[Question #9177] Hpv transmission

35 months ago

Hello doctors, thank you for the respond of my last questions. As you may notice, my anxiety of stds might be because of the lack of sexual education here in my country. I tried to learn by myself but internet isnt a really appropriate place as there’s so many misinformation, therefore i tried to learn from some your answers here. There are some things i want to ask more about hpv transmission :

1. I’ve seen some of your comments stating that oral sex rarely transmit HPV. Is it in the scenario when the transmission occur from the giver who has oral hpv and infecting the receiver? How about when the receiver has hpv while the giver doesnt? In my case is when im doing cunnilingus to someone with possible hpv (if im not mistaken there’s some anal warts). Im not saying i dont have hpv. I might have it and it already cured by itself.

2. What is the percentage of hpv transmission for vaginal sex, oral sex (giver infecting receiver), and oral sex (receiver infecting giver)?

3. For hpv that make warts in genital or anus, is it always hpv-16 (which is the most dangerous hpv if im not mistaken)? Or it can be from various types of hpv? And will the warts go away or stays in the infected body part for the rest of people’s lives?

4. Do infections of hpv-16 always leads to cancer? Or it actually can be cured by itself from our antibody?

5. Im a sexual active male (25 y/o) that had a multiple partners and start to have a serious relationship. I dont know if im infected or not (tho im 95% sure did). Do you recommend me to get hpv vaccine as well?

The articles on the internet makes stds seem scary which is a good thing to prevent, however for people like me who might not have a good access for sex education, it makes us anxious because of the lack of knowledge. Thank you doctors

Edward W. Hook M.D.

35 months ago

Welcome back to the Forum. Thanks as well for your confidence in our service. FYI, while you are correct to worry bout the accuracy of much of what is to be found on the internet, much reliable information on STIs and on HPV in particular can be found at the web site managed by our sponsor, the American Sexual Health Association (ASHA) or a similar website managed by the U.S. CDC. Regarding your specific questions, I'll provide brief responses:

1.. I’ve seen some of your comments stating that oral sex rarely transmit HPV. Is it in the scenario when the transmission occur from the giver who has oral hpv and infecting the receiver? How about when the receiver has hpv while the giver doesnt? In my case is when im doing cunnilingus to someone with possible hpv (if im not mistaken there’s some anal warts). Im not saying i dont have hpv. I might have it and it already cured by itself.

There remains much to be known about oral HPV. In general, rates of oral HPV are lower than rates for genital infections and most experts believe that oral HPV is less likely to be acquired and, when oral infection is present in a person performing oral sex, less likely to be transmitted than HPV infections occurring in the ano-genital region. Most oral HPV infections appear to resolve without specific treatment over a few years although there are not precise estimates. Most oral HPV infections are totally asymptomatic

2. What is the percentage of hpv transmission for vaginal sex, oral sex (giver infecting receiver), and oral sex (receiver infecting giver)?

This too is unknown. We do know however that infections are common. Close to 80% of North American adults will get genital HPV. Oral HPV is less common nd is found in about 10% of people.

There are over 200 different types of HPV of which about 40 are sexually transmitted. Some types such as HPV 16 are associated with development of pre-cancerous lesions while other, such as HPV 6 an 11 which cause most visible genital warts are not. Even with those HPV types associated with cancer such as HPV 16, less than 1-2% of infected persons will develop pre-cancerous lesions

4. Do infections of hpv-16 always leads to cancer? Or it actually can be cured by itself from our antibody?

No- see above

Yes, I highly recommend the HPV vaccine for you. You may have had an HPV infection in the past but there may be other types that you have not had and would be protected from by a vaccine.

Hope this helps. EWH?

---

35 months ago

Thankyou for the response Dr. Hook. The truth is that in my geographic environment and culture, its very taboo to talk about sex. Honestly i just learnt that hpv is an std this year, and some of my guy friends didnt even know about other stds apart from hiv syphilis and gonorrhea. What we learn about hpv here is that hpv causes servical cancer and thats about it. Thats why ive tried to look at some forums, which makes the anxiety even worse because all people in the forum have the same anxiety, without any proper comments from proper medical practitioners.

I have some follow up questions

1. As you answered my previous thread, hpv is rarely transmit via oral sex. Do you mean genital hpv transmitted by infected oral, or oral hpv transmitted by infected genital? Or actually both are rare? I saw some articles stated that oral sex have a high risk for hpv as well.

2. For genital hpv, what are the other symptoms beside the appearance of warts? Could it be itching on the surface of the genital? How about other typical std symptoms such as burning sensation during urination or discharges?

3. Regarding for another std which is hiv. What are the chances of failure of pep if taken correctly without any exposure during the window period?

4. If i do 3rd generation test for hiv antibody after 4-5 weeks of exposure and the result is negative, (i know its not accurate yet nor convincing) but do can it be assumed for a good sign of a real negative from hiv?

5. A lot of sources said people needs to wait until 3 months after exposure for testing. I assume it is outdated? Because even in my home country the doctors dont recommend testing before 3 months so im a little bit confused.

6. For chlamidya, gonorrhea, and syphilis infections in the genital or throat, are they cured by the same antibiotics? Lets say azythromycin, levofloxacin, or cefixime?

Sorry for the repeated/long questions. I just want to tell my friends also about the anxiety/questions i have for stds with the correct information, so that they can be more careful.

Edward W. Hook M.D.

35 months ago

Both are rare. As I said above, oral infections are less common than genital infections, thus both are acquired and transmitted more rarely than genital-genital sex. Further, like genital infections, once acquired most HPV infections will resolve over a few years- this is true for both genital and oral infections. Very fe HPV infections progress to cancer.

Other than appearance of visible genital warts, most HPV infections are asymptomatic and do not cause noticible symptoms

3. Regarding for another std which is hiv. What are the chances of failure of pep if taken correctly without any exposure during the window period?

PEP failures are rare as long as PEP is started within 72 hours of exposure (and the earlier one starts, the better PEP works).

After PEP, meaningful testing should be done after completion of the medication. Tests at any time more than 4 weeks after completion of PEP are good news but results are not conclusive until 6 weeks after completion of medication if testing is done with a 4th generation test and after 8 weeks after completion of medication for 3rd generation tests.

The 3 month recommendation is out of date for all tests

6. For chlamidya, gonorrhea, and syphilis infections in the genital or throat, are they cured by the same antibiotics? Lets say azythromycin, levofloxacin, or cefixime?

Yes, for oral infections the same antibiotics are recommended

EWH

---