Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. HPV is spread through skin-to-skin sexual contact and can infect both men and women. There are over 100 different types of HPV, with around 40 types that can infect the genital areas. HPV is so common that nearly all sexually active adults will get it at some point in their lives. However, most people never know they have HPV because they do not develop symptoms. HPV infections often clear up on their own without causing problems. But sometimes HPV infections persist and can lead to health issues like genital warts and cancer.
What percentage of sexually active men have HPV?
Studies estimate that between 45-73% of sexually active men in the United States have some type of genital HPV infection. However, many of these infections show no symptoms and clear up on their own. At any given point in time, around 25% of men have an active genital HPV infection that could be transmitted to partners through sexual contact.
HPV is very common among young sexually active men. A recent study found that around two-thirds of healthy American men ages 18-22 were infected with genital HPV. The prevalence was lower in older age groups, but still significant. Around half of men ages 23-29 had genital HPV, along with over a quarter of men in their 30s, 40s, and 50s.
HPV infection rates by age in men:
- 18-22 years old: 65%
- 23-29 years old: 51%
- 30-39 years old: 28%
- 40-49 years old: 29%
- 50-59 years old: 26%
These numbers show that HPV is extremely common across all age groups sexually active men. Even men in long-term monogamous relationships can still get infected, since the virus is easily transmitted through skin contact.
What are the high-risk HPV types that can cause cancer?
There are about 12-15 HPV strains that are considered high-risk or oncogenic types because they can lead to cell abnormalities and cancer. Two of the most common high-risk HPV types in men are:
- HPV 16 – This strain causes around 60% of penile cancers and 95% of anal cancers.
- HPV 18 – This type accounts for 12% of penile cancers.
Other high-risk HPV strains include 31, 33, 45, 52, and 58. Men infected with these types have an elevated risk of developing penile, anal, head/neck, and other cancers over time if the HPV infection persists.
Estimated HPV prevalence in men by type:
| HPV Type | Prevalence |
|---|---|
| HPV 16 | 3-13% |
| HPV 18 | 1-4% |
| Other high-risk types | 6-24% |
| Low-risk types | 34-69% |
This table shows estimated infection rates for some of the most common HPV types in men. Low-risk HPV strains like 6 and 11 cause 90% of genital warts cases, but do not lead to cancer.
What cancers are caused by HPV in men?
There are several types of cancer that can result from untreated HPV infections in men:
- Penile cancer – HPV causes around 60% of penile cancer cases. This is a rare cancer with around 1 case per 100,000 men in developed countries.
- Anal cancer – Around 91% of anal cancers are attributed to HPV. This cancer is also not common, with approximately 1 case per 100,000 men.
- Head/neck cancers – HPV accounts for about 70-80% of oropharyngeal cancers found in the throat, tonsils, tongue, etc. These cancers are more common, with 7 cases per 100,000 men.
- Rarer cancers – HPV is also associated with some rarer genital cancers like penile intraepithelial neoplasia (PeIN).
The risk of these cancers increases the longer a high-risk HPV infection persists. But even infections that last for many years often do not progress to cancer. Getting regularly screened and treated can prevent most HPV-related cancers in men from developing.
What are the symptoms of HPV in men?
Most men with HPV never develop any symptoms. Detecting an HPV infection usually requires screening tests like:
- Visual inspection of genitals for warts
- HPV testing on genital samples
- Anal Pap tests
When HPV does cause symptoms in men, the most common are:
- Genital warts – Small, fleshy bumps in the genital area caused by certain low-risk HPV types. They may appear within weeks or months after infection.
- Penile, anal, or head/neck cancers – Persistent high-risk HPV can lead to abnormal cell growth and cancerous tumors over many years.
Other less common symptoms:
- Itching, burning, or irritation of genitals
- Abnormal penile discharge or odor
- Bleeding from penis, anus, or throat
- Swollen lymph nodes in the groin or neck
- Genital rashes or ulcers
If men experience any unusual symptoms in the genital or anal region, it’s important to see a healthcare provider. Early diagnosis and treatment is key for cancers associated with HPV.
