HPV - Human Papillomavirus

Every year, nearly 9 million people under the age of 25 get a new STI (sexually transmitted infection).¹ One of these infections is human papillomavirus (HPV) infection. If you've had sex, you could have an STI. Some STIs cause symptoms. Others don't. You could have one and not know it. Some STIs make you sick today and others can cause problems later in life. The include serious problems like cancer or infertility. Some can even kill you.

What is HPV and how do you get it?
Human papillomavirus (HPV) is a very common viral STI. You get HPV from having sex with an infected person. You can also get it from just "fooling around." Babies can get it from their mothers during childbirth. Although most infected people have no symptoms, they can still pass on HPV.

Am I safe if I only have oral or anal sex?
HPV can also be passed during oral or anal sex.^2,3

What happens if I'm infected?
If you are like most people, you will have no symptoms at all. Some people with HPV have warts. These are usually in the genital area. People with HPV can get cervical, vaginal, penile, anal, or oral cancer.^4,5 Babies who get the infection from their mothers can get warts in their throats.⁴

How do you treat HPV?
Most people with HPV infection clear it on their own. However, some people will go on to develop warts or cancer. Although warts can be treated, they may return. For females, a Pap test can detect changes caused by HPV before they turn into cancer. Abnormal Pap tests and cervical cancer can be treated. The earlier you are treated, the more likely you are to be cured. All sexually active females should talk to a doctor about when to start having regular Pap tests.

Am I safe if I always use a condom?
If you always use condoms for vaginal sex, you can cut your chance of getting HPV by up to 70%.^6-9 So far, there is no evidence that condoms reduce your chance of getting HPV during oral or anal sex.

Is there anything else I can do to reduce my chance of getting infected?
HPV vaccine is recommended for young women. However, vaccination does not protect against all types of HPV that cause cancer and warts. How long it works is unknown.^10,11

What can I do to avoid getting infected?
Avoid sexual activity if you are single. Be faithful to one uninfected partner for the rest of your life. Already had sex? See a doctor and get checked.

References
1 Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health; 2004;36(1):6-10.
2 Edwards S, Carne C. Oral sex and the transmission of viral STIs.Sex Transm Inf. 1998;74:6-10.
3 Syrjanen S. PL7 Oral viral infections that could be transmitted oro-genitally. Oral Dis. 2006;12 Suppl 1:2.
4 Winer RL, Koutsky LA. Genital human papillomavirus Infection. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually Transmitted Diseases. 4th ed. New York, NY: McGraw Hill, Co; 2008:489-508.
5 Pintos J, et al. Human papillomavirus infection and oral cancer: A case-control study in Montreal, Canada. Oral Oncology. 2008;44(3):242-50.
6 Vaccarella S, Franceschi S, Herrero R, Munoz N, et al. Sexual behavior, condom use, and human papillomavirus: pooled analysis of the IARC human papillomavirus prevalence surveys. Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):326-33.
7 National Institute of Allergy and Infectious Diseases, National Institutes of Health. Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention. 2001.
8 Manhart LE, Koutsky LA. Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis. Sex Transm Dis. 2002;29(11):725-735.
9 Winer RL, Hughes JP, Feng Q, et al. Condom use and the risk of genital human papillomavirus infection in young women. N Engl J Med. 2006;354(25):2645-2654.
10 Centers for Disease Control and Prevention (CDC). STD-prevention counseling practices and human papillomavirus opinions among clinicians with adolescent patients--United States, 2004. MMWR Morb Mortal Wkly Rep. 2006 Oct 20; 55(41):1118-20.
11 Mao C, Koutsky LA, Ault KA, Wheeler CM, Brown DR, Wiley DJ, Alvarez FB, Bautista OM, Jansen KU, Barr E. Efficacy of human papillomavirus-16 vaccine to prevent cervical intraepithelial neoplasia: a randomized controlled trial. Obstet Gynecol. 2006 Jan;107(1):18-27.

Authored by: Sheetal Malhotra, MBBS, MS
Date: May 2007
Reviewed by: Kate Hendricks, MD, MPH&TM
Date: May 2007
Revised by: Jennifer A. Shuford, MD, MPH
Date: December 2009