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Human Papilloma Virus
What is human papilloma virus?
HPV is a family of over 100 viruses that affect different parts of the body. Some strains of HPV cause warts on the feet, hands and other parts of the body while other strains are sexually transmitted and cause warts that affect the skin in the genital area, including the vulva, vagina, cervix, rectum, anus, penis or scrotum. More than 30 strains of HPV can affect the genital area and depending on the type of HPV involved, symptoms can be in the form of wart-like growths or abnormal cell changes, especially in a woman's cervix, that can be precancerous.
Is it common?
In the United States, HPV is considered to be the most common STI. Approximately 5.5 million people are newly infected with genital HPV each year and about 20 million people are currently infected. Some studies estimate that 50 to 75 percent of the sexually active population are exposed to at least one strain of HPV although most people do not develop symptoms. Because HPV is a common infection, a person can have very few sexual partners and still come into contact with the virus.
How is it transmitted?
HPV is transmitted through vaginal, anal and oral sex and skin-to-skin genital contact or rubbing. Because genital HPV infections often are asymptomatic, they can be transmitted by sex partners who do not know they are infected. A pregnant mother who is infected with HPV can also transmit the virus to her infant during vaginal childbirth.
What are the symptoms?
A majority of HPV infections have no signs or symptoms. This means that many people may not be aware that they are infected and are continuing to transmit the virus to sex partners.
Depending on the type of HPV, some women have infections that cause abnormal cell growth, or dysplasia, on the female cervix. A woman may only find out she has HPV when her annual Pap smear test indicates abnormal cervical cell changes.
Other types of HPV cause visible genital warts. In women, these growths may develop inside the vagina where they are hard to detect. They can also develop on the lips of the vagina or around the anus. In men, they usually appear on the penis, but they are also found on the scrotum or around the anus. Very rarely, growths can be found in the mouth and throat.
The growths are typically soft, moist, pink or red swellings. They are usually painless but may itch. If allowed to grow, they can block the openings of the vagina, urethra or anus and can become very uncomfortable. The growths can be single or multiple growths or bumps, raised or flat, small or large or in a cauliflower-like shape. Depending on their location, genital warts can cause sores and bleeding.
How soon after exposure to HPV will symptoms appear?
Warts typically appear within three weeks to six months after sexual contact with an infected person, but they can also take years to appear. This time period makes it difficult to track the infection as it is passed from one partner to the next.
How is it diagnosed?
Genital warts are diagnosed by a visual inspection from your medical provider. They might also perform a vinegar wash to make the warts easier to see. For women, a Pap smear test will also be performed to detect any changes in the cervical cells caused by HPV infection. If the Pap smear indicates abnormal cell changes, a woman will be required to have a colposcopy, a procedure used to magnify cervical and vaginal tissue, and a biopsy, a procedure that removes tissue samples so that they can be examined under a microscope.
Most men with HPV do not have any symptoms, making a diagnosis of HPV in men more difficult. Since there is no treatment for asymptomatic HPV, most men are not treated. Men may also think that they have no symptoms when they actually do. Sometimes a medical provider can see small warts that have gone unnoticed, particularly if they are inside the opening of the penis.
Men and women should stop having sexual contact as soon as they know or think they have genital warts and they should seek treatment immediately.
How is it treated?
The goal of the following treatments is to control the virus, but it is important to understand that the underlying HPV infection cannot be cured. Like any type of viral infection, HPV remains in your body and can cause warts to appear in the future, particularly when your immune system is suppressed.
There are many ways to remove visible genital warts, depending on their size and location. A medical provider can remove the smaller warts by freezing them through cryotherapy, burning them with an acidic chemical or removing them with laser surgery. Cyrotherapy and acid treatments can be performed by medical providers at the Student Health Center and referrals will be given to women who need to be treated through laser surgery. All three procedures may require multiple follow-up visits or treatments. Some patients with HPV are also able to use a cream at home to help treat the warts.
If a woman has cervical dysplasia, the treatment depends on the severity of the diagnosis and the risk of sexual transmission. For less serious cell changes, a woman may be asked to repeat the Pap Smear test and to treat her cervix with an antibiotic cream. A medical provider might also choose to remove the affected cells with cryotherapy, laser surgery or electrocautery.
What about the HPV vaccine?
The HPV vaccine, Gardasil, helps protect against four major types of HPV: 6, 11, 16 and 18. This results in protection against two types of HPV that cause seventy percent of cervical cancer as well as two types that cause ninety percent of genital warts; however, the vaccine does not protect against all types of HPV that cause cervical cancers or genital warts. Thus, a woman who receives the vaccine should still receive routine cervical cancer screenings (PAP tests) and practice safer sex methods.
- Who should receive the vaccine?
- The vaccine is currently recommended for females ages nine to twenty-six years. Data is still being collected in regard to the vaccine's effect on women over twenty-six years of age as well as boys and men.
- Who should not receive the vaccine?
- If you are pregnant or have an allergy to baker's yeast, aluminum or a previous dose of HPV vaccine, you should not receive the vaccine.
- When should the vaccine be administered?
- Current recommendations state that the vaccine should be administered prior to the first sexual contact and possible exposure to HPV. The vaccine also is of benefit to women who are sexually active because they may not have yet been exposed to the types of HPV that the vaccine protects against.
