About 50% of Americans have been infected with HPV at some point, though most show no symptoms and the virus clears on its own. Persistent infections with high-risk HPV strains can cause cancers, affecting over 12,000 women with cervical cancer annually in the U.S. There are vaccines to help prevent infection from high-risk HPV strains. While there is no cure for HPV, regular screening can detect cellular changes early to prevent cancer if high-risk strains are present. Treatment options aim to remove visible warts and relieve symptoms, though the virus may still remain dormant in the body.

1. Chancesare youhave beenexposedtothe humanpapillomavirus(HPV) anddidn’tevenknow it.In
fact, itis estimatedthatatleast50 percentof the reproductive-agepopulationhasbeeninfected
withone or more typesof genital HPV,andan estimated6 millionnew infectionsoccureachyear.
As manyas 20 millionAmericansare infectedwiththe genitalformof the virus.
The good news:Inthe vast majorityof cases,the viruscausesno symptomsorhealthproblemsand
will goawayon itsown whena healthyimmunesystemclearsthe infection.The badnews:A
persistentinfectionwithhigh-riskstrainsof HPV occursin about5 percentof womenandcauses
nearlyall casesof cervical cancer, whichthe AmericanCancerSocietyestimatesaffectedan
estimated12,170 womenin2012, killingabout4,220.
HPV can alsoleadto anal cancer inboth menandwomen,a cancer thataffectsabout4,430 women
and 2,630 men peryearand causes550 deathsinwomenand330 inmen.Otherhealthproblems
can resultfromHPV infectionaswell,including:genitalwarts;recurrentrespiratorypapillomatosis
(RRP),a rare conditionwhere wartsgrow inthe throat;and otherlesscommonbutpotentially
seriouscancers,includingcancerof the vulva,vaginaandpenis,andoropharyngeal cancer,atype of
headand neckcancer that affectsthe backof the throat, base of the tongue and the tonsils.
In manyways,the issuesraisedbyinfectionwithhigh-riskstrainsof HPV are similartothose raised
by genital herpes.Bothoftenhave nosymptoms;bothcancause medical problemsinsome women;
and bothhave become widespreadinthiscountry.Like herpes,persistentHPV isincurable,though
some formsof HPV disappear,anditisnot yetknownwhethertheycompletelygoawayor merely
entera dormantstage,like herpes.Unlikeherpes,however,HPV cancause cancer.
There are more than 150 strainsof HPV and at least40 HPV typesthat can infectthe genital andanal
areas.The HPV familyof virusesiscalledpapillomavirusbecausetheytendtocause warts,or
papillomas—benign(noncancerous) tumors.Wartsmayappearon the handsand feetor onthe
genital andanal areas.The strainsof HPV that cause wartsto grow on handsand feet,however,are
rarelythe same type that causeswarts inthe genital andanal areas.
The U.S. Food andDrug Administration(FDA) hasapprovedtwoHPV vaccines,calledGardasil and
Ceravix,whichcanprotectwomenagainstthe HPV typesthatcause mostcervical cancers.Gardasil
alsoprotectswomenagainstvaginal andvulvarcancersand protectsbothmenand womenagainst
mostgenital wartsand anal cancers.(See Preventionsectionformore information.)
In additiontothe HPV vaccine,the Paptest andthe HPV testare importantscreeningteststo
preventcervical cancerinwomen.WhencombinedwithaPaptest inwomenage 30 and older,the

2. HPV test isbetterat identifyingwomenatriskfordevelopingcervical cancerthanthe Paptestalone.
(See Diagnosissectionformore information.) ThereisnoFDA-approvedHPV screeningtestformen.
Because of earlydetectionandtreatmentof cell changes,the numberof invasivecervical cancer
casesand deathsinthe UnitedStateshas steadilydecreasedoverthe pastseveral decades.The
cervical cancerdeathrate declinedby74 percentbetween1955 and1992, and the incidence of
cervical cancerdroppedsignificantlyby2.3percentperyear between1999 and 2008.
Conversely,the numberof newanal cancercaseshas beenincreasingforanumberof years,with
mostcases occurringin adults,withthe average age beinginthe early60s. Anal canceraffects
womenmore oftenthanmen.
How isHPV spread?
