What Is HPV, Exactly?

Fitness

This informational guide, part of PS’s Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Human papilloma virus is the most common sexually transmitted infection in the US. There are hundreds of types of HPV, and while most aren’t dangerous, some can cause genital warts, and others may lead to cervical, vaginal, vulvar, head and neck, and anorectal cancers. “About 80 percent of sexually active people will have HPV at some point, and most will clear the infection on their own — but if it doesn’t go away, it can cause serious health problems,” notes Sangini Sheth, MD, associate professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Public Health. (Although, while it’s important to know that various cancer can be caused by HPV, the vast majority of people with HPV will not get cancer.) This guide lays out what the virus is, how it’s transmitted, and how you can protect yourself from it.

Experts Featured in This Article:

Sangini Sheth, MD, is an associate professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Public Health.

What Is HPV?

“HPV is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex,” per the National Cancer Institute. Sexually transmitted HPVs tend to be either high risk or low risk. In the majority of low-risk cases, your body’s immune system will ward of will the infection before bodily warts appear. But there are also 14 high-risk types of HPV, according to the National Cancer Institute. If you’re infected with one of these types and your immune system doesn’t fight it off within two years, the virus can turn normal cells in your body into precancerous cells. If those mutated cells aren’t removed in time, they can become cancerous.

Does HPV Cause Symptoms?

With high-risk types of HPV, there aren’t typically visible symptoms, but they can result in precancerous and cancerous cells which can cause lumps, bleeding, and pain. “Both women and men can get HPV-related cancer,” Dr. Sheth notes: HPV can affect cells in the cervix, vagina, vulva, penis, anus, or mouth and throat. The Centers for Disease Control and Prevention (CDC) reports that each year in the United States about 47,984 new cases of cancer are found in parts of the body where HPV is found.

Genital warts, on the other hand, are common among low-risk subtypes of HPV and will not turn into cancer. Warts on or around the anus, mouth, and throat may also occur with low-risk infection. Many people are exposed to both subtypes since both can be asymptomatic and spread easily from skin-to-skin contact.

Causes of and Risk Factors For HPV

HPV infection occurs when the virus enters the body, often through a cut or abrasion on your skin. It spreads mostly through vaginal, oral, or anal sex — but as Dr. Sheth notes, “you don’t have to have penetrative sexual activity to transmit it.” Any intimate sexual contact can transmit HPV, and while condoms and dental dams can reduce the risk, since the virus lives on the skin in the areas outside of what the condoms/dental dams cover, they don’t offer complete protection.

There are also certain risk factors for infection — according to the Mayo Clinic, these include:

  • Number of sexual parters, as well as the number of partners your partners have had.
  • Age: about three in four HPV infections occur in people who are between ages 15 and 25. Genital warts in particular are most common in adolescents and young adults.
  • A weakened immune system, which can result from factors like being on immune-suppressing drugs, having previously existing conditions like HIV/AIDS, or lifestyle choices, like smoking. (Worth noting: people with HPV who also smoke may be significantly more likely to go on to develop cervical cancer.)
  • Having direct contact with genital warts or common warts (aka warts that are caused by HPV but aren’t on the genital area), especially if your skin is damaged or cut.

How Is HPV Diagnosed?

If genital or bodily warts are present, your provider may be able to make a diagnosis by assessing them, per the Cleveland Clinic. Other times, non-symptomatic HPV is diagnosed via an HPV test or during aroutine Pap smear, which is designed to detect any cervical changes that could lead to cancer.

How to Protect Yourself From HPV

There is no cure for HPV, but vaccination offers protection from nine of the high-risk strains of the virus, including the ones that are responsible for most types of HPV-related cancer. The vaccines can be given to children as young as 9 and are recommended starting at age 11 — but they can be given into adulthood. “While the vaccines are most effective in people who aren’t yet sexually active or haven’t had much sexual activity, they’re approved for women and men up to age 45,” Dr. Sheth notes. So if you haven’t been vaccinated, talk to your doctor to see if it makes sense for you to get one. The vaccine doesn’t treat or clear prior HPV infections, but it can protect you from strains you haven’t yet been exposed to.

Since HPV is so often asymptomatic, getting regular screenings is also key. Pap tests, which look for cervical cancer, and HPV tests, which detect the strains of the virus that are known to lead to cervical cancer, are both useful tools. Your doctor can help you determine which type of test is right for you and how often you need them. For cervical-cancer screening, the American College of Obstetricians and Gynecologists recommends people age 21 through 29 get a Pap test every three years, unless a cervical abnormality is detected (in which case your doctor will recommend follow-up screenings); at age 30, your doctor may suggest getting a Pap and HPV test together every five years instead. (Currently, there’s no approved HPV screening test for people with penises.)

Even so, you may have a normal Pap test with a negative HPV test and still have low levels of the virus. This means that your risk of cancer is very low, but you can still transmit the virus to others — hence the reason more than 80 percent of us get HPV at some point in our lives. Important to note: you don’t have to abstain from sex just because you have HPV, but you should be aware of how to reduce your partners’ risk, including when you should disclose your status to them.

How Is HPV Treated?

Again, there is no cure for HPV. If you do contract a subtype that causes genital warts, which look like soft, flesh-colored bumps on the genitals or anus and sometimes hurt or itch, doctors typically medically or surgically remove them. “Treatment can get rid of the warts, but it doesn’t necessarily get rid of the underlying HPV infection,” Dr. Sheth notes.

High-risk HPV, on the other hand, can causes cell changes in the cervix that can lead to cancer. If these changes are detected via an HPV or Pap test, your provider will likely perform a colposcopy to get a closer look at the cervix and a biopsy of any areas that look abnormal, per Planned Parenthood. If precancerous cells are detected, cryotherapy (which freezes and removes the cells) or Loop Electrosurgical Excision Procedure (which uses an electrical current for removal), may be done.

Ultimately, many people with HPV go on to lead healthy lives, per the Cleveland Clinic. “If you have a lower-risk strain of HPV and you’re in good health, chances are your body will clear the infection within 12 to 24 months,” the Clinic states. While certain HPV strains are more likely to lead to cancer, dealing with high-risk HPV or getting an abnormal Pap test does not automatically mean you will get cancer. “Your healthcare provider will monitor these strains and recommend further testing or treatment. Early detection of high-risk strains and follow-up screenings such as frequent Pap tests can prevent HPV from causing cervical cancer.”

Ginny Graves is an award-winning writer in the San Francisco Bay Area whose work focuses on science, psychology, health, nature, and the human-animal bond.

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