired and transmitted HPV, the first question is whether or not her Pap smear abnormality is due to HPV. Non-HPV Pap smear abnormalities are quite common. If she has not been already tested for HPV, a second HPV a HPV test should be performed. 
2.  Most single encounters with infected partners do not lead to transmission of infection.  Your risk of having acquired HPV from either receipt of oral sex or having giving oral sex to your partner is particularly low. HPV acquisition or transmission through oral sex is rare.
3.  If you acquired HPV through the encounter you described, it would also be unusual for it not to have spontaneously resolved without therapy in the subsequent two years.  

Thus, in summary, if your wife’s Pap smear abnormality is due to HPV, it is more likely that her infection is a recurrence of a prior infection which she had than for her to have acquired HPV from you which you had as a result of your dalliance in 2013. To be able to answer the question with 100% assurance however is impossible.  I urge you not to go down the “what if” rabbit hole. The likelihood that your wife’s Pap smear abnormality is a result of your 2013 encounter is very very low. 

I hope these comments and perspective are helpful. If there are lingering questions or any of my explanation is unclear, please don’t hesitate to use your up to to follow up questions for Clarification. EWH
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11 months ago
Thank you for the response. Basically the odds of this happening are very low. In your experience have you encountered many case as of hpv transmission based on a single exposure of receiving and giving oral sex? 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Correct, the odds,are quite low.  I have not seen a case in which someone clearly acquired HPV from a single encounter and then went on to transmit it onward.  EWH---
11 months ago
Last questions. When we had hpv years ago probably about 18 years ago we both had outbreaks of warts. I have not had any in many years neither has she and I have had no outbreaks from this 2013 encounter and neither has my wife. Does that make it less likely i contracted hpv? Also I have read that high risk strains take two years to clear. What is the possibility I did not clear this before engaging in sex with my wife again since it was 21 months and not 24? I ask because you said it would be unusual for it to not clear without treatment in 2 years. Why would it clear without treatment?

Thank you 

Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Final responses.  You follow up is a bit redundant and suggests you are going down the “what if” rabbit hole.  The natural history of HPV infections is that they go away without therapy. Treatment accelerates the clearance.  That you had diagnosed HPV previously would reduce your risk for future infections with the same HPV type, if exposed.  If you were exposed ( this is unknown) and again exposed to the same HPV type (again unknown) it would further reduce the already low likelihood of infection.  If infected (doubtful) your infection would most likely have cleared.

This is my third response to your questions.  As per forum guidelines, this thread will be closed without further responses.  Please don’t worry.  EWH
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