STD Risks: HPV Vaccination and Oral Sex Safety

Q: STD Risks: HPV Vaccination and Oral Sex Safety

Hello： <br>1. <br>If someone has received the nine-valent vaccine and has no lesions, can they still transmit the HPV virus? --- It is possible; the vaccine only protects against certain types of HPV and does not provide 100% prevention.<br>2. <br>If my girlfriend has received th

Risk of sexually transmitted infections (STIs)

Hello Doctor: I started dating my girlfriend at the end of last year.
Prior to dating, I had not engaged in sexual activity for three years and tested negative for HIV, syphilis, gonorrhea, and other STIs, with no HPV lesions present.
After starting the relationship, I had intercourse with my girlfriend on January 1st (using a condom), but we engaged in unprotected oral sex afterward (and continued to do so).
On February 6th, we had unprotected intercourse.
My girlfriend had sexual encounters with two different men on October 16th and November 10th of last year, both times with condoms, and during the October 16th encounter, she also had unprotected oral sex.
She received three doses of the nine-valent HPV vaccine one to two years ago, and after a recent gynecological examination, the doctor found no lesions.
We also took an anonymous rapid HIV test last month, which was negative.
I would like to ask the doctor: 1.
Can someone who has received the nine-valent vaccine and has no lesions still transmit the HPV virus? 2.
If my girlfriend has received the nine-valent vaccine but performed unprotected oral sex on a stranger, does the absence of lesions in her mouth three months later indicate that there is no issue? 3.
I have not received any HPV vaccine, and if no lesions appear three months after unprotected intercourse and oral sex, is it unlikely that lesions will develop later (even if I have been infected but remain asymptomatic)? Would receiving the nine-valent vaccine afterward help prevent lesions from appearing if my immune system weakens?

ZN, 20~29 year old female. Ask Date: 2022/03/20

Dr. Du Shixi reply Urology

Hello:
1.
If someone has received the nine-valent vaccine and has no lesions, can they still transmit the HPV virus? --- It is possible; the vaccine only protects against certain types of HPV and does not provide 100% prevention.
2.
If my girlfriend has received the nine-valent vaccine but performed oral sex without a condom on a stranger, and three months later there are still no lesions in her mouth, does that mean she is fine? --- It's hard to say.
3.
I have not received any HPV vaccine, and after unprotected vaginal and oral sex, if no lesions appear after three months, is it unlikely that lesions will appear later (even if I have been infected with the virus but remain asymptomatic)? --- HPV can take over a year to show symptoms.
If I get vaccinated with the nine-valent vaccine afterward, can it prevent lesions from appearing when my immune system is compromised? --- There is no treatment; only preventive effects can be referenced from the vaccine insert or health education materials.

Reply Date: 2022/03/20

More Info

When it comes to understanding the risks associated with HPV (human papillomavirus) and the implications of vaccination and sexual practices, it's essential to consider several factors. Let's break down your questions and concerns regarding HPV transmission, vaccination, and safety measures.

1. Transmission of HPV After Vaccination: The nine-valent HPV vaccine (Gardasil 9) is designed to protect against the most common high-risk HPV types that can lead to cervical cancer, as well as types that cause genital warts. If your girlfriend has received the full series of the vaccine and has no visible lesions, her risk of transmitting HPV is significantly reduced, particularly for the types covered by the vaccine. However, it is important to note that the vaccine does not provide protection against all HPV types. Therefore, while the risk is lower, it is not entirely eliminated.

2. Assessing Risk After Oral Sex: Your girlfriend's previous encounters, particularly the unprotected oral sex, do introduce a potential risk for HPV transmission. However, the absence of visible lesions or symptoms three months after her last encounter is a positive sign. It is important to understand that HPV can remain dormant for extended periods, and not all infections lead to visible symptoms. Regular screenings and check-ups are essential for early detection and management.

3. Your Situation Without Vaccination: Since you have not received any HPV vaccination, your risk profile is different. Engaging in unprotected oral sex and intercourse does carry a risk of HPV transmission. However, the absence of any lesions or symptoms three months post-exposure is reassuring. It is possible to be infected with HPV without showing symptoms, but many individuals' immune systems can clear the virus naturally over time.
4. Vaccination After Exposure: Getting vaccinated after potential exposure can still be beneficial. While it may not clear an existing infection, it can protect you from other HPV types that you have not been exposed to yet. The vaccine is most effective when given before the onset of sexual activity, but it can still provide benefits even after exposure.

5. Monitoring and Preventative Measures: Regular health check-ups, including Pap smears for women and HPV testing, are crucial for early detection of any abnormalities. For men, while there is no routine screening for HPV, being aware of any changes in your health or symptoms is important. If you have concerns about your sexual health or potential HPV exposure, consulting with a healthcare provider for personalized advice and potential testing is advisable.

6. General Recommendations: Practicing safe sex, including the use of condoms and dental dams during oral sex, can significantly reduce the risk of HPV and other sexually transmitted infections (STIs). Additionally, maintaining open communication with your partner about sexual health and history is vital for mutual safety.

In conclusion, while the risks associated with HPV can be concerning, understanding the role of vaccination, regular health screenings, and safe sexual practices can help mitigate these risks. If you have further questions or concerns, it is always best to consult with a healthcare professional who can provide tailored advice based on your specific situation.

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