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About Mark Behar
Expertise
Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience
Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; Wisconsin Academy of Physician Assistants; American Society of Colposcopy and Cervical Pathology (ASCCP); Board of Directors, National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA)

Education/Credentials
Physician Assistant Certified, since 1982; Masters in Physician Assistant Studies; Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);

Awards and Honors
Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI

You are here: Experts > Teens > Health for Teens > Sexually Transmitted Diseases > HPV

Sexually Transmitted Diseases - HPV

Expert: Mark Behar - 10/28/2009

Question
Hi Doctor! I am a 26 years homosexual old male and knowing the risk of contracting myriad of STD, I hardly engage in unprotected sex. About 8 months ago while vacationing in Thailand I had some petting around (mutual masturbation,intimate touching nand receptive oral sex but no penetration) with some guys I met. Soon after I found that some warts developed around my anus. I consulted a physician who referred me to a dermatologist and learnt that it was HPV. After a few consultation with the doctor and some medication, the warts are gone. I have the following questions.

a) Is it true I can spread the virus to the others through intimacy/touching although I no longer have warts now?

b) Can I donate blood? I had a test and apart from HPV, I am free from other STD diseases, including HIV.

c) Fearing of unknowing spreading the virus to others, I have not had intimacy for some time. The warts have been gone for about 5 months. Is it advisable for me to start doing so? Is there any precaution which I should take before having sex?

d) If my partner has oral contact with my affected area, would he develop warts in his mouth?

Would really appreciate your advice. I wish to start having a healthy sex life again but I want to know the precautions which I should take.

Thank you very much.

Answer
Hi Tan,
a) The warts may be gone, but the cause of warts are human papillomavirus (HPV), which may still be present. It is possible for you to spread HPV, even in the absence of visible warts. However, actively growing warts are clearly more infectious than those not growing or visible. The bottom line, is that it is possible! Note, one of the secondary signs of syphilis are a skin condition that looks like warts from HPV; it is called "condyloma lata." Your doctor should be aware of the differences, and make sure your treatment is effective.
b) Although you may be free from other STDs, men who have sex with other men (MSM) are thought to be at higher risk for hepatitis B, syphilis, and HIV. In the US, MSM are considered at too high a risk to be allowed to donate. Screening questions usually are used for this purpose. The risk is of course, theoretical-- however hepatitis B, syphilis, and HIV may be transmitted early in their infections, prior to the tests being accurate. Thus, the screening questions are used here for that added "protection." Guidelines may be different in your part of the world!
c) Unfortunately, there is risk in everything we do. We must be well informed, and understand the risk we are about to embark upon. It is possible for you or a future partner to develop warts.
d) It is possible for the HPV to cause infection of the mouth, tonsils and throat may be causes of mouth, tongue, and throat cancers when older. This is very new information, and is somewhat speculative. However, there is risk in everything we do.

Sorry that this sounds so depressive. I, like many other gay and heterosexual people, accept such risk, but are aware of the possible consequences, and make sure our own doctors are aware of the situation, so they can look for problems before they get out of hand.

Good luck!
--mark

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