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The Basics and Beyond: Human Papillomavirus (HPV)

Sep 25, 2013
By Kristen Foskett

A quick web search for HPV yields more than 19 million results — with all kinds of information, much of which is medically inaccurate. Whether you’ve been recently diagnosed or are simply looking to understand more about the most common sexually transmitted infection, this article is intended to bring you some peace of mind, with answers to some of the most frequently asked questions about human papillomavirus (HPV).

What is HPV?

HPV is a virus that is often–although not always–sexually transmitted. HPV encompasses more than a hundred different strains. Just like any diverse family, every strain is different. Some strains cause warts on the hands, feet (plantar warts), or genitals. Although warts are pesky, they’re rarely harmful and are easily treated. Other strains of HPV can cause changes to your cervical cells, which can lead to cervical cancer, and, more rarely, throat, anal, and, in men, penile cancers.

How common is HPV?

The figures are staggering. According to the Centers for Disease Control and Prevention (CDC), 79 million Americans have the virus, and there are 14 million new HPV infections each year. In fact, HPV is so common that experts say nearly all sexually active men and women will get at least one strain of the virus at some point during their lives.

Luckily, 90 percent of HPV infections are transient, meaning most clear on their own in about two years without any treatment. It’s very possible to have had–and have cleared–an infection without ever knowing you were infected in the first place.

How is HPV transmitted?

HPV is most commonly transmitted from skin-to-skin contact. That means certain strains can also be transmitted sexually, and contrary to popular belief, HPV isn’t just a concern for women. It affects both men and women whether they identify as straight, bisexual, transgender, gay, lesbian, or queer. Because HPV is passed so easily just from skin-to-skin contact, condoms help, but they’re not foolproof. And it’s not passed just through genital-to-genital contact, either. Fingers and toys can also pass the virus to a partner.

What are the symptoms of HPV?

Most strains of HPV are asymptomatic, meaning you won’t notice any signs that you have the virus. If you have symptoms, they will usually develop between a few weeks and several months after you’ve been exposed. Some viral strains cause warts, which appear as cauliflower-like lesions on the skin or in the genital regions. Other strains may not cause warts at all, but can cause dangerous cancers. Fortunately, these strains can be identified via Pap tests, which is why testing is so important.

How do I get tested for HPV?

For women, the most common time to test for HPV is during a cervical cancer screening or Pap test. The screening guidelines have changed a lot recently. Here’s an overview of when you should be tested, based on CDC recommendations:

  • Ages 21 to 24: Screen every 3 years for cervical cancer. Because women younger than 25 clear HPV infections and changes to cervical cells so quickly, there is no reason to test for HPV.
  • Ages 25 to 29: Screen every 3 years for cervical cancer. Your health care provider will not test for HPV unless abnormal cervical cells are present.
  • Ages 30 to 65: If you decide to forgo testing for HPV, your provider will recommend cervical cancer screening every 3 years. If you’d like to get tested for high-risk strains of HPV, then you can prolong your screenings to every 5 years. Discuss these options with your provider to understand which option makes the best sense for you.

Men who have receptive anal sex with men should be screened for rectal cancers. While there are no guidelines for HPV screening in men, your health care provider may also recommend that you be tested for high-risk HPV. Men who do not engage in receptive anal sex are not able to be tested for HPV.

What does it mean if my test came back positive for HPV?

Even though HPV is extremely common, it can still be a shock to get a diagnosis. If you are 25 or older and discover that you have HPV but no cervical cell changes on your Pap test, you can just watch, wait, and keep your immune system healthy. Keep in mind that most people with healthy immune systems will clear the virus on their own with no treatment. The best thing you can do is to avoid smoking. Smoking greatly decreases your ability to clear the virus. You should also get plenty of rest and keep your stress levels low.

If a recent screening shows that you have cervical cell changes and one of the high-risk strains of HPV, your follow-up will be slightly different. Again, this is very common. Since a Pap test is just a screening tool and not a diagnostic test, your provider will need to examine your cervix with a special microscope called a colposcope in order to determine whether there are any abnormal changes to the cells. If there are, your provider will take a freckle-sized sample of your cervical cells and send them to a pathologist for more information. This procedure may involve light cramping, but it won’t have any effect on your fertility or ability to have a healthy pregnancy in the future.

If I was vaccinated against HPV, am I immune?

The HPV vaccine, also known as Gardasil, protects against the four most common strains of HPV. It covers two of the most common strains that cause genital warts (types 6 and 11) and two of the more serious strains that cause cervical cancer (types 16 and 18). The HPV vaccine is highly effective in preventing cervical cancers–but it won’t protect against all strains of the virus.

Should I be vaccinated against HPV?

The CDC strongly recommends vaccination in the following groups of people:

  • Females: Ages 9 to 26
  • Males: Ages 9 to 21
  • Men who have sex with men and HIV-positive males: Ages 21 to 26

The Gardasil vaccine is typically covered by insurance in these age groups, but check with your insurance company if you have questions.

Are there any downsides to getting the vaccine?

Anyone who is allergic to the ingredients of Gardasil, including those who are severely allergic to yeast, should not receive the vaccine. Gardasil is not for women who are pregnant. The vaccine is most protective in people who have never had sexual intercourse.

Does the vaccine cure HPV?

The vaccine is strictly preventive; it doesn’t treat or cure existing HPV, cervical cell changes, or genital warts.

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Kristen Foskett

The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, Portland, the San Francisco Bay Area, Seattle, and Washington, DC.

Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.