Hello, 

I am a 27 year old heterosexual male who has had 23 sexual partners. All of which have been  protected sex with a condom. Except for 1 encounter that was unprotected and occurred a little over 2 and a half years ago.  My most recent sexual encounter with a condom was 3 and a half months ago. Before that, it was a year and a half ago. 

I have been tested for std/sti’s and all exams have been negative. My most recent test was done a month and a half ago all came up negative. I am uneasy about HPV since it is something that can not be tested for. 

Since HPV is extremely common I am assuming that I have gotten HPV at some point. However I have never seen or noticed any signs of warts.

1. is there a percentage of people who have HPV that have the strand that cause genital warts?
2. Assuming that I have HPV, since I have never seen any symptoms would it be possible to assume I did not get a strand of HPV that causes genital warts?
3. Besides my most recent sexual encounter that took place 3 1/2 months ago. Where I had a lapse of 1 year and a half, because I did not have any signs or symptoms within that time could I assume my body has fought of any HPV that I possibly could have had? Should I be worried only of my most recent encounter?
4. My most recent encounter was with a sex worker and the intercourse was very clean and very quick. We wore a condom and intercourse lasted about a minute. I’ve heard that genital herpes is something that needs to be massaged into the skin and takes several minutes, is this true? Do you think that this encounter put me at a high risk? She also did not have any visible warts. 
5. Moving forward, do I have reason to be paranoid, what symptoms and where in my body should I keep an eye on and for how long? 
6. Last question, with my age and the number of partners that I have had would it be a good choice to be vaccinated for hpv?

Thank you for taking the time to answer my questions. 

Welcome to the Forum. thanks for your questions.  I'll do my best to answer them.

I do agree with you that despite your consistent condom use, it is highly likely that you have acquired one or more strains of HPV.  It sounds as though you have not yet had the HPV vaccine and as such, it is likely you have acquired both some types which cause visible genital warts and some which do not.  (Over 90% of visible genital warts are caused by HPV type 6 or 11 but these infections may also coccur without causing visible warts.  With that, let's try to address your specific questions:

1. is there a percentage of people who have HPV that have the strand that cause genital warts?

The frequency of infection with the HPV types which cause visible genital warts is variable.  I would not be surprise if you had been infected with one of these strains but cannot provide a specific figure. 

2. Assuming that I have HPV, since I have never seen any symptoms would it be possible to assume I did not get a strand of HPV that causes genital warts?

Please see my comments above.

3.  Besides my most recent sexual encounter that took place 3 1/2 months ago. Where I had a lapse of 1 year and a half, because I did not have any signs or symptoms within that time could I assume my body has fought of any HPV that I possibly could have had? Should I be worried only of my most recent encounter?

The expression and ability to detect HPV in most persons with infection tend to be self-limited and resolve over a year or two.  Whether or not you currently have HPV might be detected is not clear.  Further, there are no tests recommended for HPV testing for use in men. 

4.  My most recent encounter was with a sex worker and the intercourse was very clean and very quick. We wore a condom and intercourse lasted about a minute. I’ve heard that genital herpes is something that needs to be massaged into the skin and takes several minutes, is this true? Do you think that this encounter put me at a high risk? She also did not have any visible warts. 

Most persons who acquire genital herpes develop symptoms within 7-9 days of exposure.  Even when exposed to herpes, most persons do not acquire the infection,  Condoms reduce the risk for acquisition of herpes even further.  MY guess is that you did not acquire herpes form the exposure you described. 

5.  Moving forward, do I have reason to be paranoid, what symptoms and where in my body should I keep an eye on and for how long? 

I would not be worried about this recent exposure.  It appears that you have had a substantial number of sex partners and may continue to do so. In this situation, even with measures to protect yourself through condom use, we would recommend periodic (annual perhaps) sexual health screening (that is, testing even in the absence of symptoms) for the most common STIs- gonorrhea and chlamydia.  I would expect the tests to be negative but testing, which can be done on a voided urine specimen, will provide reassuring results. 

6.  Last question, with my age and the number of partners that I have had would it be a good choice to be vaccinated for hpv?

Vaccination is a personal choice. If I were you, even given the likelihood that you may have become infected at some point in the past, I would get vaccinated for the protection it would provide against future infections.

I hope this helps.  EWH

Thanks for your follow-up.

1. I would not recommend repeat testing with a herpes blood test. While these tests are not recommended for this purpose, your results, as well as the lack of lesions since the encounter are good evidence that you were not infected. 

2.  Having not seen warts to date, it is unlikely that a pre-existing infection will lead to development of warts.  OTOH, a future partner may have occult HPV that she is unaware of.  I would still get the vaccine if I were you although, as I mentioned, this is up to you and a personal choice.  EWH

Small white bumps of the sort you describe are not at all suggestive of oral herpes. Oral herpes lesions typically are present is "water blisters" and last only a few days , quickly becoming shallow ulcers within a few days of appearance. Further, they typically occur on the outside border of the lips, not the inside.

While I cannot make a diagnosis of what your lesions might be, I am quite comfortable in saying that they are not HSV.

As you know, we provide up to three responses to each client's questions.  This response will complete this thread.  Take care.  EWH