Warning Graphic Material Below
Three Simple Facts:
- Human papillomavirus (HPV) infection is a sexually transmitted disease (STD) that can be treated, but not cured. However, most infections eventually go away by themselves.
- Most HPV infections cause no symptoms and cause no serious health problems.
- Some types of HPV sometimes cause genital warts. Other types somtimes lead to cancer of the the cervix, other genital areas, or anus.
Additional Information:
- HPV is a virus and is not curable with treatment.
- Most HPV infections do not cause symptoms.
- Most HPV infections go away by themselves.
- HPV is passed by vaginal and anal sex, and once in a while by oral sex.
- HPV is extremely common; most sexually active persons catch it at least once.
- Genital warts are the most common visible sign of HPV infection.
- Warts of the genital or anal area are usually a minor health problem, but they can sometimes cause bigger problems; they can get very large and become infected or block urine (pee).
- Some HPV types cause cervical cancer in women and anal cancer in men who have sex with men or, much more rarely, cancer of the labia in women and the penis in men.
- The main protection against cervical cancer is the Pap smear, which detects changes caused by HPV many years before cancer itself appears.
- Newborn babies rarely catch the virus from the mother during birth, resulting in warts of the mouth and throat (respiratory papillomatosis).
- Warts of non-genital areas, such as the hands and feet, are caused by different HPV types and are not sexually transmitted.
Risk:
What do you think are your risks?
What do you do to reduce your risk of getting an STD?
Recognition:
What are your symptoms?
Do you know that some STDs cause NO symptoms?
Response:
Stop having sex.
Get tested and treated at a clinic or doctor’s office .
Treat your partner(s). This reduces reinfection
What is human papillomavirus (HPV)?
HPV is a large family of viruses that infect the skin, often causing irregular cell growth or warts. There are more than 60 types of HPV. Some types of the virus are transmitted by nonsexual personal contact and cause common skin warts. Several types of HPV are spread by sex and primarily infect the genitals or anal area. Of the sexually transmitted types, some cause cancer and pre-cancerous changes of the cervix, anus, or the skin of the penis or female genitals. Other types cause warts of the genitals or anal area. Genital warts are the most common symptoms of HPV infection. However, most HPV infections do not lead to either warts or cancer; most infections go away by themselves, without causing any symptoms.
How common is HPV?
HPV infections are believed to be the most common of all sexually transmitted diseases (STDs); most sexually active persons get at least one HPV infection, usually without ever knowing it. At any time, somewhere around 20 million to 40 million Americans are infected with sexually transmitted types of HPV, and the frequency of infection and disease appears to be increasing.
What are the symptoms of HPV infection?
Most HPV infections cause no symptoms at all. However, some infections cause warts of the genital or anal areas and others cause cancer or pre-cancerous changes.
Genital Warts
Genital warts range from cauliflower-like growths that are easily seen to smooth bumps or flat, almost invisible growths. Some warts are hard and rough and others soft and fleshy. They are painless, but may bleed easily or itch. Warts usually remain small (less than a quarter inch in size), but very large warts (sometimes an inch or more across) sometimes occur if warts are not treated when small. Warts are most common at sites of friction or rubbing during sex. Therefore, the most common sites in women are on the labia minor or around the vaginal opening. In men, the head or shaft of the penis is most commonly involved. However, warts commonly are seen in other areas, such as the anus, scrotum, or labia major. Anal warts are most common in gay men, but also occur frequently in both women and heterosexual men. Warts usually appear a few weeks up to 3 months after catching HPV, but sometimes warts may first appear many months or even a few years after catching the virus. Therefore, the appearance of warts doesn’t always mean recent sex with an infected partner.
Cancer and Related Problems
The types of HPV that cause cancer and pre-cancerous changes are called “high risk” types. Most infections with high-risk HPV types do not lead to cancer; the immune system is able to remove the virus before it causes problems. When it does occur, cancer takes time to develop. First HPV causes abnormal cells to grow. It usually takes 5 years to 10 years, or even more, for cancer to develop. This is why Pap smears are so important for women; a Pap smear can detect these abnormal cell changes so that they can be treated before they lead to cancer. At this stage, the disease is easily cured by minor surgery to remove the abnormal cells. Therefore, a woman who gets regular Pap smears every one to three years is almost 100% protected from getting cervical cancer. Research is going on to learn whether Pap smears of the anus might help protect men who have sex with men from developing anal cancer. Other cancers due to HPV (cancer of the penis in men or vulva in women) are extremely rare and usually show up first as a wart-like growths.
How is HPV transmitted?
Genital HPV is only transmitted through skin-to-skin contact during sex; infected skin of one-person rubs against the skin of the other person and transfers the virus. Almost all infections are acquired through vaginal or anal intercourse, but rarely HPV may be transmitted by oral-genital sex. The male condom is not as effective at preventing HPV transmission as it is for the prevention of other STDs; the male condom does not prevent all skin-to-skin contact during sex. The female condom provides wider coverage and therefore might offer greater protection. Most infections do not have symptoms–no warts or Pap smear abnormalities– but transmission of the virus is possible even though there are no visible signs of infection. Infants born to infected mothers may become infected, usually in the mouth or throat.
How do I avoid HPV infection?
Because most genital HPV infections do not have symptoms and millions of people already are infected, HPV infection is very difficult to prevent. On the other hand, most HPV infections remain entirely silent and never cause serious health problems, so it may be less important to avoid HPV than it is to prevent most other STDs.
- Abstinence from all sexual activity (not having vaginal, anal, or oral sex) is the surest way to avoid becoming infected with HPV.
