Everything You Need to Know about HPV
What Is HPV?
Human papillomavirus (HPV) is one of the most common sexually transmitted infections in the world — in fact, over 100 strains of HPV viruses have been identified. These viruses can infect the skin, mouth, throat, genitals, and anus. [1]
However, despite its commonality, there is still a lot of confusion and misinformation in the general population about the virus and how it affects the body.
One key thing to know about HPV is that while some strains of HPV are completely harmless, others can lead to serious health problems including cancer. This is why it’s important to be knowledgeable about the virus and be vigilant and proactive about your sexual health.
Types of HPV
You will hear the term “HPV strains” fairly often. To clarify, it refers to the different types or kinds of HPV that exist. “Strains” is a more scientific term and is likely what you would expect to hear from your healthcare provider.
HPV is categorized into two main groups: low-risk HPV and high-risk HPV.
Low-risk HPV
Low-risk HPV types rarely cause cancer, but a few strains of low-risk HPV can cause warts on or near the genitals, anus, mouth, throat, larynx, or other sections of the respiratory tract. Warts can also occur on the feet or hands, though these are not sexually transmitted. Of the known strains that are numbered, HPV types 6 and 11 are the most common. [2]
High-risk HPV
There are twelve strains of HPV that are considered high-risk. All strains are numbered, and those that are high risk include HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. Of those twelve, HPV strains 16 and 18 are the types that are responsible for the majority of HPV-related cancers. When a high-risk HPV infection goes untreated and is long-lasting, the infection causes changes in the cells found on the cervix, anus, oropharynx, vagina, vulva, or penis, which can cause cancer. [2]
How HPV Is Transmitted
HPV is transmitted via skin-to-skin contact, often during vaginal, anal, and oral sex, though it can also be transmitted from a pregnant person to an infant during childbirth.
The risk of transmitting HPV to an infant during childbirth is quite low, but if you have ever tested positive for HPV or exhibited symptoms, you should alert the healthcare provider(s) that are helping you through pregnancy and childbirth, as there are steps you can take to further prevent the transmission. [2]
Who Is at Risk for HPV?
Anyone who has intimate skin-to-skin contact with a person living with the virus can become infected, for example during penetrative sex, oral sex, anal sex, or close genital contact. [3]
Other things to note, according to the Cleveland Clinic [3]:
- If you are HIV-positive, your body may not be able to fight off HPV infections as effectively.
- People with penises who have sexual contact with people who also have penises may be at higher risk of contracting high-risk HPV.
- HPV poses the greatest risk to people AFAB because high-risk HPV can lead to cervical cancer.
Common Symptoms of HPV
HPV can lead to the growth of lesions, or warts. High-risk HPV infections can lead to the development of cancer.
HPV-related lesions/warts can appear on or near the genitals, anus, mouth, throat, larynx, or other sections of the respiratory tract in addition to the feet or hands. In many cases, your immune system may defeat an HPV infection before it creates warts, but when they do appear, they vary in appearance and location on the body, depending on which kind of HPV is involved.
Genital warts mostly appear on the vulva, anus, or cervix for those assigned female at birth (AFAB). For those assigned male at birth (AMAB), they will mostly appear on the penis, scrotum, or around the anus. These warts appear to be flat and are not likely to be painful, though they may itch or be tender to the touch.
Common warts are rough, raised bumps that appear on the hands and fingers. They can be painful or bleed but are mostly just unappealing to look at.
Plantar warts are usually hard and pop up on the heel or ball of the foot and may cause some discomfort.
Flat warts can appear on the face (usually on children), in the beard area (for people AMAB), or on the legs (for people AFAB). [1]
HPV Prevention
The only way to completely prevent HPV is to not engage in intimate contact with other people. However, there are many ways that you can protect yourself from HPV transmission and infection.
Vaccines
The best way to protect yourself and others from HPV is by getting the HPV vaccine before you become sexually active. The HPV vaccine given in the US is Gardasil®9.
According to its manufacturer, Gardasil®9 "protects individuals ages 9 to 45 against the following diseases caused by 9 types of HPV: cervical, vaginal, and vulvar cancers in females, anal cancer, certain head and neck cancers, such as throat and back of mouth cancers and genital warts in both males and females.” [4]
The vaccination is recommended for everyone–despite the common misconception that it is only for those assigned female at birth.
The CDC offers the following recommendations [5]:
- Vaccination can start as young as 9 years old
- Children between 11 and 12 years old get two doses of the HPV vaccine, administered six to 12 months apart. Only two doses are needed if the first dose was before the recipient’s 15th birthday.
- People 15-26 years old need three doses of the vaccine over six months
- People with weakened immune systems should get three doses if they are 9–26 years old
- Vaccination is not recommended for everyone older than age 26 years.
- Some adults aged 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit because more people in this age range have already been exposed to HPV.
For more information on these guidelines, talk to your healthcare provider.
Get Tested
Talk to your healthcare provider and consult reputable sources on the current guidelines and recommendations for HPV testing.
Practice Safer Sex
Using condoms, dental dams, and barrier methods in general can reduce your risk of contracting HPV, but they are not a guarantee.
Communicate Honestly
Disclose your diagnosis and have open conversations about the steps you and your partner(s) can take to be as safe as possible.
FAQs About HPV
Here are some quick answers to some frequently asked questions about HPV.
Is HPV common?
Almost all sexually active people, independent of their assigned sex at birth, gender, or sexual orientation are infected with HPV and only half of these infections are high-risk. [2]
What types of cancer can HPV cause?
HPV can cause six types of cancer, including anal cancer, cervical cancer, oropharyngeal cancer, penile cancer, vaginal cancer, and vulvar cancer. [2]
Does the HPV vaccine prevent cancer?
HPV vaccination can prevent cancer by way of preventing a person from contracting high-risk HPV strains that can cause cancer (and other symptoms). [2]
Do you have to have penetrative sex to get HPV?
No, HPV is spread through skin-to-skin contact. People who have not had/do not have intercourse can still have/get HPV. [6]
Does HPV go away?
In 90% of cases, your immune system fights off the infection within two years, however, there is no cure for the HPV virus. There are treatments for HPV symptoms and HPV-related health issues. [6]
Living With HPV
The only way to know for sure whether you have HPV is through testing. The majority of people living with HPV aren’t aware that they carry the virus and many people do not develop symptoms. A healthcare provider can test you for HPV, or you can test at home with kits like the Everlywell HPV test which screens for 14 high-risk genotypes of human papillomavirus (HPV), including the high-risk genotypes HPV 16 and HPV 18 that are associated with over 70% of cervical cancer cases.
References
- HPV Infection. Mayo Clinic. October 12, 2021. Accessed December 9, 2024. Medical Citation URL.
- HPV and Cancer. NCI. October 18, 2023. Accessed December 9, 2024. Medical Citation URL.
- What is HPV (human papillomavirus)? Cleveland Clinic. October 21, 2024. Accessed December 9, 2024. Medical Citation URL.
- Gardasil®9 (human papillomavirus 9-valent vaccine, recombinant): Official Site. Gardasil 9. Accessed December 9, 2024. Medical Citation URL.
- HPV Vaccination. Centers for Disease Control and Prevention. Accessed December 9, 2024. Medical Citation URL.
- Berkowitz D. HPV and cancer: 9 myths busted. MD Anderson Cancer Center. May 2015. Accessed December 9, 2024. Medical Citation URL.