HPV Testing and Vaccination: Key Insights for Men

HPV testing and vaccine issues?

Recently, my girlfriend tested positive for HPV types 18 and 51.
I'm a bit worried about whether I might be infected and whether I should get vaccinated.
However, when I consulted a urologist, the doctor said that there was no need for testing because the presence of the virus is not directly correlated with the development of penile or anal cancer, and I could go ahead and get vaccinated.
On the other hand, I heard that when my girlfriend visited her gynecologist, the doctor mentioned that if someone is already infected with the virus, the vaccine would be ineffective.
So, I asked the urologist whether it would be better to get tested before getting vaccinated, as the vaccine might not work for those already infected.
However, the urologist said it would still be effective and that I could proceed with the vaccination.
Therefore, I would like to ask the following questions: 1.
Do I need to get tested, and if I am infected with HPV types 51 and 18, would the vaccine still be beneficial? 2.
Is there a difference between males and females that explains the differing opinions between the gynecologist and the urologist? 3.
It seems that the nine-valent vaccine does not include HPV type 51; does this mean that I have no other means to prevent this type of HPV? I apologize for the lengthy questions, and I appreciate your response.
I'm not sure if my questions were submitted successfully.

Awei, 20~29 year old female. Ask Date: 2023/03/13

Dr. Li Xinyi reply Urology

Most HPV infections resolve on their own.
Although it is associated with cancer, the incidence in males is relatively low, and the vaccine's efficacy lasts for about 10 years.
Should one get tested? Should one get vaccinated? Personally, I do not have specific recommendations; it is a decision that should be made individually.
In terms of prevention, it is more important to avoid high-risk behaviors, ensure adequate lubrication, and maintain overall health to boost immunity, as the vaccine covers only a limited number of HPV types.

Reply Date: 2023/03/13

More Info

Understanding HPV (Human Papillomavirus) and its implications for men is crucial, especially in light of your concerns regarding potential infection and vaccination. Let's address your questions systematically.

1. Should You Get Tested for HPV?
The necessity of HPV testing for men is a topic of ongoing debate. Unlike women, who can undergo Pap smears to detect cervical changes due to HPV, there is no standard HPV test for men. Most men do not exhibit symptoms, and many HPV infections are transient and cleared by the immune system within a couple of years. However, if your girlfriend has tested positive for high-risk HPV types (like 18 and 51), it is understandable to be concerned about your own status. While testing is not routinely recommended for men, if you have had multiple sexual partners or are experiencing symptoms (such as genital warts), discussing testing options with your healthcare provider may be beneficial.

2. Effectiveness of the HPV Vaccine After Infection:
The HPV vaccine, particularly the nine-valent vaccine (Gardasil 9), is designed to protect against several strains of HPV, including types 16 and 18, which are associated with cancer. If you are already infected with a specific type of HPV, the vaccine will not treat that infection, but it can still provide protection against other types included in the vaccine. Therefore, even if you have been exposed to types 18 and 51, getting vaccinated can still be advantageous as it may protect you from other strains and reduce the risk of future infections.

3. Differences in Medical Opinions:
The differing opinions between your urologist and gynecologist may stem from the distinct focuses of their practices. Gynecologists often emphasize the importance of screening and prevention in women, particularly concerning cervical cancer. In contrast, urologists may focus more on the implications of HPV in men, which are less clear-cut. It is essential to consider both perspectives, but ultimately, the consensus is that vaccination is beneficial even if you have been exposed to certain HPV types.

4. Vaccination Against HPV Types Not Included in the Vaccine:
You are correct that the nine-valent HPV vaccine does not cover all HPV types, including type 51. Unfortunately, there is currently no vaccine available that specifically targets HPV type 51. The best preventive measure against HPV is vaccination before the onset of sexual activity. However, practicing safe sex, including the use of condoms, can help reduce the risk of transmission of HPV and other sexually transmitted infections (STIs).

In summary, while testing for HPV in men is not routinely recommended, vaccination remains a valuable tool for prevention. If you are concerned about your HPV status, discussing your worries with a healthcare provider who understands both the male and female perspectives on HPV can provide clarity. Additionally, maintaining open communication with your partner about HPV and vaccination can help both of you make informed decisions regarding your sexual health. Regular check-ups and practicing safe sex are also essential components of managing your health in relation to HPV.

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