Human papillomavirus, or HPV, is by far the single most common sexually transmitted infection (STI) in the world. Nearly 80 million Americans are infected with at least one strain, and about 14 million are infected every year. Almost everyone who is sexually active will contract at least one strain of the virus at some point in their lives.
Learn more about this common STD, what it does to the body and how it can be prevented (and how that might potentially save your life).
In This Section
- HPV Symptoms
- HPV Transmission
- HPV Prevalence
- At-Risk Groups
- HPV Complications
- HPV & Pregnancy
- HPV Testing
- HPV Treatment
- HPV Prevention
More than 200 strains of HPV have been identified, and most of them aren’t harmful. Plus, most HPV infections clear up on their own without causing any trouble. In fact, about 9 in 10 HPV infections go away within a couple of years.
The vast majority of people with HPV are unaware they have been infected, but for those who do become infected, the most common symptom are warts that appear on the vulva, cervix, penis, scrotum, anus or elsewhere on the genitals. These are similar to warts that appear elsewhere on the body and appear as a small bump or group of bumps.
While genital warts can be uncomfortable and annoying, the strains of HPV that cause them (typically HPV-6 and HPV-11) are not high-risk strains. The more serious health concern with HPV is cancer, and symptoms of HPV-related cancer vary depending on the location of the cancer. Symptoms of these cancers include:
- Cervical: Irregular periods or spotting, bleeding after sex and increased vaginal discharge can occur.
- Penile: The color or thickness of the penis can change, and painful sores may appear.
- Anal: Bleeding, discharge and pain can occur, and bowel habits might change.
- Vulvar: The color and thickness of skin on the vulva can change, lumps can appear, and chronic pain or itching can occur.
- Throat: A persistent sore throat or ear pain can occur, along with weight loss, constant coughing or trouble swallowing.
The strains of HPV that have been found to cause cancer (13 in total) are not the same as those that cause genital warts.
HPV is spread easily during both anal and vaginal sex, and it also can be spread (though usually less easily) during oral sex or other skin-to-skin contact, and it can be spread even if there are no obvious outward signs of infection, such as genital warts.
While it can be spread through skin-to-skin contact, it can’t spread through casual contact like shaking hands or hugging. However, it’s important to remember that HPV, like most STDs, can spread even if penetrative sex doesn’t happen or any kind of sex doesn’t happen to completion.
Almost every sexually active person who goes unvaccinated will contract at least one strain of HPV at some point in their lives. In fact, because it’s so common, it’s difficult to pinpoint exactly how many people get the virus every year as well as how many currently have it, though the Centers for Disease Control and Prevention estimate that about 80 million Americans have HPV.
This makes HPV by far the most common STD in the world, though low-risk strains of HPV are considerably more common than high-risk strains. The most recently available federal data indicates that about 43% of adults 18 to 59 have any strain of genital HPV, while 23% have a high-risk strain of genital HPV. Oral HPV is considerably less common with about 7.3% of all adults 18 to 69 having any strain of oral HPV.
Prevalence rates are higher in men than in women, with 45.2% of men 18-59 having any strain of genital HPV and 39.9% of women having any genital strain. High-risk strains are less common, but still troubling — 25.1% of men and 20.4% of women 18-59.
Anybody who engages in sexual activity is at a high risk of contracting HPV because the virus is so incredibly common, but some lifestyle factors and sexual activities can increase a person’s risk:
- Age: Adolescents and young adults are more likely to contract strains that cause genital warts than warts in other parts of the body, which are more common in children.
- Skin damage: Parts of the skin that have been punctured or are otherwise open are more likely to develop warts from HPV.
- Sexual partners: Having many sexual partners increases the risk of contracting HPV.
- Immune disorders: People with HIV and other immune-suppressive disorders are at higher risk of contracting HPV and other STDs.
In both men and women, HPV is most common in those between the ages of 25 and 29 and least common in those between 15 and 19, while both men and women have seen HPV rates, as measured by the prevalence of genital warts, fall in recent years.
The majority of HPV strains cause no serious health complications, but a handful of strains have been connected to many types of cancer, including cancers of the cervix, vagina, vulva, penis, anus and throat. High-risk strains of HPV more frequently cause cancer in women than in men, as 91% of cervical cancers are tied to HPV.
HPV-associated or -attributable cancer cases by cancer type
|Cancer type||Average HPV-associated cases||Percentage linked to HPV|
Cervical cancer is the type of cancer most closely tied to HPV, though anal cancer is linked to the virus in similar numbers. Still, cervical cancer remains the most common HPV-associated cancer. Thanks to increasing awareness of the link between HPV and cervical cancer, cases have fallen in recent years, but the rate of deaths has remained relatively steady for about the past decade.
