HPV Infection: How to Prevent Infection
Human papillomavirus (HPV) infection is a common sexually transmitted infection (STI) and causes warts around the genitals and other surrounding areas.
What is an HPV infection?
HPV is a group of over 150 to 200 related viruses that can be transmitted from person-to-person. Depending on the specific type, the virus can be transmitted either non-sexually or sexually.
HPV that are not sexually transmitted can cause infections that result in warts (papillomas) on the hands, feet, or sometimes in the mouth. An abnormal pap smear in women can indicate presence of the infection in which a follow-up test is completed for confirmation.
There is no specific treatment for the infection; however, it can be prevented with vaccination and other measures. Some types of sexually transmitted HPV can lead to aggressive cancers in both men and women, making knowledge and prevention of this condition very important.
You should visit your primary care physician to discuss symptoms.
Symptoms of an HPV infection
HPV infection can be challenging to identify. Symptoms can sometimes develop years after infection, and some people never show any symptoms at all. Furthermore, there is no test to ascertain a person's "HPV status."
Nevertheless, the following signs and symptoms can be suggestive of an HPV infection:
- Genital warts: The presence of genital warts is a strong indicator of HPV infection.
- Abnormal pap smear: Many women find out they have HPV during screening for cervical cancer (screening for cervical cancer begins in women who are 30 years and older). During a cervical cancer screen, a pap test/smear is used to sample cells from the cervix to check for abnormalities. Changes and abnormalities on a pap smear are often caused by HPV. There is a special HPV test with the pap smear that can confirm presence of the infection.
Causes of an HPV infection
HPV infections are the most common sexually transmitted infections (STIs) in the United States. According to the CDC, about 14 million new sexual HPV infections occur every year. Approximately 90 percent of men and 80 percent of women respectively will be infected with at least one type of sexually transmitted HPV at some point in their lives.
HPV is transmitted through intimate skin-to-skin contact. Sexually transmitted HPV types can be spread via vaginal, anal and/or oral sex with someone infected with the virus.
There are two categories of sexually transmitted HPV which have different outcomes:
- High-risk HPV: These are the HPV types that cause conditions such as cervical, vaginal and penile cancer. Approximately 12 high-risk HPV types have been identified, but types 16 and 18 are most responsible for causing cancer in the U.S. population.
- Low-risk HPV: These types do not cause cancer but can cause warts in the genital area and anus called condylomata acuminate.
Who is at risk for HPV infection
HPV is easily transmitted between sexual partners. People who have multiple sex partners or have sex with another person who has had many partners are at an increased risk of contracting the disease. Nevertheless, since the infection is so common, many people can contract HPV after having sex for the first time; a person who has had only one partner can still get HPV.
Treatment options and prevention for HPV infection
Once the virus is transmitted and a person becomes infected, there is no treatment for the virus itself. However, there is a vaccine that is very safe and effective in preventing HPV. The vaccine protects against the cancers and other manifestations of HPV when given at the recommended time.
Who should get vaccinated
The CDC recommends that all boys and girls who are 11 or 12 years of age should be vaccinated. For those who were not able to get the vaccine at 11 or 12, catch-up vaccines are recommended for boys and men through age 21 and for girls and women through age 26.
The vaccine is also recommended for gay and bisexual men (or any man who has sex with a man) through age 26. It is also recommended for men and women with compromised immune systems (including those living with HIV/AIDS) to be vaccinated through age 26 if they did not get fully vaccinated when they were younger.
Other ways to prevent HPV infection
In addition to the vaccine, there are some lifestyle strategies you can practice in order to lower the risk of transmission such as:
- Condom use: Use a condom every time you have sexual intercourse. This can lower your chances of getting HPV; however, since HPV can infect areas not covered by condoms, you may not be fully protected.
- Monogamy: Being in a mutually monogamous relationship is a good way of preventing transmission, especially if neither partner has the virus.
Complications and prognosis
Luckily, most people's immune systems can naturally clear an HPV infection (high-risk or low-risk) within two years; this is why people often get infected multiple times and sometimes do not develop complications.
However, when the body's immune system cannot clear an HPV infection, especially the high-risk type, the virus can turn normal cells into abnormal cells and cause health complications. Fortunately, the health problems that HPV can cause — genital warts, cervical cancer, and other cancers — can usually be treated.
- Genital warts: These can be treated with medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
- Cervical cancer: This can be treated with options such as surgery, radiation, and chemotherapy depending on the extent and severity of the disease; however, cervical cancer can be prevented with routine pap tests and follow-up.
- Other HPV-related cancers: These are also more treatable when diagnosed early.
When to seek further consultation for HPV infection
If you have not received a vaccine and are within the recommended age ranges, you should make an appointment to get an HPV vaccine soon.
If you are outside of the recommended age ranges
You should make an appointment with your physician to get appropriate follow-up and screening for HPV and its complications.
Dr. Gambrah-Lyles is a resident pediatrician at the Children's Hospital of Philadelphia. She is a graduate of the University of Pennsylvania Perelman School of Medicine (2019). She graduated cum laude and received her undergraduate degree in Biochemistry and Spanish from Washington University in St. Louis (2013). Her research explores the intersections between neurology, public health, and infectious disease. She has investigated nutrition and cerebral palsy in Botswana, and completed a year-long project in Brazil, researching growth and developmental outcomes of Zika virus infection in pediatric patients as a Doris Duke International Scholar. Dr. Gambrah-Lyles speaks four languages, loves staying active, and enjoys sharing her love for medicine through teaching and writing.
- Doorbar J, Egawa N, Griffin H, Kranjec C, Murakami I. Human papillomavirus molecular biology and disease association. Reviews in Medical Virology. 2015;25(Suppl Suppl 1):2-23. NCBI Link
- HPV and cancer. NIH: National Cancer Institute. Published February 19, 2015. National Cancer Institute Link
- Genital HPV infection - fact sheet. Centers for Disease Control and Prevention. Published November 16, 2017. CDC Link
- Basic information about HPV and cancer. Centers for Disease Control and Prevention. Published August 22, 2018. CDC Link
- Human papillomavirus (HPV): Questions and answers. Centers for Disease Control and Prevention. Published August 23, 2018. CDC Link
- HPV vaccine is cancer prevention for boys, too! Centers for Disease Control and Prevention. Published September 19, 2018. CDC Link
- Questions from readers: HPV duration. Foundation for Women's Cancer. Foundation for Women's Cancer Link