What is it?
Human Papillomavirus is one of the most common groups of viruses that are sexually transmitted.
How is it spread?
Over 130 different types of HPV have been identified on the skin or mucous membranes, like the hands,feet, throat etc. Over 40 of these different types of HPV can infect the skin or mucous membranes in the genital area. This includes the skin of the penis, vulva and anus and the mucous membranes of the cervix, vagina, and rectum. HPV is spread when the infected skin or mucous membranes from one person touches the skin or mucous membranes of another person. The two people do not actually need to have sex for this to happen, but if they do have sex, skin contact will occur even with condom use. A pregnant woman with genital HPV can pass it to her baby during a vaginal delivery. A person can be infected with many different types of HPV during their lifetime.
What are the symptoms?
Many people will have no symptoms. Some genital HPVs are “low risk” and may only cause the growth of genital warts. Genital warts appear as soft, moist, pink or flesh-coloured solid bumps that can be raised like “cauliflower” or flat, one or many, small or large. There can be bleeding, itchiness and discharge from the warts. Genital warts can disappear without treatment, but this will take time. Warts may appear within 1-8 months from the time the person became infected.
Some genital HPVs are “high risk”. Specific “high risk” types can cause changes to the cells of the cervix, and other types can cause changes to the cells of the skin, mouth/throat, anus, and penis, overtime. These changes can lead to cancer cells forming. You may not have symptoms caused by these changes for a long time. It can take up to 20 years from the time a female is infected with a “high risk”type of HPV before cancer of the cervix develops.
How can I get tested for HPV?
If you see or feel a bump, bumps, or raised areas on the skin anywhere where the “boxer shorts” cover,a doctor/nurse practitioner can look at the area and tell you if you have genital warts.
If you are female, cells of your cervix can be collected by a doctor/nurse and sent to the lab to see if there are any serious changes that could lead to cancer developing. This is called having a “Pap Test”. If other areas look to be infected, the doctor/nurse practitioner may order different tests to rule out cancer.
What can HPV do to the body?
The immune system may gradually clear the infection from the body. Often within two years, genital warts and abnormal cells of the cervix may disappear. Genital warts may grow back.If cancer develops, the immune system has not been able to clear the HPV. Approximately 400 women die each year in Canada from cancer of the cervix.
How is it treated?
If the warts are easy to reach, a medicated cream can be applied that will help the immune system work to make the warts shrink and go away. If there are many warts or they are hard to reach, a doctor can apply different medicated solutions, or use laser or surgical removal.
When a Pap test result indicates that changes have occurred to the cervical cells, often the woman will be asked to have another pap in six months, or she may be sent to a gynecologist for a colposcopy. During colposcopy, the doctor looks through a piece of equipment to make the cervixlookbigger. A solution can be put on the cervix to help the doctor find the abnormal cells. The doctorcan then remove a small sample and have it checked for cancer (biopsy). The abnormal cells of thecervix can be removed, and usually normal cells will grow back. Pap tests will be done more often to be sure the cells stay normal.
What about sexual partners?
It may be helpful to tell your sexual partner(s) so they can see their own doctor/nurse if they think they have genital warts or need a pap test done. You will not be asked by your doctor/nurse or Public Health staff who your past partners have been. Partners without genital warts or abnormal Pap test results do not need to be treated.
How can I lower my risk of getting HPV?
In Ontario, there are vaccines available to help protect against certain types of HPV. Talk to your health care provider or Public Health staff for more information. Once you become sexually active, have sex with as few people as possible. Always use a condom to protect against other STI transmission.
If female, have regular pap testing done starting at age 21, whether you received the HPV vaccine or not. Talk to your partner about sexually transmitted infections and how to protect each other.
References
- Public Health Agency of Canada, Canadian Guidelines on Sexually Transmitted Infections, 2008.
- The Society of Obstetricians and Gynaecologists of Canada, Your HPV Toolkit, January 2009.
