Photo: James Gathany
That’s an astounding number, but here another incredible number; around 6 million new cases of sexually transmitted HPV are reported yearly and more than 50% of sexually active men and women acquire the infection some time in their lives.
The human papillomavirus or HPV is the virus that causes warts of all types, genital or non-genital. There are over 100 types of HPV with the majority being harmless, however more than 30 types are spread through sexual contact. These sexually transmitted types are classified as high-risk or low-risk.
In a nutshell the high-risk types are the ones known to cause cancer (cervical, and to a lesser extent; vulvar, vaginal, penile and anal. The low-risk HPV types are responsible for the formation of genital warts. These are not implicated as causes of cancer. Good news is in the vast majority of cases (90%) the immune system clears the infection within 2 years.
How do you get genital HPV infections? It is through sexual contact, primarily vaginal or anal sex. It is rarely transmitted via oral sex. What is different about HPV compared to most other sexually transmitted infections (STIs) is that it can be transmitted through skin to skin contact during sexual activity.
Like many STI’s, you may not show any signs or symptoms of infection. In fact one study sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) reported that almost half of women infected with HPV had no obvious symptoms. Sometimes low-risk HPV types will demonstrate genital warts.
Genital warts usually appear as small bumps or groups of bumps, usually in the genital area. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. Warts may appear within weeks or months after sexual contact with an infected person. Or, they may not appear at all. If left untreated, genital warts may go away, remain unchanged, or increase in size or number.
In women, genital warts occur on the outside and inside of the vagina, on the opening to the uterus (cervix), or around the anus.
In men, genital warts are less common. If present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus.
Rarely, genital warts also can develop in your mouth or throat if you have oral sex with an infected person.
Some types of HPV can infect a woman's cervix and cause the cells to change. Most of the time, HPV goes away on its own. When HPV is gone, the cervix cells go back to normal. But sometimes, HPV does not go away. Instead, it persists and continues to change the cells on a woman's cervix. These cell changes can lead to cancer over time, if they are not treated.
Your doctor can usually determine if you have genital warts just by appearance. They may be able to identify some otherwise invisible warts in your genital tissue by applying vinegar (acetic acid) to areas of your body that might be infected. This solution causes infected areas to whiten, which makes them more visible.
For the diagnosis of cervical cancer a Pap smear, a primary cancer-screening tool for cervical cancer or pre-cancerous changes of the cervix and an HPV DNA test will be run. The Pap test looks for cell changes on your cervix that could develop into cervical cancer. The HPV test looks for HPV, the virus that can cause these cell changes.
There is no treatment for HPV and the body eventually removes the virus from the body. There are treatments for genital warts depending on size and location; various creams and solutions, freezing, burning and surgery.
What can you do to prevent this common STI? There is a vaccine available, Gardasil, which is recommended for girls ages 9-26. This sometimes controversial vaccine protects against 4 types of HPV, 2 high-risk types (cancer) and 2 low-risk types (warts). However it doesn’t prevent against all high-risk types so it is important to continue routine cervical screenings.
The following are recommendations to reduce risk of getting HPV from the American Social Health Association:
• Not having sex with anyone.
• Having sex only with one partner who has sex only with you. People who have many sex partners are at higher risk of getting other STDs.
• If someone has visible symptoms of genital warts, he or she should not have sexual activity until the warts are removed. This may help to lower the risk of giving the virus.
• Condoms used the right way from start to finish each time of having sex may help provide protection - but only for the skin that is covered by the condom. Condoms do not cover all genital skin, so they don't protect 100%.
• Spermicidal foams, creams, jellies (and condoms coated with spermicide) are not proven to be effective in preventing HPV and may cause microscopic abrasions that make it easier to contract STDs. Spermicides are not recommended for routine use.
• When someone has HPV, they are not likely to be reinfected if exposed again to the same type. This is probably due to the immune system's response to the virus. However, it is possible to be infected with a different type of HPV from a new partner.
Additional information: HPV in men
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