Cervical cancer rates and deaths per 1,000 people by year
HPV-associated cancer rates also vary by race and ethnicity, with white men and women having the highest rates, and black men and women having the second-highest rates.
HPV-associated cancer rate by race/ethnicity and sex per 100,000 people
|Native Americans/Alaska Natives||9.7||6.7|
In most cases, having HPV has little to no impact on the health of a pregnant woman or her unborn baby. But women who have HPV still can experience the development of genital warts or abnormal cervical cells white they are pregnant, and pregnant women still should receive routine screenings for cervical cancer on their normal schedule.
Most people with HPV are unaware they have it, but routine testing for HPV generally is not recommended because the majority of strains are harmless and most cases go away on their own.
Federal guidelines generally call for screening women for cervical cancer, and a doctor may recommend screening for high-risk strains of HPV for women between the ages of 25 and 30 in lieu of a pap test or for women 30-65 in addition to a regular pap test. Also, many women who have abnormal cells detected in a pap test are tested for high-risk HPV strains in a follow-up or if pap results are unclear.
Men who are at increased risk of contracting HPV, such as those who regularly have unprotected sex, are gay or bisexual or have multiple partners, could be screened for HPV through a urine test, though the availability of these tests varies. Additionally, some doctors recommend anal swab testing for men who have anal sex, though this has yet to become a standard recommendation.
A diagnosis of genital warts usually can be made on sight by a doctor, but people who want to get tested for high-risk strains of HPV may choose to get screened at their doctor’s office and other places, depending on availability of HPV or cervical cancer tests, such as:
- Pharmacy clinic
- Urgent care center
- Planned Parenthood
- Campus health clinic
- Community health clinics
- At-home test kits
No treatment exists for the HPV virus itself, though the body clears most infections within a couple of years naturally. Up to 90% of HPV infections are cleared up by the body’s own immune system.
Other treatments can alleviate the symptoms of HPV in some cases. For instance, genital warts can be frozen off using cryosurgery in some cases, and it may be possible to remove abnormal cells from the cervix in high-risk HPV infections that are caught early.
High-risk strains of HPV can lead to other forms of cancer, and these can often be treated when they are diagnosed early.
While treatment may be possible in some cases, it’s not possible to completely remove HPV from a person’s body through any medical means. That’s why, as with other STDs, prevention is the best cure.
Fortunately, when it comes to HPV, multiple vaccines have been developed to prevent the strains that cause genital warts as well as the high-risk strains that can lead to multiple types of cancer.
Federal guidelines call for the HPV vaccine to be administered during adolescence, but it’s possible to get vaccinated up to age 26. Children at age 11 or 12 should get two doses of the vaccine, but vaccination can begin as early as age 9, assuming the child has never been exposed to the virus. People who get their first dose after they turn 15 will need three doses, but others need only two.
Despite widespread availability and recommended application of the HPV vaccine, just over half of 17-year-olds have received all necessary doses, and more girls than boys have been vaccinated properly.
Percentage of adolescents up-to-date on HPV vaccine by age and sex
In addition to variations by age group and sex, huge disparities are seen across the country, with youths in the District of Columbia having the highest HPV vaccination rates and those in Mississippi having the lowest.
Percentage of adolescents 13-17 up-to-date on HPV vaccine by state
|District of Columbia||78.0%|
While it’s true that most strains of HPV are not harmful and the majority of infections are rebuffed by the body’s own immune system. But the danger of HPV is very real — thousands of people are diagnosed with cancer as a result of having been infected with HPV, and many of those people will not survive for long. The good news is that a vaccine administered when most children are in middle school can protect them from the most harmful strains of this incredibly common virus.
- Centers for Disease Control and Prevention, Human Papillomavirus, Genital HPV Infection - Fact Sheet. (2019.) Retrieved from https://www.cdc.gov/std/hpv/stdfact-hpv.htm
- Centers for Disease Control and Prevention, 2015 STD Treatment Guidelines, Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. (2015.) Retrieved from https://www.cdc.gov/std/tg2015/screening-recommendations.htm
- National Cancer Institute, Surveillance, Epidemiology and End Results Program, Cancer Stat Facts, Cervical Cancer. (Undated.) Retrieved from https://seer.cancer.gov/statfacts/html/cervix.html
- Centers for Disease Control and Prevention, Number of HPV-Associated and Estimated Number of HPV-Attributable Cancer Cases per Year. (2019.) Retrieved from https://www.cdc.gov/cancer/hpv/statistics/cases.htm
- Centers for Disease Control and Prevention, Annual Number and Rate of HPV-Associated Cancers by Cancer Site, Sex, and Race and Ethnicity, United States, 2012–2016. (2019.) Retrieved from https://www.cdc.gov/cancer/hpv/statistics/race.htm