HPV is spreadbyskin-to-skincontactwithanHPV-infectedarea.Infectionscanbe subclinical,
meaningthe viruslivesinthe skinwithoutcausingsymptoms.Thisiswhymanypeople withHPV do
not knowtheyhave itor that theycouldspreadit.For a personexposedtoa partnerwhohas a low-
riskgenital wart-causingstrainof HPV suchas HPV 6 or 11, it usuallytakesaboutsix weeksto three
monthsfor genital wartstoappear.However,infectionswithhigh-riskstrainsof HPV cause no
symptomsandcan onlybe detectedonPapor HPV tests.
Researchersalreadyknowthatcondomsdon’talwaysprotectagainstthe virusbecause the viruscan
grow onareas of the genitalsnotcoveredbyalatex barrier.
Researchersdon’tknowwhetherpeopleinfectedwithgenital HPV butwhodon’thave symptoms
are as contagiousaspeople withsymptoms.Theyalsodon’tknow how muchHPV istransmitted
throughsexual contactversusskin-to-skincontact.
Diagnosis
Because humanpapillomavirus(HPV) infectionsoftencause nosymptomsinmenorwomenandare
hard to identify,youmustrelyonyourhealthcare professional fordiagnosis.

3. Genital wartscan be flesh-coloredandhiddeninsidethe cervix,vagina,penis,scrotumoranus.They
can be small orlarge,alone or inclusters,flatorround.They can spreadalongthe groinor thighor
be foundinthe mouth.
Genital wartscome in twoforms—growthsthatcanbe seenwiththe nakedeye andare onthe
surface of the skinandsmaller,lessvisiblegrowthscalledsquamousintraepithelial lesions(SILs)that
coverthe cervix andrequire aspecial instrument,calledacolposcope,tosee.
StudiesfindthatspecificHPV typesare responsible forthe developmentof genital warts,previously
knownas “condylomaacuminata.”EachHPV type hasbeennumberedanddividedinto“highrisk”or
“lowrisk”categoriesdependingonwhetherthe virusisassociatedwiththe developmentof cancer.
For example,HPV types6and11, whichare usuallyassociatedwithgenitalwarts,are considered
“lowrisk.”HPV types16, 18, 31, 33 and 45, foundon the genitalsandinthe anus,have beenlinked
to mostHPV-relatedcancersinbothmenandwomenandare therefore considered“highrisk.”
If you notice warts,see yourhealthcare professional.Youshouldalsoseekanexaminationif:
You see anyunusual growths,bumpsorskinchangeson or nearthe penis,vagina,vulvaoranus.
You experience unusual itching,painorbleedinginthe genital oranal area.
You have a sexual partnerwhotellsyouthathe or she has genital HPV or genital warts.
Duringyour examination,yourhealthcare professional mayuse acolposcope,alightedmagnifying
lens,tofindsmall wartsor abnormal areas.Your healthcare professional mayalsoapplyavinegar
solutiontothe genitals,whichcausesabnormal tissue toturnwhite.Thisdoesn’thurt,butitdoes
make it easiertosee wartsor precancerouslesions.
You may alsohave a Pap test,whichwasdesignedtoidentifycervical cancerinitsearlieststage but
can alsofindabnormal precancerouscellsandactive HPV infections.
The Pap testis a simple procedure.Inthe Paptest,ahealthcare professional usesa special brush
and/orspatulato collectcellsfromthe cervix andplacesthemona glassslide orin a liquid
preservative,whichissenttoa laboratoryforevaluation.

4. There isalso an anal Pap testthat ismuch like the Paptestfor cervical cancer.It involvesswabbing
the anal liningandlookingatthe swabbedcellsunderamicroscope.The anal Paptest isrelatively
newand hasn’tbeenstudiedwell enoughtodetermine when,how oftenandonwhomitshouldbe
performedorif itactuallyreducesrisk of anal cancer.Some expertsrecommenditbe done regularly
inmenwho have sex withmen.
There are differentclassificationsforabnormal resultsforthe cervical Paptest,butthe most
commonis calledatypical squamouscellsof undeterminedsignificance (ASCUS).