Who is at highest risk for HPV infections?
Any man who is sexually active can get HPV, but certain factors increase risk:
- Multiple sexual partners – Having many partners significantly raises HPV exposure.
- Weak immune system – Infection risk goes up for those with weakened immunity like HIV patients.
- Younger age – HPV rates peak in men under 30 years old.
- Uncircumcised men – Some studies show higher HPV prevalence in uncircumcised men.
- Men who have sex with men (MSM) – Anal HPV is more common in MSM, raising cancer risks.
- Tobacco use – Smoking makes men more susceptible to persistent HPV and related cancers.
Using condoms reduces, but does not eliminate HPV risk. The virus spreads through skin contact, so condoms do not provide complete protection. Partners limiting sexual contact to each other can lower their chances of getting infected.
Should men get vaccinated against HPV?
Yes, the CDC recommends routine HPV vaccination for boys and men up to age 26. The vaccines protect against infection from the most high-risk HPV strains that cause cancer and genital warts.
There are currently three HPV vaccines approved by the FDA:
- Gardasil
- Gardasil 9
- Cervarix
These vaccines require a series of either two or three doses given over several months. HPV vaccination provides the most benefit if administered before boys become sexually active.
Recent studies have shown that HPV vaccination significantly reduces infection rates in young men and lowers their risks of genital warts and anal precancer. Vaccines may also reduce oral HPV infections that can lead to cancers of the head and neck.
Some health organizations even recommend HPV vaccines for men up to age 45, especially for those that have sex with men or are immunocompromised. Talk to your doctor about whether HPV vaccination is recommended for you.
HPV vaccine effectiveness:
| Outcome | Reduced Risk with Vaccination |
|---|---|
| HPV infections | 90%+ |
| Genital warts | 90% |
| Anal precancer | 80%+ |
HPV vaccines can prevent the vast majority of infections and diseases caused by the specific virus types they target if given prior to exposure.
How can sexually active men reduce their risk of HPV?
Safe sex practices that may lower HPV transmission include:
- Use condoms – Provides some protection, but not 100%.
- Limit sexual partners – Having fewer partners reduces exposure.
- Get vaccinated – HPV vaccines greatly reduce infection risk if given before sexual activity starts.
- Communicate with partners – Disclose any known infections or symptoms to partners.
- Regular STI testing – Annual screening can detect early HPV-related cell changes.
Stopping tobacco use may also help clear HPV infections faster in infected men. Even with precautions, HPV transmission between partners is difficult to control. But safe sex practices can reduce the likelihood of spread.
Can HPV be cured in men?
There is currently no treatment available that can eradicate HPV completely from the body once infected. However, most HPV infections clear from the body on their own thanks to the immune system.
Around 90% of new HPV infections, even with high-risk types, are able to be cleared or suppressed by the immune system within 2 years. Only a small percentage of men with HPV develop persistent infections lasting many years or decades.
For men with persistent high-risk HPV, regular screening and prompt treatment of any precancerous lesions or early cancers can help prevent progression. Stopping tobacco use and optimizing immune health may help some men clear long-term HPV infections.
HPV infection outcomes:
- 70-90% regress spontaneously within 1-2 years
- 10-30% become persistent infections
- 1% or less persistent infections progress to cancer
While HPV has no cure, most men are able to clear the infection without any treatment, especially when living a healthy lifestyle. But cervical cancer screening is highly recommended for female partners of men with known high-risk HPV.
Conclusion
HPV is extremely common in men, with most sexually active males getting infected at some point. While HPV often causes no symptoms and goes away on its own, high-risk strains can lead to genital warts, penile and anal cancer, and oral cancers. HPV vaccination and safe sex practices help lower infection risk. But even vaccinated individuals can get infected with HPV types not covered by the vaccine. Regular screening and follow-up care is important for the small portion of men with persistent high-risk HPV to prevent cancers from developing.