The Basics and Beyond: Human Papillomavirus (HPV)

Updated August 23, 2022.

A quick web search for HPV yields millions of results — with all kinds of information, much of which is medically inaccurate. Whether you’ve been recently diagnosed or are simply looking to understand more about the most common sexually transmitted infection, this article is intended to bring you some peace of mind, with answers to some of the most frequently asked questions about human papillomavirus (HPV).

HPV is a virus that is often – although not always – sexually transmitted. HPV encompasses more than a hundred different strains. Just like any diverse family, every strain is different. Some strains cause warts on the hands, feet (plantar warts), or genitals. Although warts are pesky, they’re rarely harmful and are easily treated. Other strains of HPV can cause changes to cells, which can lead to certain cancers, such as cervical, throat, anal, and penile cancers.

The figures are staggering. According to the Centers for Disease Control and Prevention (CDC), more than 42 million Americans have the virus, and there are approximately 13 million new HPV infections each year. In fact, HPV is so common that experts say nearly all sexually active individuals will get at least one strain of the virus at some point during their lives.

Luckily, 90 percent of HPV infections are transient, meaning most clear on their own in about two years without any treatment. It’s very possible to have had – and have cleared – an infection without ever knowing you were infected in the first place.

HPV is most commonly transmitted from skin-to-skin contact. That means certain strains can also be transmitted sexually. It affects all individuals of all sexual orientations. Because HPV is passed so easily just from skin-to-skin contact, condoms help, but they’re not foolproof. And it’s not passed just through genital-to-genital contact, either. Fingers and toys can also pass the virus to a partner.

Most strains of HPV are asymptomatic, meaning you won’t notice any signs that you have the virus. If you have symptoms, they will usually develop between a few weeks and several months after you’ve been exposed. Some viral strains cause warts, which appear as cauliflower-like lesions on the skin or in the genital regions. Other strains may not cause warts at all, but can cause cancers. Fortunately, these strains can be identified via cervical cancer screening, which is why testing is so important.

For individuals with a cervix, HPV testing may be performed during a cervical cancer screening. At One Medical, we believe the decision to start screening for cervical cancer and testing for HPV should be tailored to your unique health needs. We encourage you to have a discussion about when to start screening for cervical cancer at age 21. Because most individuals with a cervix younger than 25 clear HPV infections and changes to cervical cells so quickly, we do not recommend screening for HPV before age 25. For individuals at average risk between the ages of 25 and 65, we recommend screening for cervical cancer with HPV testing every five years. There are no guidelines for HPV testing outside of cervical cancer screening at this time, but other individuals may still benefit from the HPV vaccine or other routine screenings, we recommend discussing this with your provider.

Even though HPV is extremely common, it can still be a shock to get a diagnosis. If you are 25 or older and discover that you have HPV but no cervical cell changes on your cervical cancer screening test, you can just watch, wait, and keep your immune system healthy. Keep in mind that most people with healthy immune systems will clear the virus on their own with no treatment. The best thing you can do is to avoid smoking. Smoking greatly decreases your ability to clear the virus. You should also get plenty of rest and manage your stress levels.

If a recent screening shows that you have cervical cell changes and one of the high-risk strains of HPV, or you have an HPV infection that has not resolved on its own, your follow-up may be slightly different. Again, this is very common. Since cervical cancer screening is just that, screening, and not a diagnostic test, your provider may recommend an examination of the cervix with a special microscope called a colposcope in order to determine whether there are any abnormal changes to the cells. If there are, your provider may take a freckle-sized sample of your cervical cells and send them to a pathologist for more information. This procedure may involve light cramping, but it won’t have any effect on your fertility or ability to have a healthy pregnancy in the future.

The HPV vaccine, also known as Gardasil, protects against the nine most common strains of HPV. It includes coverage for two of the most common strains that cause genital warts (types 6 and 11) and two of the more serious strains that cause cervical cancer (types 16 and 18). The HPV vaccine is highly effective in preventing cervical cancers–but it doesn’t protect against all strains of the virus.

The CDC strongly recommends vaccination for everyone ages 9 to 26.

The Gardasil vaccine is typically covered by insurance in these age groups, but check with your insurance company if you have questions.

Additionally, some adults ages 27 through 45 years may decide to get the HPV vaccine after discussing the potential benefits with their provider. Insurance coverage in this age group is more variable and we recommend checking with your insurance company regarding your benefits.

Anyone who is allergic to the ingredients of Gardasil, including those who are severely allergic to yeast, should not receive the vaccine. Gardasil is not for individuals who are pregnant. The vaccine is most protective in people who have never had sexual intercourse.

The vaccine is strictly preventive; it doesn’t treat or cure existing HPV, cervical cell changes, or genital warts.