- What side effects can occur?
- The most common side effects are usually mild and include pain, redness, or swelling at the injection site or fever.
- What does the vaccine not protect against?
- The vaccine does not protect against the other strains of HPV and it does not prevent other STIs. In addition, the vaccine does not treat existing HPV infections, genital warts, precancers and cancers and often is less effective in women who have been exposed to one of the types of HPV that the vaccine protects against. If you do receive the vaccine, you should still have regular cervical cancer screenings (PAP tests) and practice safer sex methods.
- How long does the vaccine last?
- Since the HPV vaccine has only been introduced in the past few months, the length of protection is unknown. Current research suggests that the HPV vaccine lasts for at least five years. More research will need to be done to find out how long the HPV vaccine's protection lasts and whether a booster shot may be needed.
- What is the vaccination process?
- The vaccine involves three doses: the first dose followed two months later with the second dose and six months later with the third dose.
- Are all three doses necessary?
- It is not known how much protection only one or two doses of the vaccine offers. Because of this, you should receive all three doses to receive the maximum benefit and protection.
- How much does the vaccine cost?
- At the Student Health Center, the vaccine costs $150 per dose.
- Will my insurance cover the cost of the vaccine?
- You will need to contact your health insurance provider to find out which vaccinations they cover. The Student Health Center does not accept private insurance, but they will give you a walkout statement that can be filed with your carrier.
- How do I schedule an appointment?
- Call the Nurse's Clinic at (512) 245-2167 to schedule an appointment.
- For more information, visit:
How do I cope with an HPV infection?
Once you have been treated for HPV, you should continue to have regular check-ups. If you have been recently diagnosed and treated, you will need more frequent exams to ensure that the warts have been removed. After a successful treatment, men and women should regularly examine their genitals for warts and have annual physical exams to check for any new warts or growths that are not readily visible. Women should also receive annual Pap smear tests to identify any cervical cell changes.
As with other viral infections, you are less likely to experience genital wart recurrences if you take care of your health. This means maintaining a strong immune system by eating right, exercising, getting enough sleep, managing your stress and avoiding alcohol, tobacco or other illegal drugs. Maintaining a healthy lifestyle will decrease the chances of recurrences and, with time, most people stop having any recurrences.
You can reduce your risk of transmitting HPV to a sexual partner by abstaining from sex, by finding other ways to express intimacy, by avoiding contact with any wart and by using condoms correctly and consistently every time you have sex. Like all safer sex methods, with the exception of abstinence, using condoms is not 100 percent safe. Genital warts that are not covered by a condom can still transmit the virus, but condoms continue to be a crucial step in minimizing the risk for people who remain sexually active after developing HPV.
Being diagnosed with HPV does not mean that you must abstain from sex permanently. It is important to communicate with your sex partners and to give them information about HPV so that you can make informed decisions about sexual activity. Telling a partner that you have HPV or any other type of STI can be difficult. Some partners may react by needing some time to think about how this affects your relationship. Others may have a lot of questions, want to get tested themselves or make the decision to stop having sex for a period of time.
It is completely normal to feel frustrated, depressed, angry or guilty about having HPV. Most people diagnosed with STIs experience the same emotions. By taking care of your health, practicing safer sex and informing your partners, you are taking all the necessary steps to minimize the risk of recurrences and of transmitting the virus to others. In addition, you ensure the emotional well-being of yourself, your partner and your relationship by staying in constant and open communication with each other.
Can HPV infections be dangerous?
While a small number of genital HPV strains are linked to cancers of the cervix, vulva, vagina, anus and penis, the strains of HPV that cause genital warts do not seem to be directly associated with the strains that cause cancer. However, since a person can acquire multiple strains of HPV, medical providers consider any case of genital warts to be an indication of potentially cancerous conditions.
Most people recover from HPV infections with no health problems at all. It is not known why some people develop long-term recurrent HPV infections, pre-cancerous abnormal cell changes or cervical cancer. The symptoms of most genital HPV infections abate within six months. Many people develop an immunity against different types of HPV.
If a pregnant woman has ever had HPV in the past, she may experience a rapid growth of genital warts during her pregnancy because of the change in her hormone levels. This condition must be monitored closely, especially during delivery, since she can transmit the virus to her infant. If necessary, the medical provider can remove the warts before the birth or perform a cesarean section if the warts are likely to bleed heavily.
When a person's immune system is weakened by diabetes, an organ transplant, Hodgkin's disease, HIV/AIDS or other serious health conditions, they might experience an increase in the number and size of genital warts or more frequent recurrences of the virus.
Links you can use
Health Education Resource Center (512) 245-2309
Walk-ins and appointments are welcome to obtain confidential answers to health questions. Located in suite 201 of the Student Health Center at the corner of Sessom and Tomas Rivera Drive.
Student Health Center (512) 245-2167
Located at the corner of Sessom and Tomas Rivera Drive.
Confidential information and care is available by appointment with a physician or nurse. There are no fees for medical care at the Student Health Center. However, there may be fees incurred if laboratory tests, medications, specialist or emergency hospital care is needed.
Planned Parenthood
CDC's National Center for HIV, STD and TB Prevention
STD Resource - A Guide to Sexually Transmitted Diseases
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Last Modified:
February 28, 2007
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