In conjunctionwiththe Paptest,whichscreensforabnormal cellsonce cell changeshave taken
place,there are alsoteststhat lookspecificallyforHPV.These testscandetectHPV infectionearly
on,before cell changeshave occurred.The mostcommontestlooksforDNA fromseveral high-risk
typesof HPV,but itdoesn’tindentifywhichtypesare present.AnothertestlooksspecificallyforDNA
fromHPV types16 and18, the HPV typesthatcause mostcancers associatedwithHPV.A thirdtest
can detectDNA from several high-riskHPV typesandcandistinguishwhetherHPV-16orHPV-18 is
present,anda fourthtestlooksforRNA fromthe most commontypesof high-riskHPV.
At thispoint,these HPV testsare FDA-approvedfortwoindicationsonly—forfollow-uptestingfor
womenwhose Paptestsreveal abnormal cellsandforcervical cancerscreeningincombinationwith
a Pap testin womenoverage 30.
There are currentlynorecommendedscreeningsorFDA-approvedteststhatdetectHPV infectionin
men,butresearchis continuing.
Alongwithmedical historyandevaluationof otherriskfactors,the HPV testhelpsphysicians
determine whatfollow-upmightbe necessaryif there isanabnormal resultfromaPap test.
Pap TestScreeningGuidelines
The AmericanCancerSociety(ACS),the AmericanCollege of ObstetriciansandGynecologists(ACOG)
and the U.S. Preventive ServicesTaskForce recommendthe followingguidelinesforPaptestsand
earlydetectionof cervical cancer:
All womenshouldbeginscreeningatage 21.

5. Womenages21 to 29 shouldhave a Pap testno more than once everythree yearstofive years.
Theyshouldnothave an HPV test unlessitisneededbecauseof anabnormal Paptestresult.
Womenages30 to 65 shouldhave botha Paptestand an HPV testeveryfive yearsora Paptest
alone everythree years.(The ACSandACOGrecommendthe twoteststogethereveryfive years;the
USPSTF recommendseitherschedule.The organizationsagree thata Paptestalone once everythree
yearsis acceptable if HPV testingisnotavailable.)
Womenoverage 65 whohave beenscreenedpreviouslywithnormal resultsandare notat highrisk
for cervical cancershouldstopgettingscreened.Womenwithcervical precancershouldcontinue to
be screened.
Womenwhohave had a total hysterectomy,withremovalof theiruterusandcervix,andhave no
historyof cervical canceror precancershouldnotbe screened.
Womenwhohave receivedthe HPV vaccine shouldstill follow the screeningguidelinesfortheirage
group.
Womenwhoare at highriskfor cervical cancermay needmore frequentscreening.Talktoyour
healthcare professional aboutwhat’srightforyou.
If your healthcare professional identifiesanyunusual cell changes,he orshe will recommendaplan
of action, dependingonthe resultandyourhealthhistory.Thatmayinclude awaitingperiod,a
repeatPaptest,a DNA-basedHPV test,acolposcopyora more thoroughexaminationandbiopsyof
the abnormal area.If the Pap revealsASCUSandthe HPV testispositive,acolposcopywillbe
required.Colposcopyalsoisneededif anyothermore seriouschangesare shownbythe Papresults.
Furtherscreeningandtreatmentswilldependonthe resultsof the colposcopy.Milddysplasia(CIN
1) shouldnotbe treated,butthe Papwill be repeatedinsix to12 months.ForCIN 2 or CIN 3, further
treatmentisneededtoremove the abnormal cells.
RegularPaptestsare equallyimportantforlesbiansandbisexual womenwho,studiesfind,maybe
lesslikelytoseekroutine healthcare because of the discomforttheyfeel discussingorrevealing
theirsexual orientationtohealthcare professionals.Theyalsomaynotwantto be screenedbecause
theyfeel thattheyare not at risk.Lesbianandbisexual womenare alsoat riskforHPV infectionand
cervical cancer(for example,throughpriormale partners,vibratorsandothersexualaidsorskin-to-
skincontact withan infectedpartner).
