I reviewed your recent discussion with Dr. Hook and agree entirely with all he said. I'm going to broaden one concept that was implicit in his comments but not (that I saw) directly discussed.

HPV frequently spreads along surfaces, especially moist ones, and likely explains several aspects of HPV infections. First, nasal infection (with or without nasopharyngeal carcinoma) doesn't necessarily mean nasal inoculation (your husband's "prick and pick" comment). Oral HPV (mouth, throat) is quite common, and probably HPV can migrate along the continuous tissues that line the throat and nose. Second, the same thing probably explains your anal HPV and AIN despite no anal sex exposure -- i.e. spread of a genital infection to the anus. Finally, as that implies, even if you have not had a diagnosed HPV cervical/genital infection (e.g. by Pap smear), it is possible you could have cervical HPV at this time, as you apparently know.

Getting to your specific question about vaginal fingering, several aspects should be reassuring. First, while you likely had genital (probably cervical?) HPV at one time, you don't necessarily still have it. Have you had recent cervcal or vaginal swab HPV testing? It could negative at this time. Second, as Dr. Hook said, HPV is rarely if ever transmitted by fingering; even if you have an active infection, I see no risk. And no, your menstrual blood and the cut on his finger makes no difference. Blood doesn't transmit HPV, and there is no evidence that HPV more readily infects surface wounds than intact skin.

Finally, and perhaps most important:  worrying about your husband catching your presumed genital (or anogenital) HPV is like closing the barn door long after the horse has escaped; by now the "horse" is galloping over distant fields. You and your husband presumably have been sexually active all along, perhaps for years. He has been repeatedly exposed to your infection, involving the main susceptible tissues (his penis and genital tract). He is long since infected and likely immune to it, probably both. Immunity prevents people from re-acquiring HPV types they already have. Your husband might even have been the source of your current infection. Either way, unless one of you has other sex partners, neither of you risks transmitting HPV to the other. You should feel 100% free to participate in any sexual practices with your husband, involving any and all body parts, as long as those practices give mutual pleasure or at least are not coerced -- regardless of HPV.

HPV does not cause malignant melanoma. It causes only squamous cell carcinoma of cervix, skin, skin structures, and body cavity linings; and rarely adenocarcinomas -- but never melanoma.

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

HHH, MD

The last thing still on my mind is just ironing out one point that bothers me.  It was explained by doctor as I have posted before that anal HPV infection can spread in women even without anal sex and at our last appt this week she said they thought most typically through wiping after going to the bathroom. Presumably this would involve spreading infected skin over tiny breaks in anal skin allowing infection and would be possible as wiping involves some pressure.  I just want to check that this theory is consistent with and doesn't undermine the helpful advice I have read here that swallowing sexual fluids eg semen or cervical mucus would not in itself likely present an HPV risk as in that case there would not be the friction or pressure involved with wiping needed for transmission. I know oral sex itself causes a transmission risk but when there is skin to skin contact, so friction is involved, I just want to check about the swallowing. I can see it might sound like a crackers question, I just want to check I have this right to soothe my mind when it comes up with this mad stuff at 3 am.

Thank you so so much!

As discussed last time, you can assume your husband has been repeatedly exposed to your HPV infection, perhaps for years, including whatever risk exists from oral sex. If you're asking whether swallowing genital fluids during or after oral sex adds additional risk of him being infected is unknown and unknowable, it makes no difference in the chance he has (or has had) the HPV that caused your dysplasia, and no evidence that swallowing the virus has any health effect at all. Friction or not also makes no difference in his risk. As discussed above, your husband is at no risk on account of your current (or recent) HPV infection and you need not alter your sexual practices together in any way.

It is possible that some anal HPV infections result from toilet practices, like wiping carrying virus from the vulva to the anus. It isn't known how important this is compared with natural spread of the virus that I described in my reply above.

Does that help? My goal is to eliminate any and all concerns you have been having about your husband's health on account of your HPV infection. There is absolutely nothing to be worried about!

I am 100% reassured about ny husband, thank you, but I am still worried that if it is possible to spread hpv from the cervix to the anus without sex, possibly by wiping, I might have spread the hpv from my cervix to my mouth on my hands when swallowing cervical mucus ir semen that got on my fingers during sex. I am trying to make a distinction in my head between that and wiping in terms of risk and I think all I got was friction!! I hope that makes sense . In short: please can you reassure me that the fact one might be able to spread hpv anally by wiping has no bearing on it being v unlikely you can spread hpv from the cervix to the mouth or from there oesoohagus etc by swallowing cervical mucus from one’s fingers. Thanks in advance from 3am me….

At this point there probably is little or no risk of spreading HPV to other sites on your body. To the extent this explains HPV detected at apparently unexposed anatomic sites, it probably occurs mostly in the first few weeks of infection, before immunity develops. The context of this and your previous thread suggests you probably acquired HPV some months ago, right? And maybe years ago; newly abnormal pap often does not mean new infection, but reactivation of an old one. Most likely there is no longer any risk of auto-inoculation (self spread of the virus to new body locations), either by toilet wiping, swallowing, etc. And even if that were to happen (or already has), the chance it will actually become apparent (warts, pre-cancer, cancer itself) is very, very low.

Really, just let this go. Try to remember that having HPV is a normal, expected part of human life -- it happens to 90% of us, and often involves more than one anatomic site. But it is very rare for disease to show up at more than one site. Of course nobody can say the risk is zero. But you are at no higher risk than all the other millions of people who have (or have had) cervical dysplasia due to HPV. The truly isn't something you should be at all worried about!