Human papillomavirus (HPV) is a very common sexually transmitted infection (STI) in the United States. Statistics show that more than 42 million Americans are infected with this virus, and there are 13 million new infections each year. Research indicates that over 80% of sexually active women and 90% of sexually active men may be infected with HPV at some point in their lives.
HPV comprises a variety of strains or types. Some strains can cause genital warts, while others are associated with specific types of cancer. However, there are also some strains that never produce any symptoms and disappear on their own, which means many infected people are unaware that they have been infected. Given this, vaccination and safe sexual behavior are crucial preventive measures against HPV.
There are 12 types of low-risk HPV. Low-risk HPV strains such as type 6 and type 11 can lead to the appearance of genital warts. Some other low-risk types may not cause any symptoms and can heal spontaneously within two years.
There are approximately 14 specific types of high-risk HPV, among which type 16 and type 18 are typical. They can cause various cancers, such as about 90% of cervical cancer, 60% of penile cancer, 90% of anal cancer, 70% of oropharyngeal cancer (cancer of the mouth and throat), 65% of vaginal cancer, and 50% of vulvar cancer.
More than 90% of HPV-infected people do not show any symptoms, and the infection will subside on its own after several years. If symptoms do appear, the most common one is genital warts, that is, lumps or growths in the genital area, the inner side of the thighs, the anus, the mouth, or the throat. If you have sexual intercourse with someone who has genital warts, the risk of getting genital warts will increase significantly. Data shows that 75% of people who have sexual intercourse with a partner with HPV-related genital warts will develop warts within 8 months. It should be noted that the number and size of some warts may increase, while some may gradually subside in the first few months after infection. However, most genital warts are likely to recur within a few months even after treatment.
HPV can enter the human body through any mucous membrane (the moist inner layer of the mouth, genitals, and anus). Vaginal or anal intercourse is the main route of transmission. In addition, oral sex and skin-to-skin contact (such as touching the vagina or anus with fingers) can also lead to infection. It is worth mentioning that the transmission of HPV does not require the exchange of body fluids between partners. The following situations will increase the risk of HPV infection: having new or multiple sexual partners, having sexual intercourse with someone who has multiple sexual partners, and having a weakened immune system.
If you notice genital warts, you should seek medical attention promptly. During the visit, the doctor will conduct a physical examination and carefully examine the genital area. Usually, HPV infection can be diagnosed simply through a physical examination. However, sometimes warts may be very small or difficult to detect. In such cases, the doctor may perform a Pap smear and collect liquid or tissue samples to send to the laboratory for testing. Female genital patients can undergo a Pap smear. Most doctors recommend that women between 30 and 65 years old have an HPV test and a Pap smear every three to five years. Although 90% of men will be infected with HPV at some stage in their lives, the infection usually subsides without symptoms. Currently, there is no routine testing or screening recommendation for male genitals. However, healthcare providers may recommend that men who engage in anal sex have an anal Pap smear.
Although there are treatment methods for the diseases caused by HPV, when it leads to genital warts or cancer, the virus itself cannot be cured. The main purpose of treatment is to reduce the number of warts and relieve the symptoms of HPV-related cancers. The specific treatment plan depends on the type of HPV infected and the severity of the disease.
The treatment of genital warts is mostly cosmetic, focusing on removing the wart tissue, but it cannot cure HPV. Moreover, most genital warts are prone to recurrence within three months after treatment. The common method for removing genital warts is to use topical (skin) medications that can be applied at home. These medications usually come in the form of gels or creams, such as Condylox (podofilox), Aldara (imiquimod), Veregen (sinecatechins), Absorbica or Myorisan (isotretinoin). Healthcare providers can also use one or more of the following treatment methods under general anesthesia (sedation) or local anesthesia (anesthetic): trichloroacetic acid (using a topical solution once a week), cauterization (using electricity to burn the warts), cryotherapy (using sub-freezing temperatures to remove the warts), surgery (using a scalpel, scissors, and scraper to remove the warts), laser vaporization (using light to heat the blood vessels and cut off the blood supply to the warts), photodynamic therapy (applying a photosensitive solution that reacts to light wavelengths to the affected area to shrink the warts).
