A service provided by the BC Centre for Disease Control
A diagnosis of HPV (6, and or 11) through appearance on skin took place recently. New partner notified. Sex has not taken place yet. Some skin to skin contact has taken place and there is an understanding that this may have resulted in transmission. We want to know what is best. How long to wait after no visible appearance (understanding that it is still present in the body of course) to have sex with condoms? What are your thoughts on sex with condoms during the treatment period? Since transmission may have already taken place in a committed monogamous informed situation what are your thoughts on a decision to have sex without condoms? Both over the age of 26. Have started Gardisil 9, first shot, second and third still to come, and understand relevance of it may only be for HPV 16, 18 (no longer 6 or 11). He is also over 26 as well. Could/should he consider Gardisil 9 for his present/future health?

Hi, thanks for your questions. Genital warts are considered cosmetic and not a risk for cancer. They are transmitted through genital skin contact. Because much of a person’s skin comes in contact with the other person’s skin during sexual contact, there is a risk of transmission even when condoms are used.  Many people have been exposed to the virus but have never developed bumps on their skin and will never develop them.  Sometimes the genital warts come out on the skin a long time after transmission so its hard to identify exactly what partner had what when there is no symptoms. Most likely both of you have come in contact with many strains of HPV before including possibly the ones that cause cell changes for cancer and your own bodies have cleared those strains.
There is no specific recommendation to not have sex. Some people choose to wait until warts have cleared.  Some people use condoms to cover area being treated. Some people keep having sexual contact without condoms. 
Gardisil is recommended  for all children before becoming sexually active. The National Advisory Committee on Immunizations recommendations include all men who have sex with other men regardless of age and to individuals with immune compromised conditions ( eg HIV). In Canada, public health is funded to give Gardisil to men who have sex with men until the  age of 26 and to start school vaccination for both girls and boys. The cost of the vaccine for adults  is often covered partially by extended health care plans that consider vaccinations as medications. 

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