HPV and Warts: A Guide for Couples Facing Health Concerns

Cauliflower Inquiry - Questions from Female Migrant Workers

Hello Dr.
Wu, I’m asking on behalf of my girlfriend, who is a Vietnamese migrant worker.
We have been together since this year, and we had our first sexual encounter on February 28, which has been about once a month since then.
Last year, before we met, I experienced painful urination on the morning of March 5, so I went to a urology clinic for an injection, examination, and also had blood tests for syphilis (RPR, TPPA), Chlamydia, HIV Combi, and Gonorrhea DNA.
I returned a week later for the results, which were all normal.
However, the frenulum was still a bit red, so I went back for another check-up a week later.
The doctor casually looked and said there were no symptoms and that I could have normal sexual intercourse.
To be more cautious, I visited the city hospital on April 1 to check my sperm condition, and the follow-up on June 3 was also normal, but I did not test for HIV.
Fast forward over a year, on April 10, I noticed a slight skin tear and odor on the corona of the glans, so I went to see a urologist.
The doctor thought it was just a common Candida infection and prescribed MYCOMB ointment, which improved after 3-5 days.
Recently, I asked her about it, and she finally confessed that she has something resembling warts down there.
Initially, I thought she just had a urinary tract infection or a typical Candida infection.
Later, she mentioned that after our first sexual encounter in February, a bump appeared, and she went to see a gynecologist.
The doctor said there was no infection inside, and after blood tests, it seemed she has HPV (though not severe, it is hard to treat).
She is currently taking medication and applying a topical treatment for warts, using it for a few days and then stopping, so she has no symptoms...
which is why I didn’t notice.
We have continued to have sexual relations.
So far, I have not noticed any warts on myself.
I read online that testing three months after sexual activity is more accurate.
I also want to take her to see other doctors, but she lives in Taoyuan, and I am not familiar with the area in Tainan.
Could you recommend a clinic or hospital? (If there is a Vietnamese translator available to help communicate with the doctor, that would be great.
She needs to see a gynecologist, and I need to see a urologist.)
I have found a lot of information about warts, and I have several questions:
1.
Is using LedaMei more effective?
2.
She went for laser treatment a couple of weeks ago, but it has recurred.
Since she hid this from me, could our continued sexual relations have hindered the treatment's effectiveness?
3.
If I have no symptoms after three months, but I still want to confirm if I have been infected, do I need to pay out of pocket for a 2000 NTD HPV screening (to see which type)?
4.
If a woman has warts, does her risk of cervical cancer increase compared to others? After her treatment, is it necessary to spend money on the three doses of the HPV vaccine for prevention? (I heard from a doctor that it is not effective after infection.)
5.
Can you recommend a doctor in Taoyuan who treats warts? The clinic she found could not help her improve, and she does not understand medical terminology.
6.
If I accompany her for three months of treatment (without sexual relations), and visually it seems to be gone, how can I confirm that it is no longer contagious? Should I also pay out of pocket for an HPV screening? I read that warts can be negative for 3 months to a year.
7.
After patiently reviewing my experiences, who could have transmitted the infection to whom, or is it possible that we both have it?
Since the COVID-19 pandemic began, I have been sanitizing my entire body with 75% alcohol every time I go out, including hotel door handles, remote controls, and bus seats.
I also tend to be very meticulous about showering twice.
I apologize for the lengthy message, and I hope you can help answer my seven questions.
Thank you, doctor.

Joannes, 20~29 year old female. Ask Date: 2020/06/08

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
Is using Leda Mei more effective?
2.
She went for laser treatment two weeks ago, but it has recurred because she hid it from me, so we still had sexual relations, which may have led to ineffective treatment?
3.
If I have no symptoms after three months, but I still want to confirm whether I have been infected, do I need to pay out of pocket for a $2000 HPV screening (to see which type)?
4.
If a woman has indeed contracted genital warts, does her risk of cervical cancer increase compared to the general population? After her treatment, is it necessary to spend money on the three doses of the HPV vaccine for prevention (I heard from a doctor that it is ineffective after infection)? For questions 1-4: After electrosurgery or cryotherapy for genital warts, recurrence is still very common, and it is recommended to receive the vaccine during the treatment process (for both males and females).

