Human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI) in the United States. There are many types of HPV. Some types cause genital warts, while other types don't cause any symptoms. More aggressive forms of HPV are connected with cancer of the cervix or, less often, cancer of the anus, vulva, vagina, penis, and throat.
You may not know that your cervix or anus is infected with HPV until a Pap test shows abnormal cells. When you have a Pap test (or "smear"), the doctor scrapes some cells from your cervix and looks at them under a microscope.
HPV is normally transmitted through sexual contact. This includes having oral, vaginal or anal sex with someone who has HPV.
A person who has HPV may not show any signs of the virus, as genital warts often take years to develop. In women, the warts may be on the cervix (the opening to the uterus or womb) and therefore not visible.
The doctor rubs a small swab against your cervix or anal canal and puts the swab in a tube of special liquid. This tube goes to a lab. If the lab finds HPV in the liquid, your doctor will know what HPV type you have.
If the type of HPV you have is a type that causes cancer, your doctor may want to perform another type of test, called a colposcopy. (A colposcope is a special magnifying lens that is used to look at your cervix. An anoscope is used to look at your anal canal.) The doctor will cut a small bit of tissue from your cervix or anal and check it for signs of cancer.
If you are a man who has sex with men or you are a man who is HIV-positive, you might be a candidate for an anal Pap test. If you have warts on your anus or penis, talk to your doctor about having them removed and alert your sexual partner that you may have HPV.
Currently, there is no cure for HPV. If you have it, you'll need to have regular and frequent Pap tests to keep watching for signs of cancer. Your doctor may want you to have Pap tests every 4 to 6 months to check the status of the HPV infection. In many men and women, HPV goes away on its own without causing any health problems.
Genital warts must be treated by your doctor. Do not try to treat the warts yourself, especially with chemicals you can buy over the counter to remove warts that you would find on your hands. These chemicals are not supposed to be used for genital warts, as they can irritate the skin.
There is a vaccine (“quadrivalent”) that can prevent infection with 4 different types of HPV in young women. This vaccine targets the types of HPV that cause up to 70% of all cases of cervical cancer and about 90% of all cases of genital warts.
There is a second vaccine (“bivalent”) that can prevent infection with the types of HPV that can cause cervical cancer in women. It does not prevent infection with the types of HPV that can cause genital warts.
The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) recommends that girls and boys between the ages of 11 and 12 receive either of the vaccines, as it is important to get vaccinated before becoming sexually active. The vaccine is approved for boys and girls and men and women between 9 years and 26 years of age.
The Centers for Disease Control and Prevention also recommends the vaccine for men who are 26 years old or younger and who have sex with men, or who have sex with men and women, or who are HIV-positive.
The vaccine is given in three doses (shots) over a 6-month period. It’s important to get all three doses to make sure you are getting the most protection from HPV infection.
The HPV vaccine is listed as a covered service under the Affordable Care Act. If you are underinsured or don’t have insurance and you have a low income, you or your child may qualify to get the HPV vaccine at no cost through the Vaccines for Children (VFC) program.
Studies are currently being done to test to see if the vaccine works for men and for women older than 26 years of age.
HPV Testing in the Evaluation of the Minimally Abnormal Papanicolaou Smear by BS Apgar, M.D., M.S., and G Brotzman, M.D. (American Family Physician May 15, 1999, http://www.aafp.org/afp/990515ap/2794.html)
Written by familydoctor.org editorial staff