Treatment
There isno cure forHPV,but there are treatmentsforgenital warts.Inaddition,youngwomenmay
be vaccinatedagainstfourcommonstrainsof HPV,as well asthe typesthat cause mostHPV-related
cervical cancers.(See Preventionsectionfordetails.)Forwomenover26, the bestdefense against
HPV is to learnas muchas possible aboutthe disease totryto minimizeyourrisk.Usingcondoms,

6. limitingyournumberof sexual contactsandcontinuingtohave regularPaptestsare importantsteps
to reducingrisk.
Most people withHPV infectionsdon’trequire treatment.Yourbody’simmune systemsimplygets
rid of the viruson itsown.Onlya small portionof womendevelopproblems,rangingfromwartsto
cervical cancer,that require treatment.
Most genital wartsare treatedbecause youmaynotlike the waytheylookor because of
symptoms—notbecausetreatmentpreventsthemfromreformingorfromyoutransmittingthe
infectiontosomeone else.Infact,genital wartrecurrence iscommon,especiallywithinthe first
three months.Studiesalsofindthatsmall wartsof shortduration(lessthanone year) respond
betterto therapythanlarge warts of longduration.All warttreatmentsmaycause mildlocal
irritation.
Expertsreviewingcurrentgenitalwarttreatmentpracticesfindthatnosingle treatmentisideal for
all women.Theyrecommendthatyoube involvedinmakinganytreatmentdecisionswithyour
healthcare professional.Soit’simportantthatyouunderstandyouroptions.
You may notevenneedtreatment.There isnotreatmentavailableforsubclinical genital HPV
infection(i.e.,novisiblewartsdiagnosedbycolposcopy,biopsy,aceticacidapplicationorHPV
laboratorytests).That’sbecause there’snocertainwaytodiagnosissubclinical genitalHPV infection
and no effective therapy.The infectionwiththese low-riskstrainswill eventually goawayon itsown.
In the past,treatmentsforgenital wartswere administeredbyhealthcare professionalsandoften
causedmore damage than the disease itself.Traditional treatmentsrangedfromcryotherapy,which
froze the warts withliquidnitrogen, toelectrocautery,whichburnedoff the warts.Today,there are
a wide varietyof treatmentsthatcan be administeredbyyouoryour healthcare professional.
The goal of treatmentshouldbe toremove visiblegenital wartsandrelieve annoyingsymptoms.No
available treatmentisanybetterthananother,andno single treatmentisidealforall cases.Thus,
the CDC has developedthe followingguidelines:
Self-appliedtreatments:

7. Podofilox(Condylox).This0.5 or 0.15 percentsolutionorgel isa relativelycheap,safe,easy-to-use
treatment.Itisapplieddirectlytothe wartseverydayforthree weeksortwice a day forthree days,
followedbyfourdaysof notherapy,fora total of three to fourweeks.Wartsmay returnafter
treatment.
Imiquimod(Aldara).This5percentcreamisusedto treat external genital wartsandperianal warts,
whichappeararoundthe anus.It issafe,effective andeasytouse.The cream worksbystimulating
the immune systemtotargetthe warts.Applythree timesaweekatbedtime forupto 16 weeks.
Warts may recur aftertreatment.
Sinecatechin(Veregen).Thisisa5 percentointmentmade fromagreenteaextract.The active
ingredientsinsinecatechinare componentsingreenteacalledcatechins.Applythe ointmentthree
timesa dayuntil the warts disappear.
People toleratethese threetherapiesdifferently,sopodofiloxmayworkbetterforyouwhile
imiquimodorsinecatechinworksbetterforsomeone else.Discusswithyourdoctorwhichtherapy
youshouldtry.Side effectsof all three drugsmayinclude tenderness,irritationandlocalized
burning.None hasbeendeemedsafe touse duringpregnancy.
Treatmentsappliedbyhealthcare professionals:
Cryotherapy(freezingoff the wartwithliquidnitrogen).Thistreatmentisrelativelyinexpensive.Itis
usuallyperformedwithoutananesthesia,andyoumayexperience some discomfort.Youmay
require several treatmentsaweekforuptosix weekstoremove all warts.
Podophyllinresin10 percentto25 percent.Thissolutionisapplied once aweek,typicallyforupto
fourweeksandmustbe washedoff withinone tofourhoursafterapplicationtoreduce local
irritation.Itismore likelytocause side effectsthanthe less-toxic,over-the-counterpodofilox.
There’snoevidence thatit’ssafe foruse duringpregnancy.
