[Question #9491] hiv risk from wart/lesion in contact with vaginal fluid

32 months ago

I am a man who had protected sex with a female commercial sex worker (in the United States). And during intercourse, vaginal secretions came in contact with a wart/lesion on my penis. To be clear, the wart/lesion (not a fresh, open wound) sits right at the lower end of the shaft of my penis (or slightly below it). So the condom wasn't able to cover that exposed region. I read on a well regarded health site that when " hiv in vaginal fluid comes in contact with a herpes sore, risk for infection is high". Also, there is a 2018 HIV study that reported that since the skin of genital warts/lesions contain high levels of "HIV target cells", contact with HIV fluid can cause the transfer of HIV. And by the way, I don't know it my wart is a herpes sore or not. My question is, what is my risk for contracting HIV in this scenario? Thank you.

H. Hunter Handsfield, MD

32 months ago

Welcome. Thanks for your question.

You really needn't worry. You've been misinformed, or misunderstood information you may have found online. HPV and genital warts do not elevate the risk of HIV infection. Presumably you do not have genital herpes (or if you do, apparently no overt herpes ourbreak at the time of exposure), so the report of herpes increasing HIV risk is irrelevant. And regardless of a single report you found of a theoretical reason genital warts might increase the risk, several epidmiologic studies have found no link between HPV or genital warts and HIV risk. In any case, under one in a thousand female commercial sex workers in the US has HIV, so your partner probably didn't have it. And in any case, you used a condom, which reduced any risk by another 99%.

Herpes sores and warts are entirely different. No wart-like bump is ever herpes. In any case, even if you do have herpes, your chance of catching HIV in this event was under one chance in thousands, probably under one chance in a million.

You really shouldn't be at all worried about HIV. You do not need HIV testing on account of this event. Of coruse, like all people who are sexually active outside committed monogamous relationships, you should be tested for HIV and other STDs from time to time. If you haven't been tested recently, perhaps this would be a good time. But not because of this particular event.

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

HHH, MD

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