Over 70% of sexually active adults will show evidence of a past HPV infection. Most HPV infections are asymptomatic - that is, people are infected and do not know it. It's possible you've already been exposed to the strain that this woman was diagnosed with. Many HPV infections go away on their own. When HPV infection goes away the immune system will remember that HPV type and keep a new infection of the same HPV type from occurring again. However, because there are many different types of HPV, becoming immune to one HPV type may not protect you from getting HPV again if exposed to another HPV type.
Some HPV infections persist and stay in the body. Some strains cause warts. The strains referred to as ""high-risk"" can cause changes to cells that eventually can lead to cervical cancer, anal cancer and rarely, oropharyngeal cancer. It is not possible to know if she has cleared the virus completely and at this time there are no tests to detect HPV in men.
As for ways to protect yourself, condoms can decrease the risk of HPV transmission. There is also an excellent vaccine that protects against 9 of the most common strains of HPV -including 4 high-risk strains and 5 strains that can cause warts. Its recommended that all men and women <26 receive this vaccine.
Receiving oral sex (i.e. having your partner suck your penis or lick/kiss your vagina/clitoris), carries NO risk of HIV transmission. Performing oral sex (i.e. licking/kissing a vagina/clitoris or giving a blow job/sucking a penis) is extremely low risk in terms of HIV transmission. There are a few case reports and individual experiences that support getting HIV from performing oral sex on a penis, but it’s extremely rare. As far as whether oral sex is riskier if you swallow semen, truthfully no one really knows. Having bleeding gums, recent dental work or large sores in your mouth may slightly increase the risk.
Other STDs like syphilis, gonorrhea, chlamydia, herpes, and HPV are transmitted through oral sex. Many of these infections are easily diagnosed with simple tests and can be treated with available medications. If you are worried about your risk for HIV or STDs, talk to your health care provider about getting tested and ask them if PrEP (pre-exposure prophylaxis) makes sense for you.
Yes, over time the immune system in some people can clear chlamydia infection, but most people need to take antibiotic medication to get rid of it. Untreated chlaymdia infection can cause serious health issues —such as sterility, pain, and pregnancy outside the womb. In addition, if you have chlaymdia, you can pass it on to your sex partners even if you don't have any symptoms. Getting re-infected with chlamydia after treatment is common, so be sure that your partners know about the infection and get treated too. Here's a great resource on how to talk to your partner about STDs: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/get-tested/how-do-i-talk-my-partner-about-std-testing.
We recommend that everyone diagnosed with chlamydia get a test 3 months after treatment to make sure you were not re-infected.
It is definitely possible to spread herpes from one partner’s mouth to another partner’s genitals during oral sex, which would result in the uninfected partner contracting genital HSV-1. Transmission is more likely when sores are present, but sometimes herpes can be transmitted without any symptoms – we call this “asymptomatic viral shedding.” This shedding can happen in both oral and genital herpes infections. Shedding is most common in the first few months after getting a new infection, and the frequency of shedding depends on which type of HSV you have and where the infection is. For example, oral HSV-1 (what we call “cold sores”) sheds about 12% of days, and genital HSV-2 sheds about 20% of days (https://academic.oup.com/jid/article/198/8/1098/879583). Another study showed shedding of genital HSV-2 on 10% of days (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144252/). Since this shedding is invisible, its not possible to know for sure when your partner is potentially contagious.
Even though your partner has herpes, it is not a guarantee that you will contract the infection. One study showed that transmission between couples is about 10% per year, and about 70% of these transmissions happened when the infected partner had no symptoms (https://annals.org/aim/article-abstract/705283/risk-factors-sexual-transmission-genital-herpes?volume=116&issue=3&page=197).
Avoiding contact with visible sores will reduce your risk of getting oral HSV-1 when your partner goes down on you.
At City Clinic, we perform herpes tests by swabbing sores. This is the most accurate way to test, and this kind of test can distinguish between HSV-1 and HSV-2. There are blood tests available, but we do not routinely use these for our visits. City Clinic does not have blood tests for HSV-1 – if you would like this test, please talk with your primary care provider.
Genital herpes is common. It is usually caused by HSV-2, but it can also be caused by HSV-1. About 12% of people in the US have been infected with HSV-2. Its possible you've been infected with HSV-2 in the past and don't know it, because not everyone who gets infected with HSV-2 develops symptoms (for example, ulcers or an ""outbreak""). You could ask your primary care provider to test you for antibodies to HSV-2, this would tell you whether or not you've already been infected.
If you've already been infected with HSV-2 in the past, then your partner can’t transmit to it you. If you have not been infected with HSV-2, then there are a few things you can do to protect yourself. Condoms reduce the chances of HSV transmission by about 50%. Another way to prevent HSV-2 transmission is for your partner to take a daily anti-HSV medication (like acyclovir or valacyclovir). This will reduce the chance that your partner will pass HSV-2 on to you. For more info about herpes, look here and to http://www.ashasexualhealth.org/stdsstis/herpes/
One study of people with genital HSV-2 who took a daily antiviral medication showed that people taking medication were both less likely to shed virus, and less likely to transmit the virus to their partners. In addition, people who both took daily medication and used condoms for intercourse had further reduced risk of herpes transmission in this study.
Yes! There are many ways to access PrEP if you're uninsured. Visit PleasePrEPMe.org to find a provider near you. There are also patient assistance programs to help you cover the cost of the medication. If you're in San Francisco, walk-in to SF City Clinic or call us at 415-437-5537 for more info on our PrEP program clinic.
Kudos for being so responsible and prepared. What tests you need really depends on your gender (that is, are you a man, woman, trans man, trans woman or something else?), the gender of your sex partner and what type of sex you're having. A medical provider can help you figure out what tests you need. Also if you are in a heterosexual relationship, you should talk with your partner and medical provider about pregnancy prevention (contraception). Many people are nervous about talking to their provider about sex. Here are some strategies:
The CDC recommends that all adults > 18 years old are tested for HIV at least once in their lifetime. Men who have sex with men, trans people who have sex with men and people who inject drugs should be tested more frequently. In San Francisco, we recommend that folks in these groups get tested for HIV every 3 months. People on PrEP should also get tested for HIV every 3 months.
We recommend that you talk with your healthcare provider about your sexual and drug use practices. This will help your provider determine what tests you need and how often you should be tested. Testing recommendations depend on your situation, for instance if you or your partner use drugs (like methamphetamine or cocaine), if you're experiencing homelessness, have a history of incarceration, have a history of an STD, do sex work, or if you think your partner may be having other partners.
This really depends on what type of HIV test is done. Most labs now use what's called a ""4th generation"" HIV test. This type of HIV test detects antibodies against HIV - which your body produces in response to the virus, as well as HIV antigens which are part of the virus itself. It usually turns positive about 3 weeks after infection, and should definitely be positive by about 6 weeks after infection. If you are worried about an exposure to HIV that occurred more recently than 3 weeks ago, ask for an HIV viral load test (also called an HIV RNA test). This test will usually turn positive around 10 days after infection. Using currently available tests, it is difficult to detect an HIV infection that occurred within the last 10 days. [link to HIV testing page].
If you think you may have been exposed to HIV in the last 3 days, then you may be eligible to take PEP to prevent HIV infection.