[Question #9967] HPV Question

27 months ago

Hello - thank you for this service being availabe. I am a 50 yr old male heterosexual. I divorced about 13 years ago and, I'm not proud of it, but since that time I've had sex only with many CSWs I practiced safe sex with the ones I had intercourse with but I was, unfortunately, blissfully ignorant & unaware of the HPV risks of receiving & giving unprotected oral sex. I asked a dermatologist one time about my risk of STD's from unprotected oral sex and she told me it was mainly HSV and gonorreha/syphillis that I needed to be concerned about (no mention of HPV) During this time I got tested regularly and have always been completely clear for everything, including HIV Now I am at a point in my life where Ive just started to date. Unfortunately, I'm now terrified of my past coming back to harm a future potential girlfriend. Im still 100% STD free (of the ones that can be tested for), however, now that I've read about HPV, this is the one that keeps me up at night. By my estimate, I've probably received unprotected oral from dozens of CSWs and I've probably performed cunniligus on 10-20 at least (I am super embarrased about this, of course, just an estimate). Yes - I am going to share this information with a future partner but I have questions:

Questions: 1. Given my history & exposure via unprotected oral (giving and receiving), how likely is it that I've contracted HPV?

2. How likely is it that I have one of these "dormant" strains that could eventually cause me cancer and infect a potential girlfriend/spouse. Is this a cause for concern? Do I now need to use condoms & dental damns even in a committed relationship?

3. Am I a candidate for the HPV vaccine (or am I too old?)

Thank you!

H. Hunter Handsfield, MD

27 months ago

Welcome. Thanks for your question.

I'll start by agreeing with your dermatologist in not mentioning HPV. First, getting genital HPV is unavoidable and you undoubtedly have already been infected, perhaps more than once. Around 90% of all sexually active people acquire HPV; it is an expected, unavoidable, and entirely normal aspect of human sexuality. Second, you are mistaken in your concerns about oral sex and HPV: oral HPV infections are a lot less common than genital, and oral sex is not the usual source of genital infection. Put another way, there is no basis for your statement that you are "now terrified of your past" to harm a potential girlfriend. Another aspect is that any girlfriend you might acquire also has had HIV; sex with you is not likely to further increase her risk of being infected or, more important, having a serious health problem from HPV.

Now to your questions:

1. It probably is unlikely you acquired HPV from the oral sex events, but you can assume you have the virus (which often lasts for life) anyway.

2. Cancer in males is exceedingly rare due to HPV. The risk isn't zero, but it is very unlikely. And really it doesn't much matter anyway: penile cancer almost always first shows up as a minor wart-like problem that is easily cured with ointments or very minor surgery.

3. The HPV vaccine is not likely to have any benefit at your age.

In summary, you shouldn't be at all worried about HIV, either for your own health or that of your future sex partners. It's really no big deal!

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

HHH, MD

---