[Question #7423] Oral Hpv Disclosure

4 months ago

Drear Dr,

I grew up in a religious environment where any sexual activity before marriage is frowned upon

I have been married since 2016. In 2008, 8 years before I got married I had unprotected fellatio for about a minute or two. This has been the only encounter I have had in my life besides my wife. I only had sexual contact with my wife when we were married.

A few years after the encounter I went for an Hiv test (I live in a country with a very high Hiv population) I also went for a Syphilis test, both were negative.

At the time a spoke to a mental health professional (I was a bit traumatized by the encounter due to my restrictive upbringing) who said I don't need to tell my future wife.

My wife had no sexual contact prior to me.

I have not told her about this encounter.

My wife goes to regular gynecology check ups

And has had yearly pap tests, last week the Gynecologist took a hpv test.

We have not got the results yet.

The Dr also made her go for a syphilis test and some other tests as we are going to try to fall pregnant. The Dr told my wife that one’s religious background means nothing in terms of testing, I think she means that there is frequent non-monogamy in any culture or community.

I am wondering if I need to tell my wife about the encounter.

Is the risk of hpv high enough to need to tell my wife?

Is it possible to put the risk of my wife now having hpv from the encounter into numbers?

Are there any other std’s I need to be concerned about?

Thanks so much for your help.

H. Hunter Handsfield, MD

4 months ago

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

I'm sorry you're having so much guilt and anxiety over about such a universal human trait as sexual attraction, desires, and needs as sex -- and one particular sexual decision and event. I agree with what you have previously been told; and certainly am glad that despite the apparent cultural attitudes in your country, your doctors -- at least your wife's doctor -- understands the reality and manages her patients accordingly. That's a sign of a a knowledgeable, caring physician.

To your specific questions:

If I were in your situation, I would not tell my wife, at least not because of health risk from HPV or any other STD. But there are other reasons you might want to discuss it, which I have addressed below. HPV is rarely transmitted by oral sex; it is very unlikely you have (or ever had) HPV from that single sexual event. I can't really put a number to it, but probably under one chance in many million you infected your wife with HPV from that exposure. There also are no other STDs to worry about, especially since you have tested negative for HIV and syphilis. No other STD is likely (oral sex in general is low risk for all STDs -- STD experts rarely recommend testing at all after a single such event).

In the unlikely chance your wife has an abnormal pap smear and/or HPV infection someday, it probably won't be from the sexual exposure you are concerned about. Some HPV infections in women are simply unexplained and apparently not sexually transmitted or acquired. This is one reason pap smears are recommended for all women, regardless of apparent STD risk.

My experience with STDs and sexual practices in sexually conservative cultures (e.g. Islamic, orthodox Jewish, intensely Christian, etc) is that the women know the score, and understand their future or current husbands have had sexual experiences prior to their marriages. My superficial understanding of such cultures also is that women share many of life's intimate details with their female close friends and maybe family members. It would be surprising if those discussions didn't include sex, including men's sexual behaviors. Of course I don't know your wife and cannot judge her personality and attitudes. But you might find that she a) would not be surprised you had a sexual experience prior to marrying her, b) wouldn't mind, and c) might be very understanding and supportive. If so, maybe such a conversation would help relieve your anxieties and strengthen your relationship. You're the only one who can make that judgment. For sure there is no need to mention it to her for any reason related to her health.

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

HHH, MD

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