Trichloraceticacid(TCA) (10-25 percent) or bichloraceticacid(BCA) (80-90percent).These are two
otherchemicalsthatare appliedtothe surface of the wart once a weekforupto fourconsecutive
weeks.These chemicals are strongerformsof the over-the-counteracidsusedtoremove external
warts.Because the procedure can be painful,mosthealthcare professionalsuse atopical
anesthetic.
Laser therapy(usinganintense lighttodestroythe warts) or surgery(cuttingoff the warts) getsrid
of wartsin a single officevisit.However,treatmentcanbe expensive andthe healthcare provider
mustbe well trainedinthese methods.A local orgeneral anestheticmaybe used.If notperformed
correctly,lasertherapycancause burningandscarring.
Because HPV isa virus,yourimmune systemplaysarole inwhetheryourwartsreturnor not.The
virustravelstoa deeperlevel of tissuewhere itcanremainindefinitely.Youshouldwatchfor
recurrences,whichoccurmostfrequentlyduringthe firstthree monthsaftertreatment.

8. Eatinga balanceddiet,exercisingregularlyandavoidingillegal drugs,tobaccoandalcohol are simple
waysto helpmaintainastrong immune system.
Prevention
At least50 percentof sexuallyactiveadultsbythe time theyreachage 50 will have acquiredan
infectionwithone of the genital HPV strainsatsome point.
The U.S. Food andDrug Administration(FDA) hasapprovedtwoHPV vaccines,calledGardasil and
Ceravix,whichcanprotectwomenagainstthe HPV typesthatcause mostcervical cancers.Gardasil
alsoprotectsagainstmost strainsof genital warts,aswell asanal,vaginal andvulvarcancers.
Vaccinationshouldbe givenbefore aninfectionoccurs,ideally,beforeagirl becomessexuallyactive.
The vaccinesare giveninthree doses,anditisimportantforfemalestogetall three dosesforthe
bestprotection.Eithervaccine isrecommendedforgirlsages11 and12, as well asfor femalesages
13 to 26 who didnotreceive anyor all of the shots whentheywere younger.The vaccinescanalso
be givento girlsasyoungas age nine.
Gardasil alsoprotectsmalesagainstmostgenital wartsandanal cancers.Therefore,itis
recommendedfor11- and 12-year-oldboysandmalesages13 through26 whodid notget anyor all
of the shotswhentheywere younger.
It’simportantto note that vaccinationdoesn’tprotectagainstall HPV strains.Therefore,continued
lifelongscreeningwithPaptestsandthe HPV testif appropriate isnecessary.The vaccinesare not
effectiveforaparticularstrainof the virusif a womanisalreadyinfectedwiththisHPV type.Forthis
reason,vaccinatingbefore awomanissexuallyactiveandexposedtothe virusisoptimal toprovide
the greatestprotection.
Womenage 30 andolderwhotestpositive forHPV are more likelytohave a persistentinfection
that wasnot clearedbythe immune system.AndonlywomenwithpersistentinfectionswithHPV
are at riskfor developingcellularchangesthatcan leadtocervical cancer. Therefore,when
combinedwithaPap testinwomen30 andolder,the HPV testis betterat identifyingwomenatrisk
for developingcervical cancerthanthe Pap testalone.Inaddition,fourtestshave beenapprovedby
the FDA to lookforhigh-riskstrainsof HPV.(See DiagnosissectionforguidelinesonPaptestsand
HPV tests.)

9. Healthexpertsadvise womentouse one ormore of the followingoptionstoreduce contactwiththe
virus,whichistransmittedviaskin-to-skincontact:
Use condomswheneveryouare intimate withanew orcasual sexual partner.Latex condoms,when
usedcorrectlyandconsistentlyfromstartto finisheachtime youhave sex,canprovide some
protectionif theycoverthe areaof HPV infection.Note,however,thatwhilecondomuse will
decrease the riskof HPV infection,itcan’tpreventitentirelybecause HPV caninfectcellsanywhere
on the skininthe genital area.
Be aware that spermicidal foams,creamsorjelliesare noteffective againstanysexuallytransmitted
disease (STD),includingHPV.The FDA has advisedconsumersthatusingvaginal contraceptives
containingnonoxynol-9canincrease vaginal irritation,whichmayincrease the riskof infection.
