[Question #846] [Question #838] hpv question

99 months ago

Dr. Hook,

a few more questions in a new thread... hopefully this is allowed.

Dr. Hook stated: "IN YOUR CASE HOWEVER, when we also consider the long interval since the events you refer, my assessment of your risk and the likelihood that you acquired infection which is now manifest as an oral wart is unchanged."

Although my potential oral wart was the trigger to start this exchange, my major concern is that I passed on high risk genital hpv to my wife (at some point during our marriage which started in 2011).

So, regardless of what hand I used on her or me in 2001, would the following statement be mostly true:

1. When we also consider the long interval (2001-2011) since the events (initial sexual exposure and my marriage), the assessment of my risk and the likelihood that I I would be contagious with high risk genital hpv when I got married in 2011 is unchanged. Do you agree?

2.Thus, my summary statement can be slightly modified (to include clearance) to say this: If high risk genital HPV would ever become apparent in my wife, there is no reasonable reason to think that it would have originated from my 2001 experiences (based on our current understanding of HPV transmission and clearance). Do you agree?

Thanks,

H. Hunter Handsfield, MD

99 months ago

Welcome back. But sorry to see your concerns persist despite Dr. Hook's reassuring replies. I scanned that discussion and agree with his replies.

I would point out that all this might be superfluous. Although your dentist's visual diagnosis may be correct, there are various kinds of bumps in the mouth other than warts. In addition, not all oral warts are due to the sexually transmitted genital HPV types, so if it's a wart, it may have not have been sexually acquired. Its presence probably makes no difference in the likelihood you have (or have had) a genital HPV infection. You can assume you have, because at least 90% of all people acquire genital HPV at least once. But there is no evidence that presence of oral warts changes that statistic.

To your current questions:

1) Assuming you have an oral wart, there no reason suppose it is due to a high risk type, since most high risk HPV types do not lead to visible warts. If it's HPV, you can never knowwhen and where you caught it. And if it is high risk, it also doesn't change anything; the large majority of high risk HPV infections do not lead to cancer, even if untreated. If HPV, you probably have had it for months or years, during which time you have regularly been kissing and perhaps performing oral sex on your wife. If she is at risk, that risk started months or years ago.

2) It is almost never possible to know when and where any particular HPV infection was acquired. If you have oral HPV at all, high or low risk, you will never know when and where you caught it. My advice is that you cease any and all efforts to figure it out. At this point, it doesn't matter.

I hope that helps. Best regards-- HHH, MD

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99 months ago

Dr. HHH,

Glad to have your join the conversation, and sorry it probably a frustrating one for you. I have OCD (resulting from brain trauma to the basil ganglia and amygdala), along with a stroke from the trauma). My stroke makes it hard to comprehend things, especially if the topic is fearful to me. Life is hard, so I appreciate your answers.

I think something was lost between the threads - or my understanding of what is being communicated. Let me see if I can hone down my explicit questions more closely:

I have add essentially 2 sexual partners in my life

2001 - received brief oral (less than 20 seconds- no orgasm), and mutual masturbation - no orgasm.

2011 - married to wife- non protective vaginal sex. no oral either way. My wife was a virgin before marriage and no reason to think she had any sexual contact at all.

Would you agree with these statements:

1. My 2001 experiences was low risk for obtaining high risk genital HPV (ignoring the rare cases, which can be thrown out in these discussions, as I understand).

2. Even if I (due to a rare case) did acquire high risk genital HPV in 2001, my normal healthy immune system would have most likely cleared HPV by the time I got married in 2011 (note I had no sexual contact at all between the two time points),

3. If high risk genital HPV were to ever become apparent in my wife, there is no reasonable reason to directly connect it to my 2001 experiences.

Do you agree with the above statements?

After I understand your responses to the above statements, I promise to not post any more questions on this topic.

Thanks

H. Hunter Handsfield, MD

99 months ago

1) Correct. Oral sex is very low risk for HPV transmission.

2) Also true. The immune system usually clears HPV within a year or two.

3) Also correct.

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99 months ago

Thank your Dr HHH and Dr Hook for your help.

I will try my best to consider this a done issue.

However, do you have any advice on how someone like me (who may feel the need for mental reassurance with STDs ) finds a mental health professional who can help in this area ? Do most STD clinics in major cities have resources to refer people to counselors who can help with related psychological issues, Or any tips on how to find such a professional.

Thanks.

H. Hunter Handsfield, MD

99 months ago

The best approach usually is to discuss with one's personal physician, who in turn will be in the best position to make a referral. In many settings, STD clinics or other sources may also have experenience with such mental health professionals. And of course in the modern communications era, you can search online for mental health professionals who deal with special issues, such as sexual mental health.

Good luck.

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