Everything You Need To Know About HPV

Illustrated By Anna Sudit.
By Kendall McKenzie What’s HPV, and how common is it?
HPV stands for human papillomavirus. There are over 100 strains of HPV, and around 40 can infect our sexy areas such as the vulva, vagina, cervix, rectum, anus, penis, and scrotum, as well as the throat and mouth. HPV has the dubious honor of being the most common STD by a long shot: about 79 million Americans are currently members of Club HPV, and 14 million get newly infected every year. HPV is impressively contagious, rarely shows symptoms, and most people don’t know when they have it. As a result, nearly everybody gets at least one type of HPV at some point.
Some types of HPV cause genital warts, and others may cause cell changes that can lead to cancers of the cervix, genitals, and mouth/throat. HPV infections can hang out in your body for years without being detected, so it’s virtually impossible to tell exactly when someone got HPV, how long they’ve had it, or who gave it to them.
Advertisement
Everything you’ve read so far may sound completely terrifying, so let’s drop some good news: The vast majority of HPV infections have no harmful effects at all and go away on their own within a year or two without causing any problems. You usually have no idea you’re even infected. HPV’s connection to warts and cancer tends to freak people out, but most of the time it leads to neither.
Because HPV can live on areas that aren’t protected by condoms, condoms don’t prevent HPV as well as they prevent other STIs — but they definitely reduce your risk. Avoiding all genital contact with another person for your entire life is the only surefire way to avoid HPV. For the majority of us who eventually wind up bumpin’ pretties, getting the HPV vaccine, having regular screenings, and using condoms are the best ways to stay healthy.
Illustrated By Anna Sudit.
Genital Warts (Low-Risk HPV)
Genital warts are spread by skin-to-skin touching (usually during vaginal or anal sex), and around 360,000 people in the U.S. get them each year. The only way to completely avoid genital warts is to not have any skin-to-skin sexual contact whatsoever. If total abstinence isn’t your thing, condoms are your best bet to prevent the spread of HPV. Using condoms may also help make genital warts go away faster if you have them.
Though HPV is responsible for causing other types of warts on our body, it’s very, very unlikely that warts on your hands can be transmitted to genitals and vice versa — genital warts tend to stick specifically to genitals. There are roughly 12 strains of HPV that cause genital warts, but types 6 and 11 are responsible for most cases (luckily, the Gardasil vaccine protects against both of these types). Genital warts pop up in vaginas and on vulvas, penises, scrotums, and anuses, and rarely they’ll hang out inside rectums and urethras. You can also get them in your mouth or throat, but it’s super unlikely.
Genital warts look like fleshy, soft bumps that sometimes resemble cauliflower. They come in all sizes, can be flat or raised, and commonly cluster in groups or show up in more than one area. Genital warts are usually painless — sometimes people don’t even notice the warts (or confuse them with other skin conditions) — though for some they may itch, burn, or cause irritation during sex.
Advertisement
Genital warts can be transferred to partners even if there are no symptoms or signs of warts. It typically takes between six weeks to six months after you’ve been infected for genital warts to develop, but it could be longer. Often, our body simply fights off the virus, and the warts go away by themselves — high five, immune system — but they could also stick around or grow in size and number without treatment. Some people choose to wait it out, but you can tackle genital warts head-on if they’re causing discomfort, messing with your sex life, or generally giving you the sads. Treating genital warts may also lower the chance of passing the infection to a partner. The warts can be burned, frozen, lasered, cut off, or treated with medication, which usually successfully clears them up. These treatments don’t cure the HPV virus itself, however, so sometimes the unwanted warty visitors continue to return. Smokers and people with compromised immune systems may have a harder time fighting off HPV infections.
Genital warts can look like other common bumpy skin issues, so only a doctor can tell you for sure what’s going on. Obviously nobody’s jazzed about having warts on their fun zones, but the silver lining is genital warts aren’t dangerous and they DON’T lead to cancer — that’s why the types of HPV that cause genital warts are called “low risk.” However, the irritation from warts may lead to sores and bleeding, which can make it easier to get HIV and other STIs (more reasons to use condoms!). And lots of people have more than one HPV infection at a time, so warts may signal exposure to other, more serious types of HPV.
Illustrated By Anna Sudit.
HPV and Cancer (High-Risk HPV)
About 15 strains of HPV sometimes lead to cancer, so they’re called “high risk” HPV. Cervical cancer is the most common kind linked to HPV — almost all cervical cancer is caused by the virus — but HPV can also lead to cancer in the vulva, vagina, penis, anus, mouth, and throat. Most HPV infections go away on their own and don’t cause any serious health problems. But, if high-risk types of HPV manage to stick around, they can cause abnormal cell changes that eventually lead to cancer. Just like genital warts, high-risk HPV is spread through skin-to-skin contact, so condoms are the best way to protect yourself if you’re going to have sex.
High-risk HPV has no symptoms, and most people who have it feel totally fine. Even cervical cancer usually doesn’t show any symptoms until it’s really advanced and serious. There’s no cure for HPV, but it usually takes several years for cancer to develop, and abnormal cells in the cervix can be detected and treated before they turn into cancer. Again, most HPV infections are temporary and not serious, so you shouldn’t spend a ton of energy worrying about whether or not you have HPV. Just make sure you’re not skipping your regular screenings, which can catch problems early.