If you’re havingoral sex,use a dental dam, plasticwrapor a splitandflattenedunlubricated
condom.These materialsprovideamoisture barrierbetweenthe mouthandthe vaginaoranus
duringoral sex.Avoidbrushingorflossingyourteethrightbefore havingoral sex,whichmaytear
the liningof yourmouth,increasingyourexposuretoviruses.
Be careful aboutsharingsexual toys.It’spossible thatHPV couldbe transmittedviasexual toysthat
are insertedinthe vaginabutaren’tthoroughlycleanedbeforebeingusedonyourpartner.
Facts to Know
If you have HPV,youare not alone.It isestimatedthatas manyas 50 percentof the reproductive-
age populationhasbeeninfectedwithone ormore typesof sexuallytransmittedhuman
papillomavirus(HPV),andanestimated6millionnew infectionsoccureachyear.
Most HPV infectionshave no symptomsandare hard to identify.Wartsare causedby low-risk
strainsof the virusandcan be flesh-coloredandhiddeninside the cervix,vaginaoranus.Theycan
be small or large,alone orin clusters,flatorround.Theycan spreadalongthe groinor thighor be
foundinthe mouth.High- riskcancer-causingstrainsof HPV cause no symptomsandare detectedby
an abnormal Paptest or the HPV test.
HPV infectionisadirectcause of cervical cancer.Cervical cancerwas once one of the mostcommon
causesof cancerdeathfor Americanwomenbutisnow one of the mostpreventable,withfatality
ratesdroppingbecause of earlydetectionandtreatment.
In additiontocervical cancer,otherhealthproblemscanresultfromHPV infectionaswell,including
recurrentrespiratorypapillomatosis(RRP),arare conditionwhere wartsgrow inthe throat, and
otherlesscommonbutpotentiallyseriouscancers,includingcancerof the vulva,vagina,anusand
penis,andoropharyngeal cancer,atype of headand neckcancer that affectsthe back of the throat,
base of the tongue andthe tonsils.
In the vast majorityof cases,the body’simmune systemclearsthe infectionwithintwoyears.
Because the virustravelstolower-level tissueswhere itmayremainindefinitely,researchersdon’t

10. knowif the virusis completelyeliminatedorjustsuppressedtosucha low level thatit’shardto
detectwithroutine screening.However,womenwhotestnegative forthe high-riskstrainsof HPV
usingthe HPV test have almostnochance of developingseriouscell changesinthe nearfuture.This
can provide tremendouspeace of mind.
Womenwhoare 30 and olderwhohave persistentHPV infectionare more likelytohave the cancer-
causing,or high-risk,typesof HPV,andif theytestpositive forHPV twotimesina row,will require
furthertestingevenif theirPaptestisnormal.
In conjunctionwiththe Paptest,the HPV testcan be usedin womenage 30 andolderto helpdetect
HPV infection.WhencombinedwithaPaptestinwomenof thisage group, the HPV testisbetterat
identifyingwomenatriskfordevelopingcervical cancerthanthe Paptestalone.
It isimportantthat youwork withyourhealthcare professional todeterminewhichHPV treatment
(whetherforlow-riskHPV causinggenital wartsorforhigh-riskHPV causingdysplasia) ismost
appropriate foryou.
Because HPV isso common,and itis impossible todetermine whensomeone wasinfected,notifying
a partner of a prior HPV infectionisnotconsideredmandatory.A patientwithanactive infection
withgenital warts,however,shoulduse protectionandnotifyapartner,whomaychoose toforego
sex because the condomisn’tcompletelyprotective,andthe genital wartvirusishighlyinfectious.
Genital wartsare uncommoninchildren.Whenthey occur,theyare mostoftenthe resultof sexual
abuse.