5.
Can you recommend a doctor in Taoyuan Hospital who treats genital warts? The clinic she found couldn't help her improve, and she doesn't understand medical terminology.

6.
I accompanied her for three months of treatment (no sexual activity), and if it appears to be gone visually, how can I confirm that it is no longer contagious? Should I also pay out of pocket for an HPV screening? I heard that genital warts can have a window period of 3 months to a year with possible low positivity?
7.
After the doctor patiently reviewed my experiences above, who infected whom, or is it possible that both of us could have transmitted it? Since the outbreak of the COVID-19 pandemic, I carry 75% alcohol for full-body disinfection every time I go out.
I also disinfect hotel doorknobs, remote controls, and bus seats.
I am very meticulous about hygiene and take two showers regularly.
For questions 5-7: Genital warts are a sexually transmitted disease, and infection is primarily through sexual contact.
Male carriers often do not show symptoms, making it difficult to identify the infected person.
Currently, vaccination is the most effective treatment and prevention method.

Reply Date: 2020/06/08

More Info

Understanding HPV (Human Papillomavirus) and its implications for couples is crucial, especially when one partner has been diagnosed with genital warts, commonly referred to as "cauliflower" due to their appearance. HPV is a sexually transmitted infection that can lead to various health issues, including genital warts and certain types of cancer, such as cervical cancer in women. Here’s a comprehensive response to your questions based on the information provided.

1. Effectiveness of Treatments: Your girlfriend is currently using a topical treatment for her genital warts. While treatments like imiquimod (often referred to as Aldara or similar brands) can be effective, they may not work for everyone, and warts can recur. Laser treatment is another option, but recurrence is common if the virus is still present in the body. It's essential for her to follow up with her healthcare provider to monitor her condition.

2. Transmission Concerns: Since you and your girlfriend have been sexually active since February, there is a possibility that you could have been exposed to HPV, even if you do not currently show symptoms. HPV can remain dormant for long periods, and many individuals may not exhibit any signs of infection. If she has genital warts, it is likely that she has a strain of HPV that can be transmitted to you, even if you do not have visible symptoms.

3. Testing for HPV: If you are concerned about your own HPV status, it is advisable to get tested. While HPV testing is more common for women, some clinics offer testing for men, particularly if there are symptoms. You may need to pay out of pocket for this test, and it can help determine if you have been infected with HPV. Discussing this with your healthcare provider will help clarify the best course of action.

4. Cervical Cancer Risk: If your girlfriend has been diagnosed with HPV and has visible warts, it does increase her risk for cervical cancer, particularly if she has a high-risk strain of HPV. However, not all strains lead to cancer, and many people clear the virus naturally. The HPV vaccine can still be beneficial, even if she has been diagnosed with HPV, as it protects against other strains that may not have been contracted yet.

5. Finding a Specialist: For your girlfriend, it is essential to find a healthcare provider who is knowledgeable about HPV and its treatments. In Taoyuan, you can look for hospitals or clinics that specialize in women's health or sexually transmitted infections. It may be helpful to ask for recommendations from local health organizations or community health centers that may have Vietnamese-speaking staff.

6. Confirming Non-Transmissibility: After treatment, it is wise to abstain from sexual activity until the warts are completely gone and your girlfriend has been cleared by her healthcare provider. Even if the warts are no longer visible, HPV can still be present. Regular follow-ups and possibly HPV testing can help confirm that the virus is no longer active.

7. Determining the Source of Infection: It can be challenging to determine who transmitted HPV to whom, as both partners may have been exposed to the virus prior to their relationship. HPV is highly prevalent, and many individuals do not realize they are carriers. Open communication with your partner about sexual health and regular check-ups can help manage the risks associated with HPV.

In conclusion, it is essential to maintain open communication with your partner about health concerns, seek regular medical advice, and consider preventive measures such as vaccination. HPV is common, and while it can lead to serious health issues, many people live healthy lives after managing their infections. Regular check-ups and following medical advice will be key in navigating this situation.

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