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What is HPV?
HPV (Human Papilloma Virus) is a virus that can cause genital warts and certain cancers. There are many types of HPV that affect different parts of the body and some of them can infect the genital area.
Anyone who has ever had any form of sexual contact can have HPV.
HPV is so common that four out of five people who have been sexually active will have had HPV at some time in their lives.
How do I know if I have HPV?
Most people will not know they have HPV because it can stay inactive inside the body and never cause visible signs.
There are types of HPV that cause warts, these warts are a visible HPV episode. They appear as solid lumps and may be itchy. They can appear on the penis, vulva, anus or other area of genital contact.
HPV can be detected with a cervical screening test, even when there are no symptoms. The types of HPV detected by this test are not the same as the types of HPV that cause visible genital warts.
In most cases, a HPV infection is cleared by your immune system in around one to two years, but for some people it may remain active longer. Smoking can reduce the body’s ability to clear HPV infection.
How do I get HPV?
HPV is spread through skin-to-skin contact. This can include direct genital contact, finger penetration, oral sex, cuts and tears, and through sharing sex toys. The virus passes through tiny breaks in the skin.
The virus may be present without visible warts for years. A new episode of warts may indicate a reactivation of the virus rather than recent exposure. Use of steroid creams on the genitals can cause HPV to reactivate and cause warts. Sometimes being run down or stessed can cause HPV to reactivate, this includes medical treatments that reduce immunity.
HPV may also reactivate in the cervix and appear on a cervical screening test even if previous tests have been negative.
Using condoms with a new sexual partner helps to protect against sexually transmitted infections (STIs) and may help to decrease the risk of getting HPV. Condoms don’t provide total protection because they don’t cover all of the genital skin and the HPV infection is often invisible. If a person has visible warts then it’s a good idea to avoid wart-to-skin contact to decrease the risk of spreading the infection.
Who can get HPV?
Anyone who has had any form of sexual contact can get HPV, regardless of sexual orientation or gender identity.
What are the treatment options for genital warts?
Many people with genital warts will find that the warts will disappear by themselves within one to two years.
However, some people prefer to have them treated. There is a variety of methods available. If the method you are using is not working it’s important to discuss this with a health worker.
Treatments include:
- Wart cream/paint (Podophyllotoxin): This cream/paint is available on prescription. This can be applied by the person with the warts or by a health worker. If warts remain after 4–5 weeks of treatment, you should also be reviewed by a health worker. Do not use this cream during pregnancy/breastfeeding.
- Wart cream (Imiquimod): This cream is available on prescription. Do not use during pregnancy/breastfeeding.
- Freezing (Cryotherapy): This method involves frozen gas or dry ice applied to the warts by a health worker. It may cause some discomfort and may require several treatments. Freezing is available at SHINE SA clinics.
- Laser therapy, or electrosurgery: These types of treatments require referral and admission to hospital for anaesthesia and surgery.
HPV and cancer
There are types of HPV infection that, for a small number of people, can stay in the cells of their cervix. If the HPV is not cleared, the virus can cause cell changes that may lead to cervical cancer. This will usually take a long time—more than 10 years. Most people who have HPV clear the virus naturally and DO NOT develop cervical cancer.
Only a few of the many genital HPV types increase someone’s chance of having cancer.
A cervical screening test can detect the HPV that causes cervical cancer. Cervical screening begins at age 25 and ends between the age of 69 to 74.
If ‘higher risk’ HPV is detected, more frequent testing may be recommended. If you don’t have HPV the cervical screening test is every 5 years even if you have been vaccinated.
You can have a cervical screening test earlier than 25 if you have been sexually active before you were vaccinated or if you have any symptoms such as unusual bleeding.
If you have a health condition that reduces your immunity you should have a cervical screening test every 3 years.
Cervical screening may invole a health professional examination, however there is also an option of doing a swab yourself (this is called self-collection).
The types of HPV that can cause cervical cancer can also cause cancers of the mouth, throat, vulva, penis and anus. These are different to the HPV that causes genital warts, and having warts does not increase your risk of cancer.
Anal cancer is more common in people who participate in receptive anal sex (is the receiving partner). People living with HIV are at higher risk of HPV related cancer.
Smoking can increase your risk of developing cancer with HPV exposure.
Can HPV infection be prevented?
There is a vaccine available that can prevent infection from certain types of HPV. The vaccine is given as an injection.
Who should be vaccinated?
HPV vaccination is recommended for anyone who wants to protect themselves against HPV. It’s recommended for young people (around age 10–15 years) because the best time to have the vaccination is before a person is exposed to HPV, which means before their first sexual contact.
The Gardasil 9 vaccination is available as a school-based immunisation program and protects against 9 strains of HPV. There is free catch up program through doctors, chemists or local immunisation clinics for those aged 12-25 who have missed out on vaccination. The vaccine is also available as a private prescription.
People who have already had sex can still have the vaccine, and if they have not yet been exposed to the types of HPV covered by the vaccine then the vaccine will be fully effective. Even if they have been exposed to one or more of the strains in the vaccine they will still receive protection against the remaining strains.
The vaccine does not help clear or cure pre-existing HPV infection.
People living with HIV who are having anal sex are at increased risk of developing anal cancer with HPV exposure and should consider vaccination.
Do I need cervical screening if I’ve had the HPV vaccination?
Yes. Although vaccinations will protect against most types of HPV that cause cervical cancer, there is a small risk that you could get cervical cancer from other HPV types.
Regular cervical screening is still important for preventing cervical cancer. You can now have a cervical screening test with a self-collected swab or your health professional can do the test.
If you have symptoms, such as irregular bleeding or bleeding after sex, it’s a good idea to see a health professional for a check up even if you are not due for a cervical screening test.
More information
SHINE SA Sexual Healthline
Tel: 13000 883 793
Adelaide Sexual Health Centre
www.sahealth.sa.gov.au/adelaidesexualhealthcentre
Wellbeing SA Cervical Screening Program
www.wellbeingsa.sa.gov.au/cervicalscreening
Reviewed September 2023
