Can you get HPV from fingering or fisting?

Woman with long fingernails
Studio shot of woman's hands with artificial fingernails By:. altrendo images/Altrendo/Getty Images

Question: Can you get HPV from fingering or fisting?

HPV is a highly contagious virus that spreads from skin to skin. Various low and high risk strains infect a large portion of the population. It is best known as the virus that causes cervical cancer. However, HPV can also cause numerous other cancers in men and women. These include anal cancer, penile cancer, and certain types of oral and throat cancers.

In addiiton, low-risk types of HPV can cause genital warts. They can also cause warts elsewhere on the skin. 

There are three vaccines -- Gardasil 9, Gardasil and Cervarix -- which can reduce the risk of HPV transmission. However, most people will be exposed to one or more HPV variants at some point during their sexual lives. That's why it's important to understand the various modes of transmission of these viruses. 

Answer: It's may be possible to get HPV from fingering. However, the risk is likely low.

Studies have shown it is possible to reduce the risk of HPV transmission during oral sex and intercourse by using condoms or other barriers. However, people often wonder if other forms of sexual activity may also carry a risk of HPV transmission. For example, I was recently asked if fingering or fisting without a glove might put someone at risk of HPV infection.

For practical reasons, it is difficult to conduct a study to determine how much of an HPV transmission risk fisting and fingering have.

Still, evidence suggests you can get HPV from fingering. More specifically, research has shown that it is possible to transmit HPV from the fingers to the genitals. In 2010, scientists from the University of Washington found that HPV could be found on the fingertips of a reasonable fraction of women.

In addition, the HPV found there was frequently the same type that they were infected with genitally. This suggests that HPV went from their fingers to their genitals or vice versa. 

Repeat positive fingertip tests were rare. Therefore, the scientists concluded that fingers were unlikely to be a major source of HPV transmission. However, other studies have linked receiving fingering to an increased risk of HPV infection in men who have sex with men. These studies have indicated that having warts on your fingers or hands is associated with an increased risk of genital and rectal HPV infections. The risk may not be as high as through other types of transmission. Still, it does seem that fingering can cause HPV. 

If you are concerned about HPV exposure, it may be worth using gloves while engaging in sexual activities that involve fingering or fisting. That protects hands from exposure to genital HPV, and vice versa. If you have long nails, gloves are still an option. Just pad your nails with cotton balls under the gloves. That reduces the likelihood that nails will break, or puncture the gloves. Gloves are generally considered a good idea for these activities for a number of other reasons as well.

They don't just protect against HPV. They also reduce the transmission of other bacteria and viruses that can live under the fingernails. 

It is worth noting that infection with HPV on the fingers can also lead to cancers there. These cancers are rare. However, they are more common and more aggressive in people with HIV, due to the immune suppression it causes.In general, HPV infections are more likely to progress, and progress quickly, in people with HIV than in people with healthy immune systems. 

Sources:

Gormley RH, Groft CM, Miller CJ, Kovarik CL. Digital squamous cell carcinoma and association with diverse high-risk human papillomavirus types. J Am Acad Dermatol. 2011 May;64(5):981-5. doi: 10.1016/j.jaad.2009.10.044.

Hernandez BY, Shvetsov YB, Goodman MT, Wilkens LR, Thompson PJ, Zhu X, Tom J,  Ning L. Genital and extra-genital warts increase the risk of asymptomatic genital human papillomavirus infection in men. Sex Transm Infect. 2011 Aug;87(5):391-5. doi: 10.1136/sti.2010.048876. 

Koliopoulos G, Valari O, Karakitsos P, Paraskevaidis E. Predictors and clinical implications of HPV reservoire districts for genital tract disease. Curr Pharm Des. 2013;19(8):1395-400.

Poynten IM, Waterboer T, Jin F, Templeton DJ, Prestage G, Donovan B, Pawlita M, Fairley CK, Garland SM, Grulich AE. Human papillomavirus types 6 and 11 seropositivity: risk factors and association with ano-genital warts among homosexual men. J Infect. 2013 Jun;66(6):503-11. doi: 10.1016/j.jinf.2013.03.005.

Winer RL, Hughes JP, Feng Q, Xi LF, Cherne S, O'Reilly S, Kiviat NB, Koutsky LA. Detection of genital HPV types in fingertip samples from newly sexually active female university students. Cancer Epidemiol Biomarkers Prev. 2010 Jul;19(7):1682-5.

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