The Facts About HIV and Human Papillomavirus (HPV)

Common STD Associated With High Rates of Anal and Cervical Cancer

Updated on April 18, 2020

Medically reviewed by Latesha Elopre, MD, MSPH

Human papillomavirus (HPV) is one of the most common sexually transmitted diseases in the United States.

Because HPV can have few or no symptoms, a majority of those infected may not even be aware that they have the virus. Worse yet, the consequences of infection can sometimes be severe, no more so than in men and women with HIV.

Understanding HPV

HPV is a family of viruses that cause genital warts in men and women. The virus is also known to cause cellular changes that can lead to cancer of the cervix in women, as well as anal cancer and penile cancer in men.

Cervical cancer today kills around 4,000 women per year in the U.S., with an incidence rate higher in women with advanced HIV. Similarly, anal cancers, while considered rare in the general population, are more common in gay men—and even more so in HIV-positive gay men.

Epidemiological research has shown that HPV is a major risk factor for the development of both invasive cervical cancer (ICC) and anal cancer. Early detection through yearly Pap tests and anorectal exams is considered critical for the successful treatment of this potentially life-threatening malignancies.

hpv symptoms — Illustration by Hugo Lin, Verywell

Transmission

HPV is spread through sexual contact. Genital warts resulting from HPV infection can be found around the anus, vulva, or cervix in women and around the anus and the shaft of the penis in men. Visible warts are usually harder to see in women, mainly because they can be internalized with little if any irritation or pain.

However, not everyone infected with HPV will develop warts. It should be noted that while the risk of transmitting the virus is highest when there are visible warts, transmission can be spread when no outward signs of HPV at all.

HPV can also lay dormant for years. This can mean that, even in long-term monogamous relationships, genital warts or cervical changes can occur without an obvious infectious event. Because of this, men and women should be screened for HPV if ever there are cervical changes or appearances of wart in and around the genitals.

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Prevention

Because genital warts can occur on the scrotum, anus or other hard to protect areas, condoms and spermicides are not always 100 percent effective in preventing HPV infection. With that being said, safer sex practices can significantly reduce the likelihood of infection. Condoms are key to this, providing the most effective protection from HPV and other sexually transmitted infections.

HPV vaccinations are also available for children and younger adults, with current guideline endorsing vaccination the following groups:

All children who are 11 or 12 years of age
Teenage boys and girls who did not start or finish the HPV vaccine series when they were younger
Young women through the age of 26
Young men through the age of 21
MSM through the age of 26
Men with HIV who did not start or finish the HPV vaccine series when they were younger

If You Have HPV

For women diagnosed with HPV, it's important to get yearly Pap tests to ensure early detection of any cellular changes to cervical tissues. Similarly, high-risk gay or bisexual men should request an annual anal Pap test to identify any structural changes to anorectal cells.

Additionally, if you have HPV:

Always inform your healthcare provider about any abnormal vaginal bleeding or flank pain, or any bleeding, pain or unresolved itching from the anus or rectum.
Advise your sexual partner that you have HPV in order to make informed decisions about sexual practices.
Always use condoms during anal, vaginal, or even oral sex (most especially if warts are visible).
Suggest that your sexual partner get a complete medical evaluation and HPV screening.

It is important to remember that condoms do not totally prevent HPV transmission. HPV can be transmitted by contact with infected areas of skin not covered by a condom.

10 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.

Health and Human Services. Human Papillomavirus (HPV).
Beavis AL, Gravitt PE, Rositch AF. Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Cancer. 2017;123(6):1044-1050. doi:10.1002/cncr.30507
Ghebre RG, Grover S, Xu MJ, Chuang LT, Simonds H. Cervical cancer control in HIV-infected women: Past, present and future. Gynecol Oncol Rep. 2017;21:101–108. Published 2017 Jul 21. doi:10.1016/j.gore.2017.07.009
Koskan AM, Fernandez-Pineda M. Anal Cancer Prevention Perspectives Among Foreign-Born Latino HIV-Infected Gay and Bisexual Men. Cancer Control. 2018;25(1):1073274818780368. doi:10.1177/1073274818780368
Moscicki AB, Schiffman M, Burchell A, et al. Updating the natural history of human papillomavirus and anogenital cancers. Vaccine. 2012;30 Suppl 5(0 5):F24–F33. doi:10.1016/j.vaccine.2012.05.089
Centers for Disease Control and Prevention. Genital HPV Infection - Fact Sheet.
Centers for Disease Control and Prevention. Fact Sheet for Public Health Personnel.
Centers for Disease Control and Prevention. Vaccinating Boys and Girls.
American Cancer Society. HPV and HPV Testing.
Leeds IL, Fang SH. Anal cancer and intraepithelial neoplasia screening: A review. World J Gastrointest Surg. 2016;8(1):41–51. doi:10.4240/wjgs.v8.i1.41

By Mark Cichocki, RN
Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years.

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