HPV Risks and Cervical Cancer: A Husband's Concern

I sincerely ask the doctor to help me?

Hello, doctor.
Before marrying my wife, I only had one girlfriend for six months, during which we had sexual relations, but we always used condoms.
Additionally, before marrying my wife, I had solicited sex workers and engaged in vaginal intercourse, always using condoms because I was afraid of contracting HIV.
However, I realize that it is difficult to avoid contact with sex workers' hands or other body parts.
For the first four years of our marriage, I was very faithful and only had sexual relations with my wife, although we did not always use condoms throughout.

From the fourth year of marriage until this year, which marks our fifteenth year, I regretfully admit that I have occasionally solicited sex about twelve times, always using condoms for vaginal intercourse, but not necessarily for oral sex.
During this period, my wife and I have always used condoms for vaginal intercourse, but not for oral sex.
We have never contracted any sexually transmitted infections.
Recently, as we are trying to conceive our first child, I learned about the connection between HPV and cervical cancer.
I found online that having multiple sexual partners is a risk factor for cervical cancer.
Initially, I felt reassured because my wife has never had multiple partners.
However, some articles suggest that a husband's solicitation of sex workers is associated with an increased risk of cervical cancer for his wife.
I have already accompanied my wife (33 years old) for her first Pap smear, and we are awaiting the results.
The doctor also performed a thorough vaginal ultrasound, which showed that her cervix is completely normal.
I am currently overwhelmed with guilt and feel helpless, unable to discuss this with my wife.
I have several questions for you, doctor:
1.
Why is there a connection between soliciting sex workers with condom use and cervical cancer?
2.
If a man receives oral sex without a condom, does that not only pose a risk of HPV transmission between the male genitalia and the female oral cavity? Can HPV infection in the female oral cavity transfer to the cervix?
3.
It seems that some physical contact can also transmit HPV, and even the environment can play a role.
Does kissing also pose a risk?
4.
How is "multiple sexual partners" defined? My wife has only had me as a sexual partner; she is not promiscuous.
I always used condoms during vaginal intercourse with sex workers.
My wife is completely unaware of my solicitation, so she does not worry about the risk of multiple partners.
I am extremely anxious about whether my wife might develop cervical cancer.
If she does, I would feel responsible and guilty.
Doctor, what is the likelihood that my wife will develop cervical cancer? It shouldn't be high, right? I am so worried that I feel like I might harm myself, fearing for my wife's life.

PP, 30~39 year old female. Ask Date: 2016/05/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Having multiple sexual partners does not necessarily mean that one will contract HPV.
Infection with HPV does not always lead to cervical cancer; the likelihood is not as high as we might think.
Additionally, using condoms consistently further reduces the risk.
There is no need to worry too much; your wife should just have a Pap smear and HPV testing done.
Wishing you good health.

Reply Date: 2016/05/30

More Info

It's understandable that you are feeling anxious about the potential risks of HPV and cervical cancer, especially given your past experiences. Let's address your concerns systematically.

1. Condom Use and Cervical Cancer Risk: While using condoms significantly reduces the risk of transmitting HPV, it does not eliminate it entirely. HPV can be present on skin that is not covered by a condom, and thus, there is still a possibility of transmission through skin-to-skin contact. This is particularly relevant when engaging in sexual activities that do not involve penetration, such as oral sex. Therefore, even with condom use during intercourse with sex workers, there remains a risk of HPV transmission.

2. Oral Sex and HPV Transmission: Yes, HPV can be transmitted through oral sex. If a male has HPV and engages in oral sex with a female partner, there is a risk that the female can contract HPV in her oral cavity. Although the risk of developing cervical cancer from oral HPV is lower than from genital HPV, it is still a potential pathway for infection. Once HPV is contracted, it can lead to changes in cervical cells over time, which may increase the risk of cervical cancer.

3. Transmission Through Skin Contact: HPV is primarily transmitted through direct skin-to-skin contact. This means that activities such as kissing or other forms of intimate contact can theoretically lead to transmission. However, the risk of transmission through casual contact is much lower compared to sexual activities. The primary concern remains with sexual contact, particularly with multiple partners.

4. Definition of Multiple Sexual Partners: The term "multiple sexual partners" typically refers to having sexual relations with more than one person over a certain period. In your case, while you have had multiple encounters with sex workers, your wife has only had you as a partner. This distinction is important because the risk factors for cervical cancer are often associated with the number of sexual partners a person has had, as this increases the likelihood of exposure to HPV.

5. Cervical Cancer Risk for Your Wife: Given that your wife has had only one sexual partner (you) and that you have used condoms during penetrative sex, her risk of developing cervical cancer is likely lower than if she had multiple partners or if you had not used protection. However, it is crucial to remember that HPV can remain dormant for years, and not all HPV infections lead to cervical cancer. Regular screenings, such as Pap smears and HPV tests, are essential for early detection and prevention.

In conclusion, while there are some risks associated with your past behaviors, the likelihood of your wife developing cervical cancer is not necessarily high, especially if she has been screened regularly and has no other risk factors. It is commendable that you are taking steps to ensure her health by accompanying her to screenings. Open communication with her about health and safety is also important, even if it feels difficult. If you continue to feel overwhelmed by guilt or anxiety, consider seeking support from a mental health professional to help you process these feelings. Remember, taking proactive steps for health and wellness is the best way to support both yourself and your wife.

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