HPV: The Most Common Sexually Transmitted Infection

HPV is the most common sexually transmitted infection in the world. The CDC estimates that virtually all sexually active adults will acquire it at some point. Most infections clear without treatment and without symptoms. But some persist, and persistent high-risk HPV causes cancers that are largely preventable with vaccination and screening.

• Over 200 HPV strains exist — around 40 affect the genital area, of which approximately 12 are high-risk for cancer

• Around 90% of HPV infections clear spontaneously within 1–2 years without treatment

• High-risk strains (types 16 and 18) cause approximately 70% of cervical cancers

• Low-risk strains (types 6 and 11) cause approximately 90% of genital warts

• Gardasil 9 prevents infection with nine strains responsible for most HPV-related disease

How HPV Spreads

HPV spreads through direct skin-to-skin contact — not through blood or bodily fluids. It transmits through vaginal, anal, and oral sexual contact, including from areas of skin not covered by a condom. This is why condoms reduce but cannot eliminate HPV transmission risk. HPV is highly infectious: the majority of newly sexually active people acquire their first infection within 2–3 years of sexual debut.

Low-Risk Strains and Genital Warts

HPV types 6 and 11 cause approximately 90% of genital warts — flesh-coloured raised or flat growths on the genitals, anus, thighs, or groin. They are not cancerous. They can be treated with topical agents (imiquimod, podophyllotoxin), cryotherapy, laser, or excision. Treatment removes visible warts but does not eliminate the underlying viral infection, and warts can recur.

High-Risk Strains and Cancer

High-risk HPV strains — principally types 16, 18, 31, 33, 45, 52, and 58 — can cause pre-cancerous changes in infected cells. The immune system clears these infections in the vast majority of cases. But when infection persists over years, pre-cancerous lesions can develop and progress to cancer without detection and treatment. HPV causes virtually all cervical cancers, approximately 90% of anal cancers, 70% of oropharyngeal cancers, and significant proportions of vulval, vaginal, and penile cancers.

Symptoms and Detection

High-risk HPV infection almost never causes symptoms. This is why cervical screening exists — to detect pre-cancerous cervical changes that are invisible and asymptomatic. There is no general HPV test to check whether you have the virus. HPV co-testing is performed as part of cervical screening for women over 30. There is no approved HPV test for men or for oral HPV outside clinical research.

Vaccination

Gardasil 9 protects against nine strains: types 6, 11, 16, 18, 31, 33, 45, 52, and 58. The CDC recommends routine vaccination at age 11–12, catch-up through age 26, and vaccination up to age 45 after individual risk discussion. Countries with high adolescent vaccination coverage have seen dramatic reductions in HPV infection rates and cervical cancer.

Tips

• Get vaccinated if you haven't been — even if sexually active, you are very unlikely to have been exposed to all nine Gardasil 9 strains.

• Keep up with cervical screening — vaccination does not replace screening.

• Do not smoke — smoking is the most modifiable risk factor for HPV persistence and cancer progression.

• Use condoms consistently — they reduce but cannot eliminate HPV transmission risk.

Frequently Asked Questions

If HPV is so common, why does it matter?

Because the minority of cases that do not clear spontaneously can progress to cancer over years without causing symptoms. Cervical cancer kills around 300,000 women annually worldwide — a number that is preventable with vaccination and screening.

Can I give HPV to my long-term partner?

If you have been in a monogamous relationship for years, both partners have almost certainly shared the same HPV exposures. A positive HPV test does not indicate infidelity — HPV can remain dormant for years.

Is there any treatment for HPV itself?

No antiviral treatment clears the HPV virus. Treatment addresses the consequences: warts are removed, pre-cancerous cervical changes are treated with excision or ablation. The immune system remains the primary clearance mechanism.

Can men be tested for HPV?

There is no approved HPV test for men in routine clinical use. Genital warts are diagnosed visually. Anal HPV testing is available in some clinics and recommended for MSM with HIV given elevated anal cancer risk.

Get Tested and Vaccinated

Confidential sexual health testing is available in Los Angeles, New York City, Houston, Seattle, and Phoenix.

Related: HPV and Cancer · Asymptomatic STDs · How Often Should You Get Tested? · STD Testing: What You Need to Know · Get tested today →