Condyloma: Questions About HPV, Transmission, and Safe Sex

Condyloma

Before meeting my boyfriend, I had not engaged in any sexual activity, and after we met, he also did not have sexual relations with anyone else.
We began having sexual intercourse four months after we met, during which we consistently used condoms and there were no specific lesions.
Four months after we started having sex, I had a gynecological check-up in January in Taiwan, which revealed mild cervicitis but no lesions.
That month, I had also gone to a hot spring, and around March or April, I noticed a small white bump in the perineal area.
In June, I experienced itching and noticed another small white spot nearby, prompting me to see an obstetrician-gynecologist abroad.
Since it was not covered by insurance, the doctor did not perform a biopsy but visually assessed it as likely condyloma and performed electrosurgery.
At that time, I asked my boyfriend to see a urologist, where he tested negative for all STDs and had no lesions.
One month after the electrosurgery, I had a Pap smear abroad (which involved sampling the cervix to test for viruses), and the doctor said there were no recurrent lesions but detected HPV.
However, the strain was not a common type and was classified as neither high-risk nor low-risk, so I do not know the specific type.
Now, three months after the electrosurgery, there have been no recurrent lesions.
I would like to ask the doctor: 1.
Should I or my boyfriend get tested again for recurrence? 2.
Since we have not engaged in sexual activity since the outbreak, is it safe to have sexual intercourse three months later? Is it possible that my boyfriend currently has the virus but is asymptomatic and could transmit it to me? 3.
It cannot be said that three months without lesions guarantees no transmission, and we had safe sex at that time but still contracted the virus (except for a very small chance it was from the hot spring?).
Should someone who has had the infection refrain from any sexual activity for a year to ensure safety?

Niming, 30~39 year old female. Ask Date: 2020/09/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, checking again can provide more peace of mind.
If everything looks normal, there should be no issues.
Wishing you good health.

Reply Date: 2020/09/24

More Info

Understanding condyloma, commonly caused by human papillomavirus (HPV), involves addressing several key aspects: transmission, prevention, and treatment. Your situation raises important questions about the nature of HPV, the implications of your diagnosis, and the safety of future sexual activity.

1. Follow-Up Testing: It is advisable for both you and your boyfriend to undergo follow-up testing, even if your symptoms have resolved. Regular check-ups can help ensure that there are no recurrences of condyloma or other HPV-related issues. While your recent examinations have shown no signs of active disease, HPV can remain dormant in the body, and periodic testing can provide peace of mind and help catch any potential issues early.

2. Safety of Future Sexual Activity: After three months without symptoms and with no visible lesions, many healthcare providers may consider it safe to resume sexual activity, especially if you both continue to practice safe sex (using condoms). However, it’s crucial to understand that HPV can be transmitted even when there are no visible symptoms. Your boyfriend may carry the virus without showing signs, which means there is still a risk of transmission. Engaging in sexual activity after a period of abstinence should be approached with caution, and open communication with your partner about health status is essential.

3. Risk of Transmission: It’s true that the absence of visible lesions does not guarantee that HPV is no longer present or that transmission is impossible. While using condoms significantly reduces the risk of HPV transmission, it does not eliminate it entirely, as HPV can be present on skin not covered by a condom. The concern about contracting HPV from activities like soaking in hot springs is valid, although the primary mode of transmission is through direct skin-to-skin contact during sexual activity.

4. General Recommendations: For individuals who have had HPV-related conditions, it is often recommended to avoid sexual activity for a period following treatment to allow for healing and to reduce the risk of transmission. While there is no strict guideline stating that one must abstain for an entire year, it is wise to be cautious and consider the potential risks involved. Engaging in sexual activity should ideally be done with full awareness of each partner's health status.

5. Long-Term Considerations: HPV is a common virus, and many sexually active individuals will encounter it at some point in their lives. Most HPV infections resolve on their own without causing any health problems. However, certain strains can lead to more serious conditions, including genital warts and cancers. Regular screenings, such as Pap smears for women, are crucial for early detection of any changes that could indicate a risk for cervical cancer.

In conclusion, while your current situation appears stable, it is essential to maintain regular check-ups, communicate openly with your partner, and practice safe sex. Understanding the nuances of HPV and its transmission can help you make informed decisions about your sexual health. If you have further concerns or symptoms arise, do not hesitate to consult with a healthcare professional for personalized advice and treatment options.

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