KeyQ&A
How can I tell if I’minfectedwithhumanpapillomavirus(HPV)if Idon’thave genital warts?If youor
your partnerdo nothave warts,it isvirtuallyimpossible foryoutodetermine whether youhave
HPV.An estimated20millionAmericansare infectedwiththe virus,butmanypeopleare unaware
theyhave it.Occasionally,peoplemaynotice itchingorskinchanges,butmore oftenHPV isa silent
infection.Forthisreason,womenare stronglyencouragedtosee theirhealthcare professional for
regularpelvicexaminationsandPaptests.Menshouldalsosee theirhealthcare professionalto
learnas much as possible aboutthisdisease.Because HPV canbe a predictorof the presence or
future developmentof cervical cancer,manymedical professionalsnow alsotestforthe virusas an
adjunctto the Pap test.There are nowfourtestsavailable thatlookforhigh-riskHPV typesthatcan
leadto cervical cancer.These testscan detectHPV infectionearly on,before cellchangeshave
occurred.
Can I getHPV fromsomeone performingoral sex onme?Yes.HPV isspreadbyskin-to-skincontact,
primarilyduringsexualrelations,evenif awartis notvisible.HPV infectionsare mostcommonly
foundinthe genital area,anusand mouth.Anincreasingnumberof oral andtonsillarcancersare
causedby high-riskstrainsof HPV thoughttobe relatedtoan increase inoral sex.
If I have a wart removed,will itcome back?Because HPV isavirus,yourimmune systemplays arole
inwhetheryourwartsrecur. In some casestheydoreturn;however,inthe majorityof cases,the

11. infectionclearswithintwoyears.However,becausethe virushidesinlower-level tissue,itis
impossible toknowif the virusiscompletelyeliminatedorjustsuppressedtosucha low level that
it’shard to detect.
If I use a condom,can I still get(orspread) HPV?Yes.Unfortunately,condomsdonotprovide
complete protectionagainstHPV because theydonotcoverall the possible infectionsites,which
include the genital area,anusandmouth.Thisdoesnotmeanyou shouldnotuse them.While
condomsare notfoolproof,theyprovidethe bestavailable protection,especiallyforthose whohave
several sexual partners.Studieshave shownthatcondomsdo reduce the riskof HPV infectionsbut
are notcompletelyprotective.
If I have HPV,doesthatmeanI am at riskforother sexuallytransmittedinfectionsorcervical
cancer?Yes.HavingHPV increasesthe likelihoodthatawomanmay have othersexually transmitted
diseasesorcervical cancer.Althoughonlycertaintypesof HPV cause cervical cancer,itisimportant
that womenof all ageshave a regulargynecologicexamandall the recommendedscreeningtests
includingtestingforotherSTDsincludingchlamydia,gonorrheaandHIV,if necessary.Talkwithyour
healthcare professional abouthowoftenyoushouldbe tested.
How doesHPV affectmyfertility?HPV isnotlike othersexuallytransmitteddiseases(suchas
chlamydia) thatcan affectyourfertility. Of greaterconcernisthat a high-riskHPV straincanleadto
cervical cancer.In addition,certainHPV treatmentsmaycause scarringordamage the cervix (such
as LEEP or cone biopsy),whichmayimpairfertilityorimpacta pregnancy(suchas increasedriskof
premature delivery),soitisimportanttodiscussthe optionswithyourhealthcare professional.
What isthe besttreatmentforHPV?Thiswill dependonwhetheryouhave strainsthatcause genital
warts or dysplasia.There isnoone treatmentthatall HPV patientsshouldreceive.Eachcase is
different,andyoushouldworkwithyourhealthcare professional tochoose the one thatbestfits
your needs.A wide varietyof treatmentshave beendevelopedfortreatinggenital warts.Inmost
cases,treatmentwill require repeatapplications.
If my partneris diagnosedwithHPV,doesthatmeanhe orshe hascheatedon me?HPV isa groupof
more than 150 viruses,40of whichcan infectthe genital area.HPV cantake weeks,monthsoryears
to produce symptoms(if theyappearatall).If yourpartneris diagnosedwithHPV,itdoesnot
automaticallymeanthere hasbeenrecentinfidelity.The mostimportantthingyouandyourpartner
can do isto learnas much as possible aboutthisdisease.Itisestimatedthatasmany as 75 percent
of reproductive-agemenandwomenhave beeninfectedwithone ormore typesof HPV at some
point,andmost don’tknowitbecause notall virusesproduce warts.Furthermore,the immune
systemnaturallyfightsoff the virusandevidence of the virusgoesawayinone totwo years.