Human Papillomavirus (HPV)
- At least 1 in every 2 sexually active young women has had a genital HPV infection.
- HPV is spread through direct skin to skin contact.
- An abnormal Pap test is often the first sign of an HPV infection.
HPV, short for Human Papillomavirus, is a group of over 150 different kinds of viruses, some of which cause warts on the hands and feet and others which cause genital warts and cervical cancer. This health guide is about the sexually transmitted types of HPV. If you're sexually active, have had any sexual contact, or thinking about having sexual contact, your best protection is to learn the facts about how HPV is spread and how to prevent getting it.
What is HPV?
HPV (Human Papillomavirus) is one of the most common sexually transmitted infections. There are many different types of HPV and more than 40 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers, such as 6, 11, 16, and 18.
Some types (such as 6 and 11) cause genital warts, others (such as 16 and 18) cause pre-cancerous changes on the cervix that can later lead to cancer of the cervix. In rare cases, the virus can cause other types of cancers to the vulva, vagina, and anus in girls, and the anus and penis in guys.
Who can be infected with HPV?
At least 1 in every 2 sexually active young women has had a genital HPV infection. Any sexually active person—no matter what color, race, gender, or sexual orientation—can get HPV. HPV is mainly spread by sexual contact. Very rarely, a mother who is infected with the HPV virus can infect her newborn baby during the delivery.
How do you get HPV or genital warts?
HPV and genital warts are usually spread by direct skin-to-skin contact during vaginal, anal, or oral sex with someone who has been infected with HPV. Using condoms every time you have sex can help protect against HPV but they aren't perfect because HPV can be found on skin that isn't covered by a condom.
What can happen to me if I get the HPV virus?
If you get the HPV virus, it may cause the following:
- The infected area of your body remains totally normal (called latent or inactive infection). You may never know about it, but you may give the infection to others. Your body then usually clears the infection.
- Bumps, called genital warts, can be seen in your genital area. They almost never lead to cancer.
- Changes in the cells of your cervix can result in an abnormal Pap test. Most of the time, if you are a teenager, your body will clear the HPV and the Pap test will become normal again over several years. However, sometimes the HPV infection persists in your cervix which can lead to cervical cancer. This is why your health care provider will want to see you for follow-up visits if you have had an abnormal Pap test.
- Recent studies have shown that certain vaginal and anal cancers and some cancers of the oropharynx (back of the throat, base of tongue, and tonsils), may be caused from HPV.
You are at greater risk of getting HPV if:
- You had sexual contact at an early age.
- Either you or your sexual partners have had many different sexual partners at any time.
- You or any of your sexual partners have had a history of sexually transmitted infections.
- Any of your sexual partners did not wear a condom.
How would I know if I had HPV or genital warts?
Sometimes it's hard to know if you have HPV. Although genital warts are usually seen on, around, or inside your vagina or anus, they may be small and hard to see. And you may not have any symptoms such as pain or bleeding.
An abnormal Pap test is often the first sign of a HPV infection. This is why it is important to start Pap tests when you are 21 years old. You should start earlier if you have special risks such as problems with your immune system.
What do genital warts look like?
Genital warts are growths on your skin that look like tiny bumps. They are usually in or around the vagina, anus, on the cervix, or on the inside of the thigh. They may be raised or flat, small or large. There can be only one wart or more than one in the same area. Warts can be pink or flesh-colored, red or brown. Some bumps grow together and look like a cauliflower.
When should I go to see my health care provider?
You should make an appointment with your health care provider if you notice any unusual growths, bumps, or skin changes on or near your vagina, vulva (the outside area surrounding your vagina), or anus or if you have any unusual itching around or inside your vagina or anus. Additionally, you should contact your health care provider if anyone you have had sexual contact with tells you that he or she has genital HPV or genital warts.
What is the treatment for genital warts?
