Which statement about genital warts (condylomata acuminata) is appropriate to share with the patient?

• A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Pap smear annually.
• B. Metronidazole is the most common treatment, which should eradicate the problem within 7 to 10 days.
• C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
• D. The HPV cannot be transmitted during oral sex.

Answer: (D)

Genital warts are caused by human papillomavirus (HPV), and understanding transmission helps you counsel patients effectively. HPV can spread through close skin-to-skin contact, including sexual contact and oral-genital contact. Because of that, the belief that HPV cannot be transmitted during oral sex isn’t accurate—oral sex can spread HPV to the mouth, throat, or genitals of a partner.

When talking with a patient, it’s important to give accurate risk-reduction guidance. Condoms and other barriers reduce the chance of transmission but do not eliminate it, because HPV can infect areas not covered by a condom or barrier. So transmission can still occur even with consistent condom use.

Metronidazole is not a treatment for HPV; it targets certain bacterial infections and protozoal infections, not HPV or genital warts. The risk of cervical cancer is associated with higher-risk HPV types, so ongoing cervical cancer screening (as recommended by guidelines) remains an important part of care, and vaccination against HPV is a key preventive measure for eligible patients.

In short, the best counseling emphasizes that HPV can be transmitted through oral-genital contact, that barrier methods reduce but do not completely prevent transmission, and that appropriate screening and vaccination are important parts of comprehensive care.