Hi -- I have a question about disclosure and my possible infectivity. 

First, a short history -- I got a small number of small GW in 2017, and they were treated and went away quickly. I got vaccinated after that. Then, in February 2021, two small GW recurred in the same area. These were more difficult to treat and took 2-3 months to go away. Finally, in November 2021, these 2 seemed to come back, albeit even tinier. I had them biopsied, and they did appear to be warts under a microscope -- BUT, when tested using in situ hybridization, which I understand to be more accurate, they showed no high or low risk HPV subtypes. 

It's now been almost a year since I had GW, since the November ones were apparently negative for HPV. I recently had sex with a new partner, and didn't disclose, based on the principal that I'm effectively negative for HPV and probably out of the woods for another recurrence, at least for a while. Not to mention, she is vaccinated. The only disclosure I could really make at this point, from my view, is: I had HPV but I don't anymore. 

My question, I guess is-- does that seem like correct thinking? I feel that at this point, I'm probably as 'safe' as the average partner, or possibly moreso, since I have that negative mRNA test, indicating to me at least, that my body has HPV fully immunosuppressed. Do you agree with the assessment that I'm not infectious?

Worth noting that I have OCD, and am prone to 'spin out' slightly over small bumps... but the in-situ hybridization has been a great antidote to this, since, from my interpretation, it means that tiny, barely visible bumps I may have are probably not HPV and not infectious. 

I have to wonder whether the biopsied lesions were really warts or maybe mostly scar tissue from the previous ones; there's an inherent conflict between warts by microscopy and the negative HPV analysis. All true warts are caused by HPV. But the more important question here is whether you might have persistent latent HPV infection. Unfortunately, it's impossible to know with certainty. Some experts believe that HPV DNA persistence is nearly universal, with a potential for reactivation. Others aren't so sure. However, the frequency of late reactivation is low, and for practical purposes I think it's fair to consider yourself cured, with no obligation to inform future partners of you past warts. But you need to be aware that you may well have had (and could still be carrying) other HPV infections as well. Almost everyone is infected at one time or another, often with several HPV types -- most of which never cause symptoms, warts, or anything else.

Which comes down to agreeing exactly with your self assessment:  that you're at least as safe as the average guy a future partner would select as his or her partner -- and as you say, probably moreso on account of having been vaccinated. And I also agree with your closing statement that the biopsied bumps probably were not due to HPV. (I would trust the DNA results more than microscopy, which is entirely dependent on human observation and hence subjects to human error! The DNA analysis is a more solid kind of science, I think you'll agree.)

My only final thought is that entirely independent of protection against infection (with HPV or anything else), many new couples discuss their past sexual lifestyles and STI experiences -- an issue of partner bonding and mutual respect. In that context, you may decide to discuss your past warts. But not on account of transmission risk.

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

HHH, MD