Human Papillomavirus (HPV)
What is it?
- Human papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the United States.
- There are more than 40 types of HPV that can infect the genital areas (vulva, vagina, penis, or anus) as well as the mouth and the throat.
- While most types of HPV go away before causing serious health problems, some can cause genital warts and certain cancers such as cervical cancer and oropharyngeal cancer.
- The HPV vaccine protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers.
- The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected.
What is HPV?
Genital human papillomavirus (also called HPV) is the most common STD in the United States. Most types of HPV are not harmful to people. There are more than 40 types of HPV that can infect the genital areas as well as the mouth and throat. Most people who become infected with HPV do not know they are infected.
The same types of HPV that infect the genital areas can infect the mouth and throat. HPV found in the mouth and throat is called "oral HPV." In most cases, HPV infections of all types go away before they cause any health problems.
There are two categories of HPV. These categories are:
- Low risk strains. Low risk strains of HPV can cause warts on the genitals. Warts can be itchy, embarrassing, and unpleasant, but these strains do not cause cancer.
- High risk strains. High risk strains do not cause warts but can, in some cases, cause cervical cancer (cancer of the cervix) and oropharyngeal cancer (cancer of the head and neck area).
How common is HPV?
HPV is one of the most common sexually transmitted infections in the world. More than 75 out of 100 sexually active people will get genital HPV at some point in their life.
How is HPV spread?
HPV is passed by direct skin-to-skin contact during vaginal, anal, and oral sex with someone who has this infection. Rarely, a partner with HPV on his or her hands can pass the infection to the genitals. Most cases of HPV are spread by partners who do not have visible signs or symptoms and do not know they have the virus. A person can have HPV for months or even years without knowing it.
Only a few studies have looked at how people get oral HPV, and some of these studies show conflicting results. Some studies suggest that oral HPV may be passed along during oral sex (from mouth-to-genital or mouth-to-anus contact) or open-mouthed ("French") kissing, others have not. The likelihood of getting HPV from kissing or having oral sex with someone who has HPV is not known. We do know that partners who have been together a long time tend to share genital HPV—meaning they both may have it. More research is needed to understand exactly how people get and give oral HPV infections.
HPV vaccines are safe and effective. They can protect males and females against diseases and health problems (including genital warts and some cancers) caused by HPV when given as a series for these recommended age groups:
- All boys and girls ages 11 or 12 should be vaccinated. A vaccination series can start as early as 9 years old.
- Boys and girls who are 11 or 12 years old should receive two doses of the HPV vaccine, six to 12 months apart. Adolescents who receive their two doses of the HPV vaccine less than five months apart will require a third dose of the vaccine.
- Catch-up vaccines are recommended for males through age 21, and for females through age 26, if they were not vaccinated when they were younger. Those who are between 15 and 26 years old when they first receive the vaccine will need three doses of the HPV vaccine.
The vaccine is also recommended for gay or bisexual men (or any man who has sex with a man) through age 26. It is also recommended for men and women with compromised immune systems (including people living with HIV/AIDS) through age 26, if they did not get fully vaccinated when they were younger. Three doses of the vaccine are recommended for people ages 9-26 who are living with certain immunocompromising conditions such as HIV/AIDS.
HPV vaccines are effective at blocking infection with the HPV types associated with most cases of cervical cancer. Women who receive the full series of HPV vaccine still need screening for cervical cancer and pre-cancer as recommended below. The HPV vaccine works best if a person receives their first dose before having sex for the first time. Talk to your healthcare provider about the HPV vaccine.
What are the symptoms of HPV?
HPV can cause genital warts, which usually appear as a small bump or group of bumps in the genital area. Warts can be small or large, raised or flat, or shaped like a cauliflower.
HPV can cause cervical cancer and other cancers including cancer of the vulva, vagina, penis, anus, or throat (oropharyngeal cancer).
In most cases, HPV goes away on its own and does not cause any health problems. However, there is no way to know if people who have HPV will develop cancer or other health problems. People with weak immune systems may be less able to fight off HPV and more likely to develop health problems, this includes people with HIV/AIDS.
What are the risk factors for HPV?
A risk factor is the chance that something will harm or otherwise affect a person's health.
Risk factors for HPV include:
- Engaging in unprotected vaginal, anal, or oral sex.
- Having sex with multiple partners.
- Having HIV.
- Having a sexual partner who has HPV.
The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected.
Are there tests for HPV?
There are HPV tests that can be used to screen for cervical cancer. HPV tests are not recommended for younger women (ages 29 and younger) because HPV infections in this age group are very common and usually clear quickly. These tests are recommended for screening only in women ages 30 and older. In women who are ages 30 and older, HPV infections are less likely to be new, short-lived infections so HPV testing may help to determine which women need closer follow-up. Pap tests are recommended to check for changes in the cervical cells that may be caused by HPV and can lead to cancer if not treated early. Young women, beginning at age 21, should get regular Pap tests every three years. Women should talk to their healthcare provider about how often and which type of testing (HPV test, Pap test, or both) is best.
HPV tests are recommended for:
- Women who have mildly abnormal Pap test results. Knowing if a woman is high risk for HPV helps healthcare providers know which women are more at risk for cervical pre-cancers and cancers over time.
- Women ages 30 years and older, together with a Pap test (cervical cytology).
Currently, there is not an approved HPV test for males or that will detect HPV in the mouth or throat. Talk to your dentist about any symptoms that could suggest early signs of oropharyngeal cancer (persistent sore throat, earaches, hoarseness, enlarged lymph nodes, pain when swallowing, and unexplained weight loss).
How is HPV treated?
In most cases, HPV goes away on its own and does not cause any health problems.
There is no treatment for HPV itself. However, there are treatments for the health problems that HPV can cause:
- Genital warts can be treated with prescription medications, freezing with liquid nitrogen, and cauterization (burning or freezing of the tissue).
- Pre-cancer is treated by taking out the cells that are not normal. This is usually done through a short procedure in a healthcare provider's office or a health center.
- Most of the time cancer, including cervical cancer and oropharyngeal cancer, will be treated with surgery, radiation therapy, or chemotherapy. Sometimes more than one type of treatment is used.
Talk to your healthcare provider to help determine what course of treatment is best.
Even if you do not have any symptoms, you can still infect your sex partners. Using condoms may help lower this risk but it will not get rid of the risk completely.
If you have HPV, you should tell your sex partner(s) so they can make an appointment to discuss their options with a healthcare provider. Because a positive STD diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDs.
What are the implications of HPV on pregnancy?
If you are pregnant you can have complications from HPV during pregnancy such as genital warts or abnormal cell development on the cervix. You may elect to delay treatment until after delivery. When genital warts are large or spread out, this can complicate a vaginal delivery. In cases where there are large genital warts that are blocking the birth canal, a cesarean section may be recommended. Rarely is HPV infection transmitted from mother to newborn during childbirth. However, HPV infection of the mother may be linked to the development of laryngeal papillomatosis in the newborn—a rare, noncancerous growth in the larynx. Abnormal cell changes in women can be found with routine cervical cancer screening (Pap test). You should get screened even when you are pregnant.
Did you know? (HPV)
Content last reviewed on February 22, 2019