Reality check: about 80% of sexually active people will contract HPV in their lifetime, and most won’t know they have it. But don’t freak out – 90% of HPV cases will clear on their own within two years. It’s hard to know how to think and feel about a virus that can be as easy to get as it is to get rid of, but we’re here to help you figure it out.
What is it?
Human papillomavirus (HPV) includes over 150 different strains but only about one third are sexually transmitted. This third is divided into viral strains considered low-risk to your health and high-risk to your health. Low-risk HPV strains can cause genital warts, high-risk HPV strains can cause cancer. The two thirds that are non-sexually transmitted affect other areas of the body. They can cause warts on the hands or feet. Medical science has determined that the viruses that cause warts on the genitals differ from those that cause warts elsewhere. Therefore it would be highly unlikely for warts from fingers or feet to transfer to genitals or vice versa from contact. Sexually transmitted HPV is spread through skin-to-skin contact between the genitals, anus, mouth and throat often through vaginal, anal, and oral sex. Someone can spread the virus even if they have no signs or symptoms of infection.
Low-risk HPV strains can cause genital warts, called papillomas. They can appear on the skin around the vulva, vagina, cervix, rectum, anus, penis or scrotum. People often describe the fleshy bumps as resembling tiny cauliflower. If they are hidden in the vagina or anus they can be hard to see. They can be large or small, darker or lighter than surrounding skin, and raised or flat. They are usually painless but can present with itchiness and increase the risk of transmitting the virus to partners.
Frequently, people with an HPV strain that typically causes warts don’t ever get warts. These people can still transmit the virus to partners who may then develop warts. For some people the warts only develop once, and for others they are reoccurring. The warts may develop weeks, months, or years after coming in contact with someone who has the virus.
The only way to know if you have genital warts is for a healthcare provider to diagnose you. There are many other skin conditions that you could mistake for warts, but a medical professional can usually diagnose you upon physical examination – no blood draw required. Luckily, healthcare providers can easily treat or remove the warts. Plus, they pose no serious health risks. Note that you should not use over-the-counter treatments for warts on the hands or feet to treat genital warts. While the virus stays in your body and can still be transmitted even with no visible warts, genital warts may stay away for years after removal. Left untreated, genital warts may go away on their own, stay the same, or grow in size or number.
High-risk HPV strains can cause abnormal cell formation that can eventually lead to cancer. The cancers can be of the cervix, vulva, vagina, penis, anus, or throat, including the base of the tongue and tonsils. These viruses usually cause no symptoms but they can create serious health problems years, even decades, after initial infection. Once again, many bodies are able to rid themselves of the virus over time – even high-risk HPV. But because of the lack of symptoms, it’s crucial that people with cervixes age 30 or older get screened regularly. This is to catch the abnormal cells that may lead to cancer. Also, if you have receptive anal intercourse you should ask your healthcare provider about being screened for anal cancer.
Current medical guidelines do not recommend HPV tests for screening men, adolescents, or women under 30 years of age. ‘Pap’ tests can screen for abnormal cells and cervical cancer, and cervical or vaginal swabs can be tested for certain high-risk HPV strains. However, there is no all-inclusive test to find out a person’s “HPV status” or an approved HPV test for the mouth or throat. It is unknown why some people develop abnormal cells or cancer from high-risk HPV and some do not. Those with weak immune systems, such as people with HIV/AIDS, may have a harder time fighting off HPV. This makes them more likely to develop health problems from HPV such as warts or cancer.
How To Avoid Getting or Spreading HPV
So if there usually aren’t any symptoms and screening isn’t always an option then how can you protect yourself? Practicing safer sex by using barrier methods and having fewer sexual contacts can help reduce your risk. Use external or internal condoms or oral dams correctly every time you have vaginal, anal, or oral sex including with sex toys. However, many HPV infections and warts occur outside the area covered by condoms and oral dams so all who are sexually active are at risk of HPV infection.
Luckily, there is a vaccination available for people ages 11-27 that provides nearly 100% protection against precancers and genital warts. Getting the Gardasil-9 (Merck/HPV9) vaccine has been determined to be a safe and effective way to prevent getting the nine most common HPV strains. Since being medically recommended in 2006, rates of HPV infection, precancers of the cervix, and genital warts have decreased significantly. Ten years of clinical data has also shown that the vaccination provides long lasting protection.
As with many viral infections, it is also important to keep your immune system healthy by avoiding tobacco and limiting your alcohol consumption.
What’s the moral of the story? HPV is incredibly common and only rarely poses a health risk, but when it does the risk can be serious. Getting vaccinated is your best bet for staying protected against the riskiest strains of HPV, and practicing safer sex can help you steer clear of all strains.