Human Papilloma Virus (HPV)

General Information

HPV is a family of over 100 viruses that affect different parts of the body.  There are more than 30 strains of HPV that can be spread through sexual contact. HPV is the most common sexually transmitted infection in the United States, over 20 million people are currently infected.  Each year 5.5 million people are newly infected with HPV.  Studies estimate that 50% to 75% of the sexually active population has been exposed to at least 1 strain of HPV, although most people don't develop symptoms.  Because HPV is so common, a person can have very few sexual partners and still come into contact with this virus. HPV can cause genital warts or cellular changes on the cervix causing your Pap smear to be abnormal.  

Symptoms

• Most HPV carriers have no symptoms and are completely unaware that they have the infection, thus they transmit the virus to sex partners unknowingly.

• Depending on the type of HPV, a woman may only find out she has HPV when her Pap smear results indicate cervical cell changes.
• Some types of HPV cause genital warts:

• Genital warts may develop inside the vagina, on the lips of the vagina, cervix or around the anus.
• Genital warts can also develop in your mouth or throat if you have oral sex with an infected person.
• Genital warts are usually soft, moist, pink, gray, or red swellings and are usually painless but may itch. 
• They can be single or multiple growths or bumps, raised or flat, small or large, and sometimes form a cauliflower-like shape.

 Who is at risk?

• Since HPV often causes no symptoms, a person can "carry" the virus for many years without knowing they are infected, and can unknowingly infect others over time, thus anyone who is sexually active may be at risk.
• Young, sexually active women and men have the highest rates of infection.
• The more partners you have, the higher your risk for infection.
• Having a partner who has genital HPV or other sexually transmitted infections increases your risk.
• Not consistently practicing safe sex increases your risk.  

Possible Complications

Undetected or untreated high-risk types of HPV can lead to cancer. 

Prevention

• Use condoms to minimize the risk of any sexually transmitted infection – birth control pills DO NOT offer protection against HPV or other STIs.
• Avoid sexual activity when genital warts are visible on sex partner(s).
• Consider the new vaccine, Gardasil, which vaccinates against 4 types of HPV. It is available for females between the ages of 9 and 26.  For more information on this please visit http://www.cdc.gov/std/hpv/default.htm.

Testing

• Since most women don't develop genital warts, abnormal Pap smears are often the way for a clinician to detect HPV.
• If a Pap smear comes back abnormal, an HPV DNA test can be ordered from the same sampling to determine the presence of certain types of HPV that can grow quickly.
• A Colposcopy may be done to analyze your cervix and obtain a biopsy.  This helps to determine the degree of cervical cell change.  Depending on the degree of cell change, different management and treatment options will be discussed and arranged.
• If one person tests positive for HPV ALL of her/his current/recent sexual contacts should be notified, tested and treated.

Treatment

• HPV has no "cure" but your body's immune system is usually able to protect you from having symptoms.
• Your clinician will discuss routine pap spears and appropriate medical follow-up once HPV has been diagnosed.

Living with HPV

It's completely normal to feel frustrated, depressed, angry about having any sexually transmitted infection, including HPV.  As with other viral infections, you're less likely to experience recurrences if you take care of your health:

• Maintain a strong immune system by eating right and taking a folic acid supplement
• Get exercise, get enough sleep, and manage your stress.
• Avoid alcohol, tobacco, and illegal drugs.
• If you have genital warts and decide to become pregnant, growth of the warts may accelerate.

Being diagnosed with HPV does not mean that you can't have sex again. 

• Talk with your sex partner(s):
• Give them information about HPV and allow them to make informed decisions about sexual activity. 
• Some partners may need time to think about how this affects your relationship and may decide to get tested. 
• You can reduce your risk of transmitting HPV to a sexual partner:
• Abstain from sex and find other ways to express intimacy.
• Avoid contact with any wart.
• Use condoms and dental dams every time you have sex.  Condoms and dental dams do not give you 100% protection, but minimize risk of transmission of any sexually transmitted infection.

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