Pap tests (a.k.a. Pap smears) and HPV tests — where your doctor gently swabs your cervix and examines its cells — are some of the first lines of defense against cervical cancer. Pap tests find abnormal cell changes, and HPV tests tell whether the cell changes are caused by high-risk strains of HPV. The current guidelines for screening are: first Pap test at 21; a Pap test every three years from age 21-29; a Pap test every three years or combined Pap and HPV test every five years from age 30-64. Some people will need screening more often depending on their medical histories. The FDA has also approved a new HPV test as primary screening for people age 25 and older, so your doctor or nurse might use that instead of a Pap test.
Advertisement
It’s super common to have an abnormal Pap result, and most of the time it does NOT mean you have cancer. Your doctor will tell you what you need to do next to stay healthy — sometimes they’ll repeat the Pap, give you an HPV test, or recommend a close-up exam of your cervix called a colposcopy. Abnormal cells may heal on their own, but colposcopies and other procedures that help remove abnormal cells are highly effective at preventing cancer from developing. Why some people easily fight off HPV infections while others develop cell changes or cancer is unclear, but we do know that cigarette smokers and people with weaker immune systems have a higher risk of cervical cancer.
The survival rate for cervical cancer is 93% when it’s caught early, which is why regular screenings are so important. And, thanks to the Affordable Care Act (a.k.a. Obamacare), most insurance plans cover Pap tests without a copay, so you can hop into those stirrups with a smile on your face. Doctors are currently only able to test for HPV on the cervix — there is no HPV test for penises or other areas of the body. However, another major tool in the war against cancer, the HPV vaccine, can help protect all body parts.
Illustrated By Anna Sudit.
The HPV Vaccine
So, cancer’s super scary and warts aren’t awesome, but luckily there are vaccines to help prevent both. That’s right — vaccines that help prevent an STI and cancer! Thanks a bunch, science! While HPV vaccines won’t treat or get rid of existing infections, cancer, or warts, they’re one of the best ways to protect yourself and your partner from future infections (along with using condoms). Young people of all sexes can get the HPV vaccine. In women, the vaccine helps prevent cervical cancer and sometimes genital warts. It also protects men from genital warts and anal/penile/oral cancer, and prevents them from getting and passing high-risk HPV to their partners.
There are two kinds of HPV vaccines that have been shown to protect against the strains of HPV that most commonly cause warts and/or cancer: Cervarix and Gardasil. Cervarix is only for girls, and it protects against the two high-risk HPV strains responsible for 70% of cervical cancer (types 16 and 18). Gardasil is for both girls and boys, and it also protects against 16 and 18, along with types 6 and 11 that cause 90% of genital warts. A new version of Gardasil that protects against nine types of HPV, Gardasil 9, was just approved by the FDA in December. It also protects against types 6, 11, 16, and 18, plus an additional five types of high-risk HPV — 31, 33, 45, 52, and 58. Gardasil 9 isn’t available yet, so in the meantime people should get the other vaccines on the market.
The HPV vaccine works best for people who’ve never had any sexual contact, so it’s recommended for kids aged 11-12, and can be given as early as nine. Because research hasn't shown that the HPV vaccine is effective for people over 26 — the majority of us have already been exposed to HPV by then — the CDC cuts off their recommendation for the vaccine at that age. After 26, most insurance stops covering the vaccine and many doctors won't give it, but that doesn't mean you CAN'T get it. Some doctors will give older people the HPV vaccine if they think it makes sense. If you're over 26 and want the HPV vaccine, talk with your doctor.
Advertisement
So, are HPV vaccines safe? YES. Studies have routinely demonstrated their safety. To date, more than 57 million doses of the HPV vaccine have been given, and there’s no data that indicates it causes any severe adverse reactions. The most common side effect is temporary pain and redness where you get the shot.
One of the reasons the HPV vaccine generates so much controversy is because it prevents a sexually transmitted infection, which leads some people to believe it’s inappropriate for children. But, even though the HPV vaccine protects against an STI, it’s not meant for sexually active people — it works best for young kids (before they have any sexual contact at all) to prevent HPV and cancer later on in life. And, studies show that the HPV vaccine does NOT lead to increased sexual activity, so no, giving kids the HPV vaccine won’t turn them into turbo-humping maniacs. All it does is help protect them from genital warts and cancer in adulthood.
The CDC says that the HPV vaccine could prevent about 21,000 HPV-related cancers each year. Gardasil 9, the newly-approved HPV vaccine, has the potential to prevent an estimated 90% of cervical, vulvar, vaginal, and anal cancers. That’s a huge deal, and a big reason to encourage vaccination in everybody who’s eligible for it. In fact, the HPV rate in teen girls has already dropped by 56% since the vaccine was introduced, and the more people are vaccinated, the lower that number will go. Another bonus? Because of the Affordable Care Act, the HPV vaccine is covered under most insurance plans at no cost and without a copay. 100% win.
Advertisement