2 weeks ago, and a month after I had unprotected vaginal sex with a female friend (see question 7502), I went to the dermatologist to get a skin tag removed and he noticed, what he thought, was a couple tiny genital warts on the base of my penis where it attaches to my body. He froze them and gave me Imiquimod 5% to take.  This time my pubic area was shaved and he said they were new.  He asked if I was tested for HIV.   I told him I was tested negative about 3 days after I had unprotected vaginal sex with that female friend.  I went on HIV-PEP 65 hours after the encounter.  (See question 7502 again)

In the fall, the same dermatologist removed a previous skin tag and I was not shaven and he didn't seem to notice anything.  The warts may have been there but I didn't notice them because of the pubic hair.  Meanwhile my PCP did not think they were genital warts.

1) Why would my dermatologist ask if I was tested for HIV?  Would genital warts appear a month after possible HIV infection?

2) In a previous answer it was mentioned it's rare to get genital warts after age 40.  This has me concerned, if I beat the odds and got genital warts, maybe I got HIV as well? (I also have HSV-2 for 3 years and take Valtrex and have had no outbreaks for a year.)

3) both DRs say it's impossible to know who I got the warts from.  One thought it wasn't a new infection. Could they turn up after a month from a partner?  Thanks again!

1.  You were seeing the dermatologist for a possible STI. It is good practice for clinicians to inquire about the presence of other possible STI’s at the time of evaluation. Your dermatologist was doing her/his job properly by asking about your HIV status.  It would be most unusual for you to develop new visible genital warts just a month after an exposure. Typically visible general warts are not detectable until approximately three months following acquisition of infection.

2.  With all due respect, the lesions that were noted may or may not have been genital warts and the duration of their presence is difficult to know. They may have been missed in the past. After reading your 20 questions posted here over the past year, it appears that you have had multiple sexual partners over the past year. We’re you to acquire a new general wart it would not be something to worry about or a sign of something more serious.

3.  I believe this question has already been ask and answer. There is no way to know whether the bumps you noted were warts or not, much less where they were acquired from or how long they have been present.

I hope this information is helpful. If there are further questions please feel free to use Europe to follow up questions for clarification. EWH

1)But having genital warts is not a sign of HIV infection?

2.  Doctors who stated taking PEP will not interfere with testing for HIV, either while the PEP is being taken, or in the first 4–6 weeks following completion of PEP are incorrect. The medications used for PEP are the same medicines used to treat HIV. Thus such medicines could suppress the detection of HIV while they were being taken and it could take several weeks for a test to become positive.  The only exception from the statement that I made above is that if a person taking PEP had acquired the infection and developed symptoms due to their infection, the test would then be positive. When symptoms of recently acquired HIV are present, tests are always positive.

EWH 

I have not been vaccinated against Hep B.

As for hepatitis B, I’m surprised you haven’t been vaccinated.  As a general health measure you should be.  That said, your risk for hepatitis B from the encounter you’ve described is low and your risk for hepatitis C which is almost never transmitted through heterosexual encounters approaches zero(hepatitis C is occasionally transmitted in persons engaged in receptive rectal intercourse with infected partners.

I anticipate that your tests from today will be negative.  When they are I encourage you to move forward without concern and to consider vaccination for hepatitis B.  This concludes this thread. EWH 

Your genital herpes does not meaningfully increase your risk for acquisition of hepatitis B in the unlikely circumstance that you were exposed.  Once again, please don’t overthink things and please don’t worry.  The thread is now complete.  Take care. EWH