Human Papillomavirus (HPV)

HPV, short for Human Papillomavirus, is a group of about 150 different kinds of viruses, some of which cause warts on the hands and feet and others which cause genital warts and cervical cancer. If you’re sexually active, have had any sexual contact, or are thinking about having sexual contact, your best protection is to learn the facts about how HPV is spread and how to prevent getting it.

What is HPV?

HPV (Human Papillomavirus) is one of the most common sexually transmitted infections. There are many different types of HPV and more than 40 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers, such as 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Some types of HPV cause genital warts; others types of the HPV virus cause pre-cancerous changes of the mouth and throat, cervix, vulvar, vagina and anus that can later lead to cancer. The HPV virus can also cause cancer of the anus, and cancer of the penis in males.

Who can be infected with HPV?

According to the CDC, over 79 million Americans are currently infected with HPV.. Any sexually active person—no matter what color, race, gender, or sexual orientation—can get HPV. HPV is mainly spread by having sexual contact with someone who in infected. A mother who is infected with the HPV virus can infect her newborn baby during the delivery.

How do you get HPV or genital warts?

HPV and genital warts are usually spread by direct skin-to-skin contact during vaginal, anal, or oral sex with someone who has been infected with HPV. Using condoms every time you have sex can help protect against HPV but they aren’t perfect because HPV can be found on skin that isn’t covered by a condom.

What can happen to me if I get the HPV virus?

If you get the HPV virus, it may cause the following:

• The infected area of your body can remain totally normal (called latent or inactive infection). You may never know about it, but you may give the infection to others. Your body then usually clears the infection. According to the Center for Disease Control (CDC) 90% of women infected with HPV will clear the virus within two years.
• Bumps, called genital warts, may be seen in your genital area. They almost never lead to cancer but can be painful.
• You could have changes in the cells of your cervix, resulting in an abnormal Pap test. Most of the time, if you are younger than 24 years old, your body will clear the HPV and the Pap test will become normal again over several years. However, sometimes the HPV infection stays in your cervix which can lead to cervical cancer. This is why your health care provider will want to see you for follow-up visits if you have had an abnormal Pap test.
• Recent studies have shown that certain vaginal and anal cancers and some cancers of the oropharynx (back of the throat, base of tongue, and tonsils), may be caused from HPV.

You are at greater risk of getting HPV if:

• You had sexual contact at an early age.
• Either you or your sexual partners have had many different sexual partners at any time.
• You or any of your sexual partners have had a history of sexually transmitted infections.
• Any of your sexual partners did not wear a condom.

How would I know if I had HPV or genital warts?

Sometimes it’s hard to know if you have HPV. Although genital warts are usually seen on, around, or inside your vagina or anus, they may be small and hard to see. And you may not have any symptoms such as pain or bleeding.

An abnormal Pap test is often the first sign of an HPV infection. This is why it’s important to begin having Pap tests when you are 21 years old. You should start earlier if you have special risks such as problems with your immune system such as HIV infection.

What do genital warts look like?

Genital warts are growths on your skin that look like tiny bumps. They are usually in or around the vagina, anus, on the cervix, or on the inside of the thigh. They may be raised or flat, small or large. There can be only one wart or more than one in the same area. Warts can be pink or flesh-colored, red or brown. Some bumps grow together and look like a cauliflower.

When should I see my health care provider (HCP)?

You should make an appointment with your HCP if you notice any unusual growths, bumps, or skin changes on or near your vagina, vulva (the outside area surrounding your vagina), or anus or if you have any unusual itching around or inside your vagina or anus. You should also talk to your HCP if any of your sexual contacts tell you that they have genital HPV or genital warts.

What is the treatment for genital warts?

Treatments for genital warts range from watching to see if the warts go away, acid medicines, creams, to laser therapy. The treatment will remove visible warts and unwanted symptoms such as itchiness. The type of treatment your health care provider recommends will depend on the number, location, and size of the warts and the cost and side effects of the different treatments. It’s important to talk with your health care provider about treatment choices and what type of follow-up you will need. Tell your health care provider if you think you are pregnant so that the right therapy is chosen.

NEVER use over-the-counter “wart medicine” on genital warts. (These medicines are not meant for the very sensitive skin around your genital area).

Will I always have HPV?

Researchers used to believe that if you had HPV you would always carry the virus, but because of new medical research, we now believe that in most cases a person who has a healthy immune system will actually fight off HPV without treatment. This means that the virus can no longer be detected. However, it remains possible that in some people the virus is hidden and can cause symptoms later. It is important to remember that if you have had an HPV infection, you can still become re-infected with HPV if you come in contact with the virus again.

How can I prevent or lower my chances of getting HPV or genital warts?

The safest way to prevent getting other types of HPV is to NOT have sexual contact.

If you are having sexual contact, it is important to know that you can lessen your risk of infection by having sexual contact with only one partner who only has sexual contact with you. Using condoms every time you have sex gives you some protection, but condoms aren’t perfect. Condoms don’t cover the  scrotum (the sack where the testicles are located) which can become infected with HPV. It just takes skin-to-skin contact to get the virus. Avoid having oral sex to prevent certain HPV infections that may cause oropharynx cancers (cancers in the back of throat, base of tongue and tonsils). Dental dams may offer some protection against HPV infections from oral sex with a partner who has HPV.

HPV vaccines are also a very important way to lessen your risk of getting HPV (see below).

Is there a vaccine that lessens my chance of getting HPV?

Yes. There used to be three different vaccines that protect young women against 2, 4, or 9 different types of HPV.

Since the end of 2016, Gardasil 9® is the only available vaccine in the United States.

The vaccines work best in girls who have not yet come in contact with these viruses. This is why the vaccine is recommended for all 11 and 12 year old girls and boys, however, vaccination may begin as early as age 9 years old. Adolescents and young adults 13-26 years of age who have yet to receive the vaccine or who have not completed the vaccine series should receive a catch-up vaccine. Adults up to 45 years old should talk to their health care provider about whether they should also be vaccinated. .

Anyone receiving the HPV vaccine before their 15th birthday needs a total of 2 doses.  The 2nd dose should be given 6-12 months after the first one.

However, anyone starting the HPV vaccine series after they turn 15 years old needs to get 3 doses. The 2nd dose should be given 1-2 months after the first dose and the 3rd dose should be given 6 months after the first dose.

Is it normal to feel upset about having HPV or genital warts?

Yes. Lots of people feel worried. Some women may also be upset with their partner. It is important to learn about HPV and share your feelings and concerns with your health care provider. Talk with your health care provider about whether you should get the HPV vaccine.

If you are worried about HPV or genital warts, remember:

• You’re not alone! Millions of Americans have been infected with the HPV virus.
• There are lots of effective treatments for genital warts.
• The most serious problem related to some types of HPV is cervical cancer, and it can be prevented if you have Pap tests, treatment, and follow-up.
• Don’t smoke since it can make the HPV infection stay in your body and increase the risk of cervical cancer.
• Learning about HPV will help you understand your infection and the importance of regular checkups.
• If you think you might have HPV, contact your health care provider.

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.