HUMAN PAPILLOMAVIRUS

HPV stands for Human Papillomavirus (genital warts.) It is a viral STI (sexually transmitted disease)  That is spread through skin to skin contact, which means it can be spread through any genital contact or anal contact. It can also be passed through oral sex to the throat (although this is rare) and through mutual masturbation. It can also be passed through child birth, although this is pretty rare. The risk is greater if the parent has a current outbreak of genital warts. There are more than 100 strands of HPV. About 40 of those strands affect the genitals and can either cause genital warts (that look like cauliflower) or various types of cancer (throat, vulva, cervical, vagina, anus, and penis). Some strands do nothing at all and have no symptoms so unless you happen to catch it during an STI test you might never know. Usually the infection goes away within 8 to 13 months although the virus always stays in the body.

HPV is incredibly common. About 1% of sexually active adults in the U.S. have genital warts at any one time. Each year, about 12,000 people get cervical cancer in the U.S., most of which are caused by HPV. In the U.S. alone each year about 1,500 people get HPV-associated vulvar cancer, 500 peole get HPV-associated vaginal cancer, 400 people get HPV-associated penile cancer, 2,700 people with uteruses and 1,500 people with penises get HPV-associated anal cancer, 1,500 people with uteruses and 5,600 people with penises get HPV-associated oropharyngeal cancers (cancers of the back of throat including base of tongue and tonsils). It’s said that 1 in every 4 people with uteruses have HPV, but because it’s so difficult to test for (and there is no test for those with penises) it’s impossible to know exactly how many people have HPV.

Once the infection goes away it can be incredibly difficult to test for. Sometimes it just won’t show up in STI screenings. In fact, HPV tests are only used in certain situations because it is so common but only a few strands actually cause health problems. This is why it’s important to get frequent pap smears, because even if you test negative if you have a strand of HPV it could cause abnormal cells on the cervix that could cause cancer if left untreated. Usually an infection in the cervix and cervical cancer itself has no symptoms. There is no test for those with penises and no way to screen for the early signs of penile cancer caused by HPV. You can keep an eye out for changes in color, skin thickening, or a build-up of tissue on the penis or a growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful and bleed. It’s also important to see a doctor if you have anal bleeding, pain, itching, or discharge or swollen lymph nodes in the anal or groin area or changes in bowel habits or the shape of your stool as that could be a sign of an anal infection. Also, if you have a sore throat or ear pain that doesn’t go away, constant coughing, pain or trouble swallowing or breathing, weight loss, hoarseness or voice changes that last more than 2 weeks, or a lump or mass in the neck you may want to get checked out for an infection of the throat. All of these infections might come with no symptoms. Genital warts are a little easier to spot, they usually look like a grouping of cauliflower anywhere near or on the genitals. There may be just a one spot or many.

There is not much in the way of treatment for HPV. If it causes cancer you can treat the cancer, and that is easier the earlier you catch it. Genital Warts usually go away on their own, but to treat them they usually remove the warts, usually though regular wart removal methods like freezing. Genital warts may come back even after treatment. If you get a strand that doesn’t cause any symptoms (if you even find out you have it) there’s nothing you really need to treat.

Now there are ways to prevent getting or spreading HPV. There are vaccinations, two that work for those with vaginas (Gardasil and Cervarix) and one that works for those with penises (Gardasil). The shots do not cure HPV if you already have it and they only protect against a few strands, the ones that are most likely to cause genital warts or cervical cancer. It protects against the strains that cause 70% of HPV-related cases of cervical cancer, and 90% of genital warts. They are given in a series of three shots, you need all three shots for it to be effective. It takes about 6 months to get all of the shots taken. They protect against HPV for at least 5 years. You may need a booster shot after 5 years. It is recommended for those age 9 to 26, studies are being run to get it approved for those older than 26. The most common side effects are bruising, itching, redness, swelling, or tenderness around the area where the shot is given. You may also experience dizziness, fainting, mild fever, nausea, and vomiting. But these symptoms do not last long and usually pass on their own.  If you have a fast heart beat, high fever, hives, rash, or weakness, call a doctor as it could be an allergic reaction. If you have trouble breathing get to an emergency room. Another way to help preventing getting or spreading HPV is through barrier methods like condoms, dental dams and gloves. However, these aren’t 100% because they don’t necessarily cover all of the infected area. You may want to use internal condoms as they cover more of the vulva/anal area and could protect more. It’s important to always let your partner know if you have HPV because barriers aren’t 100% and they could be passed anyway. 

HPV infections are common.  Risk factors for HPV infection include:

  • Number of sexual partners. The more sexual partners you have, the more likely you are to contract a genital HPV infection. Having sex with a partner who has had multiple sex partners also increases your risk.
  • Age. Common warts occur mostly in children. Genital warts occur most often in adolescents and young adults.
  • Weakened immune systems. People who have weakened immune systems are at greater risk of HPV infections. Immune systems can be weakened by HIV/AIDS or by immune system-suppressing drugs used after organ transplants.
  • Damaged skin. Areas of skin that have been punctured or opened are more prone to develop common warts.
  • Personal contact. Touching someone's warts or not wearing protection before contacting surfaces that have been exposed to HPV — such as public showers or swimming pools — might increase your risk of HPV infection.

Complications

  • Oral and upper respiratory lesions. Some HPV infections cause lesions on your tongue, tonsils, soft palate, or within your larynx and nose.
  • Cancer. Certain strains of HPV can cause cervical cancer. These strains might also contribute to cancers of the genitals, anus, mouth and upper respiratory tract.