10 Things You Should Know About Human Papillomavirus (HPV)

The human papillomavirus (HPV) is a viral infection transmitted via intimate contact with another person. More than 150 different strains of HPV have been identified, and the subset of strains associated with increased cancer risk are collectively called the "high-risk" strains.

Despite increased awareness about HPV, there remains a fair amount of confusion about the virus as well as about the vaccine that can help to prevent it. Below you'll find 10 must-know facts about HPV to help you understand the infection and your risk.


HPV Is More Common Than You May Think

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It is estimated that over 79 million Americans are living with HPV, making it the most common sexually transmitted disease in the U.S.

According to the Centers for Disease Control and Prevention (CDC), about 13 million individuals in the U.S. become infected with HPV each year.

It is so common, in fact, that researchers believe almost all sexually active people will get the virus at some point in their lives. 


You Don't Need to Have Intercourse to Get HPV

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HPV is transmitted through skin-to-skin sexual contact. This shouldn't suggest, however, that intercourse is the sole route of transmission. In fact, no penetration of any sort is needed to transmit HPV, and any area not covered by a condom is vulnerable to HPV exposure.

By and large, vaginal and anal intercourse are the activities most associated with HPV transmission. Although less common, the virus can also be passed through oral sex. The risk only increases if you have multiple sex partners or have sex with someone who has had many partners. 


Not All Types of HPV Cause Cancer

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There are more than 100 different strains of HPV. Some are "high-risk" strains associated with cancer; others are "low-risk" types known to cause genital warts.

Two strains considered to be of high risk are types 16 and 18, which together cause 70% of cervical cancers and pre-cancerous cervical lesions.

There is a common misconception among many that genital warts are a precursor to cancer. This is not the case. The HPV strains responsible for genital warts are not known to cause cancer.

With that being said, having a genital wart shouldn't suggest you are "safe." Persons can be infected with multiple HPV types, and the appearance of a wart should be a warning sign of possible exposure to higher risk strains.


There Is a Vaccine, but No Cure for HPV

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The types of HPV that cause genital warts and cervical cancer can be managed but not cured. Similarly, genital warts can be treated by removing them, but their removal does not eradicate the underlying virus.

While there are vaccines today that can greatly reduce the risk of HPV in young people, they are not sterilizing vaccines and cannot neutralize the virus in people already infected.


Most People With HPV Do Not Have Symptoms

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You cannot know if someone has HPV by looking at them or searching for genital warts. It doesn't work that way. Most people, in fact, have no signs of infection and may only become aware of the condition if they have an abnormal Pap smear result.

But, even for people who do have symptoms, they are often either overlooked or misunderstood.


The HPV Vaccine Does Not Protect Against All Strains

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Gardasil-9 is currently the only FDA-approved HPV vaccine available in the U.S. It protects against two low-risk HPV types (types 6 and 11) and seven high-risk types (types 16, 18, 31, 33, 45, 52, and 58).

While Gardasil-9 typically provides ample protection, it is less effective in preventing HPV-related disease in those who have already been exposed to one or more HPV types; the vaccine does not treat existing HPV infections or associated disease.

It may also fall short in those assigned female at birth who are living with HIV. This population may develop cervical cancer as a result of an atypical HPV type.


HPV Testing and Sex Assigned at Birth

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The HPV test can be performed on those assigned female at birth in conjunction with a Pap smear during a routine gynecological exam. The U.S. Preventive Services Task Force (USPSTF) endorses routine HPV testing as follows:

  • For women aged 21 to 29 years, a Pap smear is recommended every three years.
  • For women 30 to 65, either a Pap smear can be performed every three years, high-risk human papillomavirus (hrHPV) testing alone can be done every five years, or co-testing with a Pap smear and hrHPV test can be performed every five years.

By contrast, the American Cancer Society (ACS) recommends people with a cervix undergo HPV primary testing—rather than a Pap test—every five years, starting at age 25 and continuing through 65. In doctors' offices and other healthcare facilities that do not have access to HPV primary testing, co-testing with a Pap test and hrHPV test can be performed every five years, or a Pap test can be done every three years.

There is no HPV test available to detect genital HPV in penises. However, some doctors may run an HPV test on an anal Pap smear in high-risk individuals who engage in receptive anal sex.


Some Doctors Are Reluctant to Do HPV Testing

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Although HPV testing is now widely accepted and practiced, one of the reasons some healthcare providers are hesitant to perform routine hrHPV testing is that the benefits of HPV testing may not be fully clear to them.

For example, a positive result often means nothing, as the majority of HPV infections go away in two years without any complications. However, some believe a positive result may lead to unnecessary worry or procedures for the patient.

HPV Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

HPV Vaccination Is Not Just for Young People

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The CDC recommends routine HPV vaccination for all adolescents aged 11 and 12, although the vaccine can be administered as early as nine years old. "Catch-up" vaccination for those between 13 and 26 is also recommended.

For certain individuals over 26, vaccination may still be beneficial. The CDC recommends the HPV vaccine for some adults ages 27 to 45 based on shared clinical decision-making—a discussion between healthcare provider and patient.

The CDC advises immune-compromised persons (including those with HIV) be vaccinated regardless of age as well.

If you are between 27 and 45 years old and believe you may be at increased risk for cervical or anal cancer, don't hesitate to ask a doctor about getting vaccinated. It will cost around $400 and $500 for a three-dose schedule, which your insurance may cover.


Getting the HPV Vaccine Does Not Mean You Can Skip Cancer Screening

Even if you get the HPV vaccine, you need to be vigilant about getting screened for cervical cancer. According to the CDC, getting vaccinated can prevent over 90% of cancers caused by HPV, including anal, vaginal, cervical, and vulvar precancers.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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