HPV Vaccination and Safe Practices for Gay Men - Urology

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Hello! Thank you for your questions regarding HPV vaccination and safe practices for gay men. It's great that you're taking an active interest in your sexual health and seeking information.

First, let's address the HPV vaccination. The HPV vaccine, particularly the nine-valent vaccine (Gardasil 9), is recommended for males, including gay men, up to the age of 26, and it can be given to some individuals up to age 45. The vaccine protects against several strains of HPV that are known to cause genital warts and various cancers, including anal cancer, which is a higher risk for men who have sex with men. Since you have already completed the three doses of the nine-valent vaccine, you have a good level of protection against the HPV types covered by the vaccine.
Regarding your concern about needing to get revaccinated after eight years, current guidelines suggest that once you've completed the vaccination series, you do not need to repeat it. The vaccine provides long-lasting protection, although the exact duration of immunity is still being studied. As for the possibility of recurrence of HPV-related issues, while the vaccine protects against the strains it covers, it does not eliminate existing infections. If you had a previous HPV infection, it could potentially recur if it was not cleared by your immune system. Regular check-ups and monitoring are essential, especially if you have a history of anal warts.

Now, concerning your sexual practices, using condoms significantly reduces the risk of transmitting HIV and other sexually transmitted infections (STIs), including HPV. However, it's important to note that while condoms are effective, they do not provide 100% protection against HPV because the virus can be present on skin not covered by the condom. Engaging in unprotected sex, even occasionally, does carry some risk, particularly if either partner has an undiagnosed STI.
In your case, since both you and your partner have been tested for HIV and are healthy, the risk of HIV transmission during those few instances of unprotected sex is low, especially if you are both monogamous and not engaging in high-risk behaviors. However, it is always best to maintain open communication with your partner about sexual health and testing, and to consider regular STI screenings, as some infections can be asymptomatic.

Lastly, regarding your concerns about the potential for cross-infection, it's crucial to remember that HPV can be transmitted through skin-to-skin contact, not just through penetrative sex. Therefore, even with safe practices, there is still a possibility of transmission. If either partner has a history of HPV or related health issues, it may be beneficial for both to discuss vaccination and regular health check-ups with a healthcare provider.

In summary, you are doing well by being proactive about your health. Continue to practice safe sex, maintain regular health check-ups, and communicate openly with your partner about any concerns. If you have further questions or specific health concerns, don't hesitate to consult with a healthcare professional who can provide personalized advice based on your medical history and lifestyle. Stay healthy!