[Question #9718] HPV
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29 months ago
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Background: I am a 40 yo F, with hypothyroidism, recently dating after a divorce. I've had very few sexual partners in my lifetime. About 9 years ago, I had genital warts from HPV, however was treated, pap was normal 6 months later. I've always had normal paps and have always tested negative for high-risk HPV. I decided to get Gardasil 9 (3 does series). I received my first shot in early February. I recently met a potential partner (male) and trying to decide my risk for contracting HPV. I am less concerned about the low-risk strains as I know they are common.
Question: Assuming he is not vaccinated and does not know if he is a carrier, what is my risk of contracting high-risk HPV from him after 1 dose or 2 doses of the vaccine? I'm also wondering if I'm at risk by kissing him as I've read HPV can be transmitted through kissing? I'm debating waiting the whole 6 months to have sex, but wondering if kissing or less risky sexual activities can be performed. I am health conscious, risk-averse person and most importantly want to mitigate my risk of HPV and STDs while being sexually active. Thank you for your time and education.
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Edward W. Hook M.D.
29 months ago
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Welcome to the Forum and thanks for your questions. In addition, congratulations on your attention to your sexual health as you re-enter the dating gamer - not all persons coming out of separations/divorces do so. Your assumption that your potential partner is likely unvaccinated and may have HPV is a reasonable assumption- vaccine rates in men have been quite low until recently but are now beginning to rise in persons under 25 or 30.
Protection from the HPV vaccine is partial following the 1rst dose but within a couple of weeks following the 2nd, vaccine-related protection is typically full. The 3rd dose consolidates and prolongs that protection. Thus, until about two weeks following your 2nd dose I'd recommend condoms which provide at least partial (~50-60% possibly more) protection.
HPV transmission through kissing is overblown and not something I'd worry a lot about.
Hoppe this information is helpful. I would not be overly worried about HPV once you've gotten your second dose of vaccine. EWH
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29 months ago
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Thank you for your reply about HPV. What are the most important safe sex practices you recommend with new partners (i.e. STD testing before sex, condoms)? And is kissing (generally) considered low-risk for all STDs?
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Edward W. Hook M.D.
29 months ago
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Optimally, before initiation of a new sexual relationship you and your partner should be tested (this is also a great way to provide each there with confidence regarding a partner's status). If that is not possible, then condoms are advisable, as well as a discussion of past STIs, including chronic STIs such as herpes. If that is not possible, then condoms might be wise (this is not a matter of "trust", just sexual health).
Kissing is quite low risk and not something I'd be worried about. EWH
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29 months ago
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Thank you for your reply. So for a new partner, ideally STD testing before sex, do you recommend a regular STD panel or also one that include herpes? My understanding is herpes (oral and genital) is not included in regular tests and requires a blood draw. I assume you cannot transmit genital herpes through kissing, correct? Thanks for your education.
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Edward W. Hook M.D.
29 months ago
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Thanks for the opportunity to clarify this. We do not recommend routine blood tests for herpes. They are unreliable both in terms of false positives and false negative results, and can be quite misleading.
HSV-1, the virus that causes cold sores, can also cause genital herpes. If you have not had cold sores or HSV-1 (about 50% of adult Americans have had HSV-1, whether they know it or not). Persons with HSV-1 can transmit the infection to others either by kissing or through oral sex, you could acquire it either through kissing or through receipt of oral sex with a partner who does have oral herpes. In general, person to get cold sores should share that information with intimate partners. Terry Warren, answers questions about herpes on the form. To learn more about this topic I would suggest you read some of the other threads that she has had with other clients on our firm. They are very informative.
We provide up to three responses to each client’s questions. As this is my third response as part of this thread, the thread will be closed shortly without further responses. I hope the information I have provided has been helpful. Take care. EWH.
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