Sexually Transmitted Diseases/Follow up from sore on vagina

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Question
Hello again. I scheduled an appointment with my gyno last week for a pap smear because of this sore. The problem is I had a pap done back in March and had a normal pap. Do you think I need to go this month even though I went in march?? Is it possible that I may have HPV inside my vagina hole that is not showing?? I know for sure that the shaft of his penis was covered with a condom. Is it still possible if he had HPV that it would've went inside my vagina even when the shaft of his penis was covered??

I also would like to thank you for the speedy answer and your educational response.

Answer
Hello Celeste,
A "Pap test" is simply an examination of the cervix for evidence of abnormal cells there that might develop into warts or other precancerous changes.  This is usually done once every year or so. However this is accompanied by a pelvic exam which is more thorough, and is designed to examine the external and internal parts of the vulvovagina, which also includes the cervix, but may exclude the Pap, per se.  So a pelvic exam is important, but the Pap may not be, depending on what the provider observes.

Condoms are primarily designed to cover the head and distal shaft of the penis, to prevent ejaculate from causing an unwanted pregnancy.  The secondary goal is to prevent an STD, but if you examine a penis after sex while wearing a condom, the condom frequently "rides up the shaft" to expose the base and proximal shaft.  That part may still transmit herpes or HPV/warts, as the rubbing and friction during sex can cause this to happen. So the inside of the vagina can easily be exposed to the skin of the uncovered penis, even though the end is covered with a condom, and that you are essentially protected against unwanted pregnancy, as long the condom stays on, doesn't rip, etc.

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. 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 “pre-screen” 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 consequences 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; answered 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.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), 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) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

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

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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