I hope you are well, and thank you for all that you do here. I am hoping you can give me advice on something. I obtained a new sexual partner in early February. We slept together four times, one of those times being unprotected. She is vaccinated against HPV. After our unprotected encounter (about two weeks ago), I developed burning in my urination and a general odd feeling in my penis. I was tested for everything and so was she (negative on both ends and we are each other’s last sexual partners in some time). About two weeks after this encounter, while showering, I found a small single wart like growth on the shaft of my penis. I went to my dermatologist and she took a biopsy and it came back as HPV. I was upset by this diagnosis and am trying to make sense of it. Prior to this partner, I had not been with anyone since before the pandemic began. Although I know it is impossible to tell, I am curious whether this is likely to be an old infection (I have never had warts before) or a new infection. If it is an old infection, and this is a “reactivation” and I had the wart treated and it does not come back, will the “clearance” process possibly occur for me too, so that my body will possibly be able to clear the infection within 6 months? I know you have said that is generally the case for new infections, but I am not sure about old infections, to the extent this is one. I have also never had warts before, and read elsewhere on this forum that most HPV 6/11 does show up as a wart within 2-10 months; so I am just trying to make sense of this all. Thank you so very much for your help in advance. 

First, I suspect your transient urinary burning and penile "odd feeling" were not significant; no STI is a likely cause of such symptoms, and the negative test results are reassuring. So let's leave this in the rear view mirror.

The incubation period for overt (visible) warts generally is several weeks to months. As you say yourself, "it is impossible to tell" for certain, but most likely your genital wart is reactivation of an old infection, not acquired form your new partner. That's supported by her immunization history:  although she could have been infected prior to vaccination with one of the common wart-causing types of HPV (HPV6 and 11), probably she is not the source of your infection. 

So your next question concerns the natural history (to use a medical/epidemiologic term) of recurrent as opposed to recently acquired warts or other HPV infections. Unfortunately, I am unaware of any data that directly address this issue. My personal experience, and I believe that of most STI specialists, is that there is no significant difference between new and reactivated infection. Although recurrent warts due to reactivation are not rare, repeated recurrence seems to be uncommon. Once your current wart has been treated, or perhaps removed entirely with the biopsy, most likely it will not recur.

Assuming this is reactivation from a prior infection, your new partner probably is not at risk of warts, owing to her vaccination. It isn't possible to be certain, however, and you should frankly discuss the situation with her. But you (and she) should keep in mind that genital warts generally are no more than an unpleasant inconvenience. This isn't a health crisis, and it should not interfere in any important way with this relationship, especially if it has potential for ongoing commitment.

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

HHH, MD

Thanks so much. 

As you are aware, threads are closed after two follow-up comments and replies. I hope the discussion has been helpful. Best wishes and stay safe.