10 FACTS ABOUT HPV

As a gynecologist, one of the most common things I deal with is HPV(Human Papilloma Virus) – diagnosing it, treating it, but most importantly explaining it.  Before the virus was identified, we knew that sexually active women had a higher chance of getting an abnormal Pap or cervical cancer, but we didn’t know why.  In the 1980’s, scientists discovered that HPV causes cervical cancer.  To date, HPV is the only known virus that directly causes cancer.   In 2003, a test became available to detect HPV in the office setting, and in 2006 a vaccine was developed.

Here are ten facts you need to know about HPV:

1. HPV is the most common sexually transmitted infection in the US.  75-80% of Americans will be infected with HPV during their lifetime.  Nearly half of women aged 20-24 will test positive for HPV.
2. There are over 100 subtypes of HPV.  Some of these types cause genital warts, some cause precancerous and cancerous changes in the cervix, but most have no health effects whatsoever.
3. We make the diagnosis of genital warts by visualizing warts on the skin of the vulva.  These are raised bumps with an irregular surface.  They are darker than the surrounding skin and may be slightly itchy but are not painful.
4. HPV that causes precancerous changes in the cervix (also called high-risk HPV) can be detected on a Pap.  There is no blood test for HPV.
5. There is no way for a man to know if he is a carrier of HPV, unless he has the subtype that causes genital warts.  He cannot go to his doctor to be “checked” for this infection.  So you cannot blame your partner for dishonesty about having HPV.  He truly doesn’t know.
6. If you are diagnosed with HPV, there is no way to know how long you have had it, or who you got it from, unless you have only had one sexual partner.  If HPV is found on your Pap, it is most likely from an exposure within the last two years, but that cannot be determined definitively.  You could have been exposed the very first time you had sex.
7. Condoms do not completely prevent the spread of HPV because the virus can pass through the skin that is not covered by the condom.
8. HPV (other than the subtypes that cause genital warts) does not have any symptoms.  It does not cause pain, discharge, itching or odor.  The only way to know you have it is to find it on your Pap.
9. If you find out that you have HPV, most likely your current sexual partner has it too.  While HPV can cause penile and anal cancer in men, these cancers are extremely rare (only about 2000 cases per year in the US) and the vast majority of men with HPV are asymptomatic.
10. There is no way to prevent the spread of HPV completely.  However, getting vaccinated, using condoms, and limiting the number of sexual partners can decrease your risk.

One final note…

Many women who are diagnosed with HPV ask me if they must tell their sexual partner.  And I am not sure if there is a right or wrong answer to this question.

From a health perspective, HPV rarely affects men in a negative way.  If a man is not already a carrier, he can become one and pass the virus to future partners.  However, if you have been sexually active with him previously, with or without a condom, he is likely a carrier too.  But there is no way to prove that since there is no test for it in men.

Ultimately if you are in a committed relationship, this may be something you want to share, if only for the support you may receive as you go through treatment or follow-ups with your doctor.