Treatments for genital warts range from watching to see if the warts go away, acid medicines, creams, and laser therapy. The treatment will remove visible warts and unwanted symptoms such as itchiness. The type of treatment your health care provider recommends will depend on the number, location, and size of the warts and the cost and side effects of the different treatments. It’s important to talk with your health care provider about treatment choices and what type of follow-up you will need. Tell your health care provider if you think you are pregnant so that the right therapy is chosen.
Do NOT use over-the-counter "wart medicine" on genital warts. (These medicines are not meant for the very sensitive skin around your genital area).
Will I always have HPV?
Researchers used to believe that if you had HPV you would always carry the virus, but because of new medical research, we now believe that in most cases a person who has a normal immune system will actually clear HPV without treatment. This means that the virus can no longer be detected. However, it remains possible that in some people the virus is hidden and can cause symptoms later. It is important to remember that if you have had an HPV infection, you can still become re-infected with HPV if you come in contact with the virus again.
How can I prevent or lower my chances of getting HPV or genital warts?
The safest way to prevent getting other types of HPV is to NOT have sexual contact.
If you are having sexual contact, it is important to know that you can reduce your risk of infection by having sexual contact with only one partner who only has sexual contact with you. Using condoms every time you have sex gives you some protection, but condoms aren't perfect. Condoms don't cover a man's scrotum (the sack where the testicles are located) which can become infected with HPV. It just takes skin-to-skin contact to get the virus. Avoid having oral sex to prevent to certain HPV infections that may cause oropharynx cancers (back of throat, base of tongue and tonsils). Dental dams may offer some protection against HPV infections from oral sex with a partner who has HPV.
A very important prevention option are HPV vaccines. Gardasil® protects against 4 types of HPV: 6, 11, 16, and 18. It is approved for girls ages 9 to 26 years old. Cervarix® protects against 2 HPV types: 16 and 18.
Is it true that there’s a vaccine for girls that lessens your chances of getting HPV?
Yes. There are two HPV vaccines. Gardasil® is now available to all teens and young women 9-26 years of age. The vaccine works to prevent two types of HPV: 16 and 18, which have been linked to cervical cancer—and two other types: 6 and 11, which cause genital warts. The vaccine works best in girls and young women who have not yet come in contact with these viruses. For this reason, the vaccine is recommended for all 11 and 12 year old girls as a routine vaccination and for all young women 9-26 years of age who have not yet had the vaccine. The HPV vaccine is given in a series of 3 shots over 6 months. The first shot is given at a time of your choice. The second shot should be given two months after the first shot, and the third shot should be given about six months after the first one.
Cervarix® protects against HPV types 16 and 18 and is also three shots. It is for girls and women 10-25 years old.
Since some girls feel faint after having shots, it is important to sit down or lie down for 5-15 minutes after the vaccine, especially if you feel dizzy or faint. Let your health care provider know if you have felt faint with other shots or blood tests.
Is it normal to feel upset about having HPV or genital warts?
Yes. Lots of people feel worried. Some women may also be upset with their partner. It is important to become informed about HPV and share your feelings and concerns with your health care provider. Talk with your health care provider about whether you should get the HPV vaccine.
If you are worried about HPV or genital warts, remember:
- You're not alone! Millions of Americans have been infected with the HPV virus.
- There are lots of effective treatments for genital warts.
- The most serious problem related to some types of HPV is cervical cancer, and it can be prevented if you have Pap tests, treatment, and follow-up.
- Avoid smoking since it can make the HPV infection persist and increase the risk of cervical cancer.
- Learning about HPV will help you understand your infection and the importance of regular checkups.
- If you think you might have HPV, contact your health care provider.
Getting one of the HPV vaccines is a great way to protect yourself against certain types of HPV. Gardasil® protects against the four types of HPV that cause genital warts (types 6 and 11) and cervical cancer (types 16 and 18); Cervarix® protects again types 16 and 18. Talk to your health care provider about whether the vaccine is right for you.
The safest way to prevent getting other types of HPV is to NOT have sexual contact. If you are having sexual contact, it's important to know that you can reduce your risk of infection by always using a condom and having sexual contact with only one partner who only has sexual contact with you. Don’t forget to see your health care provider for regular check-ups and Pap tests.
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