[Question #9222] HSV and HPV
35 months ago
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My girlfriend and i both have hsv-2 and hpv-16(strain 16, high risk). She had the pap test that discovered the HPV-16 and abnormal cells. Then they did a colposcopy to see if there were pre-cancerous cells, which came back negative and told to return in 6 months for checkup, so that was good that no cancer now. She is hesitant to have oral sex. I would like to understand the risks involved with oral sex, and regular missionary sex for that matter given that we have HPV-16. If i perform oral sex on her, is there a risk that i get throat cancer? And if she performs oral sex on me, can she get throat cancer? And regarding missionary, can i get penile cancer from her HPV from contact with her vagina, and can she get vaginal cancer from contact with my penis. And how does all this relate to us already having HPV? I get that we are not transmitting cancer cells, i guess it is more how our body deals with the virus, and fights off the chance of getting cancer. I do understand that the body's immune system can clear the HPV virus after 6 months to a year, but unfortunately there is no test for a man to know when it is cleared, which i think is unconscionable. Who decided we don't need a test to make sure a man does not unknowingly pass on a high cancer risk virus to a woman? Ridiculous. I read that HPV is very common in people and the body defends it off, but how real is the risk to get cancer before your body removes it? Please supply as much information as you can.
thx. Oh, and is HPV harder to fight off if you have HSV-2? Does having both virus' at the same time make either one worse?
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Edward W. Hook M.D.
35 months ago
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Welcome to our forum. Thanks for your questions. I’ll provide some general information which I hope addresses your questions. In addition, I would encourage you to go to the ASHA website for general information on HPV infection. While much of what is found on the Internet is erroneous and misleading, the information on the ASHA website is reliable and on target.
I presume that you and your girlfriend have been sexually active on multiple occasions in the past. I also presume that that those exposures included oral sex. That being the case, for starters I will state that there is no reason to modify or alter your sexual practices. You have both been exposed to each other’s HPV on multiple occasions and changing your behavior at this time will not modify this.
Second, there are over 200 different types of HPV. Those, about 40 different types affect the genital tract and among those 40 certain types are more strongly associated with cancer risk than others. Statistically however this association is a statistical phenomenon which can easily be misinterpreted. About 40 to 50% of sexually active adults will acquire HPV 16 within their first year months of sexual activity. Of those, the majority will resolve without treatment over a period of 6-24 months. Only 1 or 2% will develop pre-cancerous lesions and those pre-cancerous lesions are readily treated. The presence of HPV 16 is nothing to panic about. Women HPV 16 infection is readily managed by following standard recommendations for regular follow ups as have been recommended for your partner. For men progress to pre-cancerous lesions are far less frequent than for women. Counseling for men is that should an unusual penile lesion appear which persists for more than a few weeks, it should be evaluated by a trained clinician. This practice will prevent any risk of penile cancer.
HPV 16 can be spread between partners through oral sex but it is spread less efficiently than general infections. Overall HPV throat infections are only about 1/5 as common as general infections. Most oro-pharyngeal HPV infections resolve without treatment and without development of pre-cancerous or cancerous lesions. Dentists are now trained to look for pre-cancerous or allusions as part of their examination.
There are no data to link interactions between HSV-2 HPV infections in terms of cancer risks or to suggest that either infection makes the other worse.
I hope this information is helpful to you. EWH
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34 months ago
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thank you for that information. I am surprised to here how common it is. What is the recommendation about dating someone new? Since i have no way of knowing if/when HPV has gone away, how do i go about dating someone new? I prefer to be transparent and sharing the information but if i don't have it anymore then it's just raising unneeded concern. I believe in exchanging recent STD results with a new partner before sex, but this is crazy because i won't know if i have hpv or not.
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Edward W. Hook M.D.
34 months ago
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For better or worse, the majority of sexually active persons have acquired HPV and, like you, will not know whether they have it at the time or not as they enter new relationships. This topic is discussed extensively in many other threads on this forum which I suggest you take a look at. We feel that disclosure regarding HPV is not essential. While we agree with you that for other STI‘s, in the context of new relationships, STI testing and disclosure is advisable and desirable, HPV is the exception. As you point out, with this widespread STI, sometimes raising the topic creates unneeded and unnecessary tensions. One element of discussions about sexual health which is an important element for new relationships however is the topic of HPV vaccination which we recommend for virtually everyone.
I hope this perspective is helpful. Once again I encourage you to look at other threads on this forum regarding the topic of HPV disclosure. There are many of them and we leave them on the forum available to readers so that others can I have an opportunity to review and learn from them. EWH
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