[Question #6915] For Dr Handsfield
63 months ago
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I have spoken to dr hook about my exposure. I know my follow up to this is anxiety driven, but I always want another experts opinion which is part of my ocd. Me and my wife both have had hpv in the past. I had a brief exposure in 2013 of receiving unprotected oral sex for 5 mins and performing unprotected oral sex on a high end female csw for about 6 mins. No other activity took place. After that my wife and I did not have sex for 21 months, 2015. She gets paps ever year and has had at least one abnormal. Well her pap last week was abnormal and now I am thinking I got hpv from 2013 and passed it on in the form of a new infection.
Dr hook said this is highly unlikely..
1. Would you agree with his assessment? And how likely is it to get hpv from that encounter and pass it on almost 2 years later?
2. After that exposure I had a full work up done for every disease and all came back negative, and neither of us have had any symptoms of hpv for the past 7 years. Would those facts mean I was likely not infected?
3. How likely are abnormal paps that are not caused by hpv? Dr hook said it would be reactivation of the virus and not a new infection. Is that a common occurrence?
Thank you
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H. Hunter Handsfield, MD
63 months ago
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Welcome back, but we discourage users from seeking alternate opinions from either of us. It's only by chance I'm answering anyway: if it had been Dr. Hook's turn for your question, he would have been the one to reply (again). Dr. Hook and I have been close colleagues and friends for 35 years and our understanding of STDs and our advice are always pretty much identical. In this case, I briefly scanned your discussion with him and agree with all he said.
1. I agree. Oral sex is low risk for HPV. The chance of catching from any single episode probably is under one in thousands. If you did catch HPV, whether in that encounter or any other, it indeed could possibly be transmitted to another partner two years later, but this too is rare.
2. When it comes to HPV, absence of symptoms doesn't mean much one way or the other. The large majority of HPV infections never cause visible abnormalities or any other symptoms.
3. The vast majority of abnormal pap smears (probably over 95%) are caused by HPV. And it is true that more abnormal paps probably result from HPV reactivation than from new infection.
I hope these comments are helpufl. Let me know if anything isn't clear.
HHH, MD
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63 months ago
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Is something that I should probably stop worrying about since the chances of this happening are so low
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H. Hunter Handsfield, MD
63 months ago
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Yes indeed. And everybody gets HPV anyway. Assuming you have had at least a few different sex partners in your life, for sure you have been infected with HPV and may still be carrying it. Same for almost all human beings! In any case, the single event you had certainly did not raise the chance you are infected any higher than it already was.---
63 months ago
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Thank you, you and dr hook put me a bit more at ease. I gathered from looking at your replies to situations similar to mine and some other research that me getting hpv from having oral performed on me is almost non existent, I know me getting oral hpv from cunningulus is a possibility but is it possible to transfer oral hpv to another female through cunningulus? Or would I have cleared the infection by then? Also my wife gets a pap every year and the last five have been all normal since we resumed having sex, is it likely that a new infection would cause an abnormal 5 years later? Or still just a reactavation of her prior infection? I ask because I am the only person she has been with.
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H. Hunter Handsfield, MD
63 months ago
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All oral sex -- i.e. both fellatio and cunnilingus -- can transmit HPV, both mouth to genital and vice versa. It's a lot less common than genital to genital transmission, but it happens.
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When HPV causes an abnormal pap smear, usually it is not possible to know the exact source or when the infection was acquired. Some HPV infections are unexplained, including occasional infections in persons who say they have never had sex. However, if it is true your wife has never had sex with anyone else and someday she has an abnormal pap smear, probably it came from you. But of course there is never blame in this situation and it is nobody's fault. There's no point in getting upset by a normal, expected consequence of sexual activity.
That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.
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