Dear Alice,

A little over one year ago, I was diagnosed with genital warts. I was prescribed a topical ointment, which I applied to the affected areas. Eventually, I decided that the treatment caused me more discomfort than the warts themselves, so I stopped using it. They have since then slowly disappeared. Have they really disappeared? Or are they "dormant," "asymptomatic," etc.? Can I have unprotected sex with my girlfriend without putting her at risk?

—Optimistic in Chicago

Dear Optimistic in Chicago,

Your conscientiousness about protecting your partner's sexual health is admirable. It’s great  that your symptoms have subsided to the point that you’re wondering whether the virus is in your body anymore. Unfortunately, there's no way to know for sure whether your system has cleared the virus or if it’s simply lying dormant. Therefore, using barriers and various medications will still be useful in reducing the risk of transmission. Unprotected sex can still put your partner at risk for contracting genital warts.

Genital warts are caused by the human papillomavirus (HPV), which can be treated with medication but may become intermittently active and inactive for reasons that aren't clearly understood. Often the virus is asymptomatic, so people don't know they have it, and it often goes away (or becomes inactive) on its own. Unfortunately, the virus's activity level can't always be determined by the human eye. Fortunately, there are medicines and vaccines that may help to prevent transmission in active and inactive cases of genital warts.

Two vaccines are now available that protect against certain strains of HPV that are most often  associated with cervical cancer. The vaccines don't cure HPV and they won't work if someone has already been exposed to the strains of the virus in the vaccine, but you and your partner could ask a health care provider to see if the vaccination would be appropriate for either of you.

If you have visible warts, the safest way to prevent transmission is to avoid sexual contact around the areas with warts. Using latex barriers such as condoms and dental dams can reduce the risk of transmitting infection, but doesn't eliminate it entirely because HPV can be present on parts of skin not covered by a condom or dam. Given the uncertainty around whether HPV has cleared from your system or is simply inactive, you and your partner will have to come to an agreement about what kind of risk you are comfortable with. As part of this process, you could experiment with different kinds of condoms — textures, colors, flavors — and make it a fun experience each time you put one on.

It may be a good idea to meet with your healthcare provider to go over your options. Again, compliments to you for your concern about your own health and your partner's.


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