Human Papillomavirus

HPV is the name for a group of viruses that includes more than 100 types. More than 40 types of HPV can be passed through sexual contact. The types that infect the genital area are called genital HPV.

Genital HPV is the most common STI in the United States for both women and men. About 79 million Americans have HPV. It is so common that 80% of women will get at least one type of HPV at some point in their lifetime.

HPV is spread through:

• Vaginal, oral, or anal sex. HPV can be spread even if there are no symptoms. This means you can get HPV from someone who has no signs or symptoms.
• Genital touching. A man does not need to ejaculate (come) for HPV to spread. HPV can also be passed between women who have sex with women.
• Childbirth from a woman to her baby

Most people with HPV do not have any symptoms. This is one reason why women need regular Pap tests. Experts recommend that you get your first Pap test at age 21. The Pap test can find changes on the cervix caused by HPV. If you are a woman between ages 30 and 65, your doctor might also do an HPV test with your Pap test every five years. This is a DNA test that detects most types of HPV.

Another way to tell if you have an HPV infection is if you have genital warts. Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. Doctors can usually diagnose warts by looking at the genital area.

HPV usually goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems including:

• Cervical cancer
• Other genital cancers (such as cancers of the vulva, vagina, penis, or anus)
• Oropharyngeal cancer (cancer of the back of the throat, including the base of the tongue and tonsils)
• Genital warts
• Recurrent respiratory papillomatosis (a rare condition that causes warts to grow in the respiratory tract)

• If you are 21 to 29 years old, your doctor might suggest the HPV test if you have had an unusual or unclear Pap test result. The test will help determine if HPV caused the abnormal cells on your cervix. Most women younger than 30 do not need the HPV test, because the immune system fights off HPV within two years in 90% of cases in that age group.
• If you are 30 years or older, you may choose to have the HPV test along with the Pap test to screen for cervical cancer.
• If results of both tests are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor might then say that you can wait up to five years for your next HPV screening.

HPV does not affect your chances of getting pregnant, but it may cause problems during pregnancy.

Some possible problems during pregnancy include:

• Cervical cell changes. Continue to get regular cervical cancer screening during and after pregnancy to help your doctor find any changes.
• Genital warts that bleed and grow. Hormonal changes during pregnancy can cause any genital warts that you had before getting pregnant or that you get during pregnancy to bleed and grow (in size and number).
• Cesarean section. If genital warts block the birth canal, you may need to have a cesarean section (C-section).
• Health problems in the baby. A woman with genital HPV can — very rarely — pass it on to her baby. Babies and children may develop growths in their airways from HPV. This rare but potentially serious condition is called recurrent respiratory papillomatosis.

No, HPV has no cure. Most often, HPV goes away on its own. If HPV does not go away on its own, there are treatments for the genital warts and cervical cell changes caused by HPV.

There are two ways to prevent HPV. One way is get an HPV vaccine. The other way to prevent HPV or any STI is to not have sexual contact with another person.

If you do have sex, lower your risk of getting an STI with the following steps:

• Use condoms. Condoms are the best way to prevent STIs when you have sex. Although HPV can also happen in female and male genital areas that are not protected by condoms, research shows that condom use is linked to lower cervical cancer rates. The HPV vaccine does not replace or decrease the need to wear condoms. Make sure to put the condom on before the penis touches the vagina, mouth, or anus. Also, other methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STIs.
• Get tested. Be sure you and your partner are tested for STIs. Talk to each other about the test results before you have sex.
• Be monogamous. Having sex with just one partner can lower your risk for STIs. After being tested for STIs, be faithful to each other. That means that you have sex only with each other and no one else.
• Limit your number of sex partners. Your risk of getting STIs goes up with the number of partners you have.
• Do not douche. Douching removes some of the normal bacteria in the vagina that protects you from infection. This may increase your risk of getting STIs.
• Do not abuse alcohol or drugs. Drinking too much alcohol or using drugs increases risky behavior and may put you at risk of sexual assault and possible exposure to STIs.

The steps work best when used together. No single step can protect you from every single type of STI.

The HPV vaccine helps prevent cervical cancer, genital warts, and some other rare cancers. The Food and Drug Administration (FDA) approved the HPV vaccine to prevent HPV-related diseases, including cervical cancer in women.

Experts recommend that most people get the HPV vaccine at age 11 or 12. The HPV vaccine works best when you get it before you have any type of sexual contact with someone else. The Food and Drug Administration (FDA) approved the HPV vaccine for people ages 9 through 45.

There is not enough research to show whether the HPV vaccine is safe for pregnant and breastfeeding women. As a result, experts do not recommend the HPV vaccine for pregnant women. If you got an HPV vaccine shot while pregnant, wait until your pregnancy is over before getting any more HPV vaccine shots. You can also enroll in the HPV vaccine pregnancy registry by calling 1-800-986-8999. Talk to your doctor, nurse, or midwife about the HPV vaccine if you are breastfeeding and want to get the shots.

If you are 45 or younger and never had the HPV vaccine, or did not get all of the HPV shots, ask your doctor or nurse about getting vaccinated. When and how often you need HPV vaccine shots depends on your age and health history. Learn more about recommended doses of the HPV vaccine from the Centers for Disease Control and Prevention (CDC).

Find a clinic near you where you can get the HPV vaccine.

Yes. You can still benefit from the HPV vaccine if you have already had sexual contact with someone else. The vaccine can protect you from HPV types you haven't gotten yet.

Yes. The vaccine does not replace or decrease the need to wear condoms. Using condoms lowers your risk of getting other types of HPV and other STIs.

Yes. There are three reasons why:

1. Although the HPV vaccine protects against many of the HPV types that cause cervical cancer, it does not prevent all HPV types that cause cervical cancer.
2. You might not be fully protected if you did not get all the vaccine doses (or at the recommended ages).
3. You might not fully benefit from the vaccine if you were vaccinated after getting one or more types of HPV before vaccination.

Yes. You can have HPV but still have a normal Pap test. Changes on your cervix might not show up right away; or they might never appear. For women 30 years and older who get an HPV test and a Pap test, a negative result on both the Pap and HPV tests means no cervical changes or HPV were found on the cervix. This means you have a very low chance of developing cervical cancer in the next few years.

Yes. There are many types of HPV, so you can get it again.

Yes. It is possible to get HPV, or any other STI, if you are a woman who has sex only with women.

Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have symptoms of HPV.

References

1. Myers, E.R., McCrory, D.C., Nanda, K., Bastian, L., Matchar, D.B. (2000). Mathematical model for the natural history of human papillomavirus infection and cervical carcinogenesis. Am J Epidemiol; 151:1158–1170.
2. Centers for Disease Control and Prevention. (2017). Genital HPV Infection - Fact Sheet.
3. U.S. Preventive Services Task Force. (2016). Cervical Cancer: Screening.
4. Centers for Disease Control and Prevention. (2013). Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States (PDF, 1.6 MB).

Source

The Office on Women's Health in the U.S. Department of Health and Human Services

Content last updated March 22, 2019