[Question #7824] Past warts and non-penetrative sex with new partner

21 days ago
Hello doctors.
Unfortunately I am back with a new question :/

Antecedents:
- 9 months ago had several warts treated on my body, including one on groin/pubis and another in the base of the penis shaft.  The later two warts were lasered out and frozen respectively.  Haven't had any recurrence since then (and I have been auto-examining myself very consciously.)
- 5 months later a girl I used to have sex with phoned me to tell me she got diagnosed with HPV16.
- 7 months later (2 months ago) I had unprotected vaginal sex with that same girl.  I asked you here about that episode.

So now, nine months after the warts were removed, I met a girl that I like a lot.  She is very young (21 years old) and despite being very mature, I am reluctant to start a relationship with her due to the age difference (19 years, too much).  Anyhow, due to that reluctance on my side we haven't had penetrative sex, but we have kissed a lot, slept in the same bed a couple of times, she has masturbated me, I have vigorously fingered her (sorry for being so explicit) and she has practiced oral sex on me a few times.  In short: we have had frottage and I have masturbated her, most likely after touching/masturbating my own penis.  Despite my efforts of avoiding my penis touching her vagina/vulva, or getting near it, I am afraid that has happened a few times.  Same with her buttocks.

Now, I am having a very hard time letting this girl go (for her own sake) and on top of that I am sick worried about the possibility of have given her warts, or the hpv16.   I don't know if she has been vaccinated (21 years old girl in Germany, I guess she has) and in that case, with what vaccine.  And to be honest, I don't want to ask her: I would die of shame really.  This HPV thing is really like a nightmare I can't awake from..

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 days ago
Welcome back, but I'm sorry you found it necessary.

As discussed in at least one past thread, maybe more, your warts may not have been cue to a sexually transmitted type. I say this because non-genital warts generally are not sexually acquired or transmitted. In that context, I pointed out that your pubic area warts don't really count as genital. As I recall, you had a single wart on your penis -- but that might have been caused by whicher type(s) are responsible for your warts elsewhere, not not high risk for sexual transmission. Furhter, hand-genital contact doesn't transmit HPV, or at least too rarely to be of concern -- so even if you have a sexually transmissible HPV infection, it is unlikely you have exposed your new partner.

I don't understand your reluctance to discuss HPV vaccination with your partner or why you (or she) would find it shameful. Couples raise this issue with each other all the time. In addition, most sexually active young people these days understand that being exposed to HPV and perhaps infected is a fact of life; and anyone who is sexually active (or planning to be) should understand s/he is going to exposed and infected. If or when your relationship becomes overlty sexual, she is probably at no higher risk of HPV or genital warts from sex with you than any other partner(s) she might have had in the past or will have in the future. And if she has been vaccinated -- which seems likely -- she is immune to the 9 HPV types that cause most genital warts and cancers.

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

HHH, MD
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21 days ago
Thanks for your promptly answer.

To confirm I understood correctly:

1) I understand that hand-genital contact is not an efficient route of infection for HPV.  Does that apply even if the masturbation is very vigorous?  What about frottage, and penis touching the vagina without penetration?  Can I relax about this?  Because it is driving me mad.

2)  If at some point I become overtly sexual with this girl (with vaginal penetration, with condoms) my warts from 9 months ago won't make a practical difference in terms of risk for her, compared to anyone else.  I really don't want her to catch genital warts.

Regarding discussing HPV and vaccination with her... you are right, it is definitely the right thing to do.  Also other STDs.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 days ago
1) No data exist on vigor of hand-genital contact and HPV transmission, but I doubt it makes any significant difference. More vigorous contact (with potential for abrasion?) is obviously common, and yet still there are no scientiifcally redible reports of hand-genital HPV transmission.

2) I don't see a question here -- just a statement that you understand my advice above. I'm glad you understand.
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21 days ago
Ok, thank you very much for your feedback.  It really helps, to look at things from a reasonable perspective.
I really appreciate the work you do here.
Stay well!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 days ago
Thanks for the thanks. Take care and stay safe.---