HPV and Sexual Practices

Dear Ask The Doctor: My boyfriend went to the doctor before we had started dating and some skin tags on his inner thigh were referred to as hpv by his doc. We've been dating about a month (I'm 24, he's 26) and our plan is not to have sex until I have received all 3 Gardisil vaccines. That is over 6 months from now and I'm concerned as to whether either of us can hold out for that long. He has no other symptoms and I am a healthy individual. He does have some skin around his shoulders that turns red and blotchy in the shower (looks fungal), I don't know if that's related to hpv. All of the information I'm finding is so vague. My question is how concerned I should be if we do decide to have sex? We are participating in oral sex and manual stimulation. Am I risking it by participating in those acts? Any help you can provide is appreciated. I'm a registered nurse and I have been trying to find information since the day we started dating. Like I said, the information available is so inconclusive, it seems...

Dear Elizabeth: Human papillomavirus (HPV) can cause genital warts, cancer of the cervix, and various cancers of the vulva or vagina. HPV vaccine (Gardasil) is used to prevent genital warts and cervical/vaginal cancers caused by certain types of HPV (types 6, 11, 16, and 18) in girls and young women. HPV vaccine is given as an injection (shot) into a muscle in your upper arm or thigh, in a series of 3 shots. You may have the first shot at any time as long as you are between the ages of 9 and 26 years old. Then you will need to receive a second dose 2 months after your first shot, and a third dose 6 months after your first shot. You may receive this vaccine even if you have already had genital warts, or had a positive HPV test or abnormal Pap smear in the past. However, this vaccine will not treat active genital warts or HPV-related cancers, and it will not cure HPV infection.

Genital warts are highly contagious. There is roughly 60% risk of getting the infection from a single sexual contact with someone who has genital warts. Recurrence rates of genital warts are greater than 50% after one year and have been attributed to the following factors: Recurrent infection from a sexual partner, potentially long incubation time of HPV, Persistence of the virus in the surrounding skin, in the hair follicle, or in sites that are missed by the treatment used, deep lesions or lesions that cannot be detected. There is no single treatment 100% effective in eliminating warts and preventing them from coming back. Genital warts may go away on their own in about 10%-20% of people over a period of three to four months. The treatment options are as follows: Cryotherapy: this freezes the wart using liquid nitrogen or a "cryoprobe." It is an excellent first-line treatment because response rates are high with few side effects. Laser treatment: is used for extensive or recurrent genital warts. It may require local, regional, or general anesthesia. The laser destroys the HPV-induced lesion. It is very costly, increased healing time, scarring, and potentially infectious viral particles in the air caused by the laser plume. Electrodessication: uses an electric current to destroy the warts. It can be done in the office with local anesthesia.

Genital warts often appear or increase in number during pregnancy. Dormant infections may also become activated. Because no treatment is 100% effective, it is important to prevent the spread of HPV which causes genital warts and some cancers whenever possible. Transmission of genital warts can be decreased if you use condoms and refrain from sexual activity until therapy is completed.