If you are infected with an HPV strain that increases the risk of cervical cancer, your doctor will recommend some treatment methods to relieve the symptoms of cancer. These include: cone biopsy (removing a conical part of the cervix through cold knife conization or loop electrosurgical excision procedure), surgery (removing part or all of the female reproductive organs, including the cervix), lymph node dissection (removing and testing lymph nodes to determine whether the cancer has spread), radiation therapy (using high-energy radiation waves to kill cancer cells), systemic treatment (medications such as chemotherapy and targeted immunotherapy can help relieve symptoms and control cancer progression).
HPV can be prevented. There are mainly three preventive methods:
Vaccination: Immunization is the most effective way to prevent HPV infection. The HPV vaccine Gardasil-9 used in the United States can prevent the strains that cause 90% of genital warts and the strains that cause 70% of genital cancers. The Centers for Disease Control and Prevention (CDC) recommends vaccinating children before they become sexually active. Most providers recommend vaccination at around 11 years old. If not vaccinated in childhood, it can be supplemented in adulthood.
Limiting Sexual Partners: The probability of getting infected with HPV through unprotected sex with an infected person is as high as 70%. Maintaining a single sexual partner or reducing the number of sexual partners can reduce the risk of infection.
Practicing Safe Sex: Correctly using preventive devices such as condoms, finger cots, and dental dams (during each sexual intercourse) can effectively reduce the risk of HPV infection.
HPV is often accompanied by some complications:
Other Sexually Transmitted Infections: About 68% of women are infected with other sexually transmitted infections in addition to HPV. Other sexually transmitted infections can aggravate inflammation in the body, may exacerbate the damage caused by HPV, leading to more HPV-related disease outbreaks and faster cancer progression.
HIV: The HPV infection rate in the genitals of women infected with HIV is 2.5 times higher. The anal HPV infection rate in women infected with HIV and men who have sex with men and are infected with HIV is three times higher. People infected with HIV have more difficulty clearing the HPV virus, especially when not treated, because HIV weakens the immune system.
Cancer: About 17,600 women and 9,300 men in the United States are diagnosed with HPV-related cancers each year.
If vaccinated before sexual activity, HPV is highly preventable. At the same time, maintaining safe sexual behavior, reducing the number of sexual partners, and regularly screening for sexually transmitted infections are equally important for reducing the risk of HPV symptoms and related cancers. If already infected with HPV, it does not mean that sexual life must be completely avoided. However, you should be honest with your potential sexual partner about your condition so that the partner can get the appropriate vaccination and take preventive measures for safe sex.
Can HPV Survive on Bed Sheets?
HPV can survive on many surfaces including bed sheets for several days. Although there is a theoretical possibility of infection through bed sheets, the actual probability is extremely low because the virus must come into contact with human mucous membranes. Vaginal intercourse, anal intercourse, oral sex, and skin-to-skin contact are the common routes of transmission.
Can You Hug Someone Infected with HPV?
You can hug someone infected with HPV. However, it should be noted that if there is sexual skin contact, finger-genital contact, or oral sex, HPV infection is still possible. It is not only sexual intercourse that can cause infection.
Can Stress Cause an HPV Outbreak?
Yes. Research shows that multiple life stresses within a few months may trigger an HPV outbreak. Stress hormones can weaken the immune response and may reactivate dormant viruses, making it difficult for the body to resist the infection and its symptoms.
Should You Tell Others If You Are Infected with HPV?
If you have sexual intercourse with someone or plan to have it, you should tell the other person that your HPV test is positive so that both parties can discuss vaccination and safe sex. It should be clear that if one's HPV test is positive, it does not mean that he or she has had extramarital sex, because many people carry HPV for a long time without realizing it.
How Long Can the HPV Virus Survive Before a Positive Test?
It is possible to be infected with HPV for many years without any symptoms or health problems. For women between 30 and 65 years old, an HPV test should be done every five years. If suffering from cervical precancerous lesions or cancer, early diagnosis can lead to better treatment results.
