Human Papillomavirus (HPV) is the name of a group of viruses that infect the skin. There are over 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women, including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own.
Some of these viruses are called "high-risk" types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk" types, and they may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.
The types of HPV that infect the genital area are spread primarily through genital contact. Most HPV infections have no signs or symptoms; therefore, most infected persons are unaware they are infected, yet they can transmit the virus to a sex partner.
HPV infection can occur in both men and women who’ve engaged in genital contact with another individual.
Most women are diagnosed with HPV on the basis of abnormal Pap tests. A Pap test is the primary cancer-screening tool for cervical cancer or pre-cancerous changes in the cervix, many of which are related to HPV. Also, a specific test is available to detect HPV DNA in women. The test may be used in women with mild Pap test abnormalities, or in women >30 years of age at the time of Pap testing. The results of HPV DNA testing can help health care providers decide if further tests or treatment are necessary.
No HPV tests are available for men.
Most people who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms. Some people get visible genital warts, or have pre-cancerous changes in the cervix, vulva, anus, or penis. Very rarely, HPV infection results in anal or genital cancers.
Genital warts usually appear as soft, moist, pink, or flesh-colored swellings, usually in the genital area. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. After sexual contact with an infected person, warts may appear within weeks or months, or not at all.
Genital warts are diagnosed by visual inspection. Visible genital warts can be removed by medications the patient applies, or by treatments performed by a health care provider. Some individuals choose to forego treatment to see if the warts will disappear on their own. No treatment regimen for genital warts is better than another, and no one treatment regimen is ideal for all cases.
The surest way to eliminate risk for genital HPV infection is to refrain from any genital contact with another individual. Sexually active adults can reduce their risk by being in a mutually faithful relationship with someone who has had no other or few sex partners, or by limiting their number of sex partners. But even persons with only one lifetime sex partner can get HPV, if their partner has had previous partners.
It is not known how much protection condoms provide against HPV, since areas that are not covered by a condom can be exposed to the virus. However, condoms may reduce the risk of genital warts and cervical cancer.
At least, do not have sexual contact if you have visible genital warts. See a health care provider. And have an open, honest discussion with your partner about HPV.
The HPV vaccine protects against four major types of HPV that can lead to precancers of the cervix, vulva and vagina, and genital warts.
Studies have found the vaccine to be almost 100% effective in preventing diseases caused by the four HPV types covered by the vaccine. The vaccine has mainly been studied in young women who had not been exposed to any of the four HPV types in the vaccine.
The vaccine was less effective in young women who had already been exposed to one of the HPV types covered by the vaccine.
This vaccine does not treat existing HPV infections, genital warts, precancers or cancers.
Because the vaccine does not protect against all types of HPV, it will not prevent all cases of cervical cancer or genital warts. About 30% of cervical cancers will not be prevented by the vaccine, so it will be important for women to continue getting screened for cervical cancer (regular Pap tests). Also, the vaccine does not prevent about 10% of genital warts—nor will it prevent other sexually transmitted infections (STIs).
The HPV vaccine is recommended for 11-12 year-old girls, and can be given to girls as young as 9. The vaccine is also recommended for 13-26 year-old girls/women who have not yet received or completed the vaccine series.
Ideally, females should get the vaccine before they are sexually active. This is because the vaccine is most effective in girls/women who have not yet acquired any of the four HPV types covered by the vaccine. Girls/women who have not been infected with any of those four HPV types will get the full benefits of the vaccine
The vaccine has been widely tested in 9-to-26 year-old girls/women. But research on the vaccine’s safety and efficacy has only recently begun with women older than 26 years of age. The FDA will consider licensing the vaccine for these women when there is research to show that it is safe and effective for them.
Yes! The HPV vaccine “Gardasil” is now recommended for men age 26 or younger. It will protect against the 2 most common strains that cause genital warts. (It is also thought that it may help prevent anal cancer as well as cancer of the penis and oropharynx but there are no studies that support this as yet.) Just as in women, it is most effective when given before a person’s first sexual contact, starting at age 11.