- The next surest way is to limit sexual contact to one uninfected partner who only has sex with you (mutual monogamy). If either of you has ever had another sexual partner, it is likely that you could already be infected with genital HPV and pass it to your partner.
- For those choosing to be sexually active, condoms should be used correctly and consistently to minimize transmission.
- Please Note: The male condom is not as effective at preventing HPV transmission as it is for prevention of other STDs; the male condom does not prevent all skin-to-skin contact during sex. The female condom provides wider coverage and therefore might offer greater protection.
- Avoid sexual contact with a new partner if you or your partner has untreated, visible warts (or bumps that might be warts) on or near the genital area, or if either partner has newly diagnosed (untreated) Pap smear abnormalities. However, it probably is not necessary to avoid sex with an ongoing partner. If you suspect that you might have genital warts or other HPV infection (or any sexually transmitted disease), seek immediate medical care.
- Before having sex, talk with your partner(s) about HPV and other sexually transmitted diseases. Negotiate a risk reduction strategy with them that feels comfortable to both of you.
- You should notify your current sex partner if you have HPV. If you have newly diagnosed genital warts, you should also inform any partners you had sex with in the 3 months before your warts appeared.
How do I find out if I have genital HPV? (Diagnosis)
Genital warts usually are diagnosed just by examining them carefully; an experienced health care provider usually can tell whether a bump is a wart by looking at it, sometimes using a magnifying glass.
A Pap smear can determine whether a woman has pre-cancerous changes caused by HPV. A newly developed test for HPV itself sometimes is used to help determine how to treat women with Pap smear abnormalities. However, testing for HPV is not recommended for healthy persons; there is no treatment for silent HPV infection and most infections never cause health problems.
When a woman with Pap smear abnormalities has a further examination, a biopsy often is done examine the tissues more carefully than is possible by the Pap smear itself. (A biopsy is the removal of a piece of tissue for examination under a microscope.) Once in a while, a biopsy also is done for genital bumps or warts, especially if the diagnosis is uncertain or the provider suspects cancer or a pre-cancerous lesion.
What is the treatment for genital HPV infection?
No treatment is recommended for most HPV infections. Treatment is only recommended if there are visible warts or Pap smear abnormalities. No antibiotics or other drugs kill HPV; treatment depends on destroying or removing abnormal tissues, such as warts, pre-cancerous cellular abnormalities, or cancer itself. Even when these tissues are removed or destroyed, HPV often persists in surrounding areas. Therefore, although the symptoms of HPV can be treated, HPV infections themselves usually cannot be cured. Most warts and pap abnormalities will eventually go away on their own, even if not treated
Genital Warts
Several treatments are available for genital or anal warts. The best choice depends on such things as the size and location or the warts, convenience, and cost. Patients should consult their doctors to determine the best treatment for them.
There are two classes of treatment, those that are applied by the health care provider and those that the patient can use at home. There are no approved “over-the-counter” treatments that do not require a prescription or treatment by a health care provider. Never attempt to treat warts without a doctor’s guidance.
Patient-applied Treatments:
The two main treatments that can be used by the patient at home are podofilox (CondyloxTM) and imiquimod (AldaraTM). Both are creams that are applied to the warts. Podofilox chemically damages the wart and imiquimod works by stimulating the body’s immune system, which in turn destroys the wart. Both require several weeks of repeated treatment and both can cause irritation and soreness of the treatment area. Pregnant women must avoid both of these treatments.
Provider-applied Treatments:
The most common provider-applied treatments are:
- freezing the warts, usually using liquid nitrogen
- trichloroacetic acid, which chemically “burns” the wart and
- podophyllin resin, which is similar to podofilox but must be applied in the doctor’s office.
All of these require several treatments over at least 2 or 3 weeks. Freezing usually works fastest, but can be somewhat painful. All three can cause soreness and irritation around the treated area. Some warts are best treated by directly removing them with surgery or by destroying them with electrocautery (burning) or laser treatment.
None of these treatments works in all cases; if the first treatment doesn’t completely clear the warts, another method usually is successful. With all methods, warts sometimes return and repeat treatment sometimes is needed. But also remember that most warts will eventually go away on their own, even if not treated.
High-Risk HPV Infection
Infection with high-risk HPV types, usually diagnosed because a woman has an abnormal Pap smear, is only treated by removing or destroying the infected tissues. The most common method is a kind of office surgery called “loop electrocautery excision procedure”, or LEEP. If early cancer is present, more extensive surgery may be necessary. The best treatment is determined by a specialist individually for each patient.
How does HPV affect pregnancy?
A mother with genital warts (or with silent infection with the wart-cause types of HPV) can pass the infection to her infant during birth. Genital warts sometimes enlarge during pregnancy. Some treatments may harm the baby in the womb and must be avoided during pregnancy.
Resources and information:
- National Institutes of Health Fact Sheet
- Genital and Anal Warts
- Genital Warts Information
- Planned Parenthood: Human Papilloma Virus: The Facts
- HPV Types and Hosts
If you would like more information or have personal concerns, call CDC-INFO 24 Hours/Day at 1-800-CDC-INFO (232-4636), 1-888-232-6348 (TTY), in English, en Español
Testing Sites:
* Broward County Health Department 780 SW 24th Ave. Ft. Lauderdale, FL (954) 788-6095 (954) 847-3567
* The Adult Men’s Evening Clinic 2421 SW 6th Ave, Fort Lauderdale, FL 33315 (954) 298-1749 Tue-Wed. 4:30-7:00 p.m. only for men.
