Is it dangerous for my partner if I have sex with them while having a papilloma on my cervix and a history of human papillomavirus (HPV) related condylomas (genital warts)?

Risk of HPV Transmission to Sexual Partners

Yes, having sex with untreated condylomas (genital warts) poses a transmission risk to your partner, as genital warts can be transmitted even when visible warts are present, and your partner is likely already infected if you are in an ongoing relationship. 1

Understanding Your Transmission Risk

Current Infectivity Status

• Genital warts can be transmitted to others even when no visible signs of warts are present, and transmission continues even after warts are treated. 1, 2
• The presence or absence of symptoms is irrelevant to transmission risk—asymptomatic warts remain infectious. 1
• The size of your warts does not eliminate infectivity; transmission can occur even with small lesions. 1
• It is not known how long a person remains contagious after warts are treated, making timing of sexual activity difficult to determine. 1, 2

If You're in an Ongoing Relationship

• Within an ongoing sexual relationship, both partners are usually already infected by the time one person is diagnosed, even if your partner shows no signs of infection. 1, 2
• Partners in long-term relationships tend to share HPV, so your partner likely already has the virus even without visible symptoms. 2
• A diagnosis of HPV does not indicate sexual infidelity in either partner, as HPV can remain dormant for years before detection. 1, 3

CDC Recommendations for Your Situation

What You Should Do Now

• The CDC recommends that patients with genital warts inform their current or new sexual partner(s) that they have genital warts, as they can be transmitted to others. 1, 2
• You should refrain from sexual activity until the warts are gone or removed, though complete elimination of transmission risk cannot be guaranteed even after treatment. 1, 2
• Treatment may reduce transmission risk by "debulking" visible warts, although no studies definitively prove this reduces HPV transmission. 1

Protection Measures (Important Caveats)

• Correct and consistent condom use can lower the chances of transmission, but is not fully protective because HPV can infect areas not covered by a condom (such as the vulva, scrotum, and perianal area). 1, 2
• Condoms reduce but do not eliminate risk, so do not be falsely reassured that condoms provide complete protection. 1

What Your Partner Should Know

Partner Screening and Management

• Both you and your partner should be screened for other STDs if one of you has genital warts. 1, 2
• HPV testing is not useful for screening your male partner—no clinically validated HPV test exists for men. 1, 4, 2
• The most common manifestation of HPV infection in men is visible genital warts; high-risk HPV types (that cause cancer) seldom cause visible warts. 2
• Your partner may benefit from examination to assess for visible genital warts and other STDs. 2

Cancer Risk Counseling

• The HPV types that cause genital warts (types 6 and 11) are different from the types that cause cervical and other anogenital cancers (types 16 and 18). 2, 5
• Genital warts are not life-threatening and will not turn into cancer except in very rare cases. 2
• However, you should continue regular Pap tests as recommended for cervical cancer screening, regardless of your genital wart history. 2

Treatment Considerations

Natural History Without Treatment

• If left untreated, genital warts may resolve spontaneously (20-30% within 3 months), remain unchanged, or grow in size or number. 1
• However, waiting for spontaneous resolution means continued transmission risk during that time. 1

After Treatment

• Genital warts commonly recur after treatment, especially in the first 3 months, so follow-up is important. 1, 2
• Recurrence is believed to be caused by incomplete removal of infected epithelium at the base of the lesion or continued reinfection. 2
• You should watch for recurrences most carefully during the first 3 months after treatment. 2

Critical Pitfalls to Avoid

• Do not assume that asymptomatic periods mean you are not infectious—transmission occurs regardless of visible symptoms. 1
• Do not delay counseling your partner about transmission risk while awaiting treatment—they need to know now. 1
• Do not rely solely on condoms for protection—they reduce but do not eliminate transmission risk. 1, 2
• Do not assume your partner needs HPV testing—it is not clinically useful and not recommended by the CDC. 1, 4

Vaccination Considerations

• HPV vaccines are available and recommended for girls and young women aged 9-26 years, even those already diagnosed with HPV infection. 2
• Male partners can be vaccinated with the quadrivalent vaccine (Gardasil) to prevent genital warts, though it does not treat existing infection. 2