What is HPV?
HPV stands for human papillomavirus. It is a very common virus that can infect both males and females. There are over 100 different types of HPV. Some types cause warts on different parts of the body while other types can lead to cancer. HPV is most often spread during sexual contact with someone who has the virus.
How common is HPV?
HPV is extremely common. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million Americans are currently infected with HPV. About 14 million more people become newly infected each year. HPV is so common that nearly all sexually active people will get it at some point in their lives if they don’t get the HPV vaccine.
What are the symptoms of HPV?
Most people with HPV do not know they are infected because they do not develop any symptoms. When symptoms do occur, they may show up weeks, months, or even years after infection. Common symptoms of HPV include:
- Genital warts (cauliflower-shaped bumps in the genital area)
- Plantar warts (fleshy, rough bumps on the soles of the feet)
- Common warts (rough, raised bumps on fingers, hands, elbows, knees)
- Recurrent respiratory papillomatosis (growths in the airways leading from the nose and mouth into the lungs)
- Cervical cell changes that may lead to cancer
Some types of HPV are more likely to cause warts and other types are more likely to cause cancer.
What is an HPV test?
An HPV test checks for the virus that causes cervical cell changes that may lead to cancer. The test specifically looks for the HPV types that are most likely to cause cancer, such as HPV 16 and HPV 18.
The HPV test can be done at the same time as a Pap smear, which screens for cervical cancer and precancerous cell changes. Performing both tests together provides a more complete assessment of cervical cancer risk.
How is the HPV test done?
The HPV test is simple and quick. It can be done in your doctor’s office during a routine pelvic exam. Your doctor will use a soft brush or swab to collect a sample of cells from your cervix. The sample is then sent to a lab for testing. Results are usually available within 1-2 weeks.
When should I get an HPV test?
The American Cancer Society provides the following guidelines for HPV testing:
- Women should begin cervical cancer screening with Pap tests at age 21.
- HPV testing should not be used in women under age 30, as HPV is very common in young women and often resolves spontaneously.
- Women age 30-65 should get an HPV test every 5 years, or a Pap test every 3 years.
- Women over age 65 who have had normal prior screening may stop screening.
- Women with a history of abnormal Pap or HPV tests may need more frequent screening.
Always follow your doctor’s specific recommendations for HPV and Pap testing based on your medical history.
What does it mean if my HPV test is positive?
A positive HPV test means you have a cervical HPV infection. However, this does NOT necessarily mean you have cancer or will get cancer. Most HPV infections go away on their own within 1-2 years.
When HPV persists for many years, it can cause cell changes that may gradually progress to cancer. The Pap test checks for any abnormal cell changes that may be happening already.
Some key points about a positive HPV test:
- Having HPV does not mean you or your partner have been unfaithful, as HPV can lie dormant for years.
- The infection is very common and does not mean you are “dirty.”
- You may have gotten HPV the first time you had sexual contact with someone.
- Many people clear the infection naturally within a few years.
- HPV alone does not mean you will develop cancer. Regular screening is important.
- Telling partners about an HPV infection is not necessary but condom use is advised.
- HPV vaccine can prevent future HPV infections but does not treat existing ones.
How concerned should I be about a positive HPV test?
There are over 100 strains of HPV but only certain strains lead to cancer. If you have one of the “high-risk” cancer-causing strains, doctors will monitor you more closely.
The following table provides some guidance on the level of concern with different Pap and HPV test results:
| Pap Test Result | HPV Test Result | Level of Concern |
|---|---|---|
| Normal | Positive high-risk HPV | Mildly concerned |
| Abnormal ASC-US | Positive high-risk HPV | Moderately concerned |
| Abnormal LSIL/HSIL | Positive high-risk HPV | Very concerned |
As shown, the concern level is higher if your Pap test shows actual abnormal cell changes in addition to a positive HPV test.
Your doctor will help determine if you need more frequent Pap tests, HPV testing, or other procedures like a colposcopy (exam of the cervix using magnification).
Can HPV be treated?
Unfortunately, there is currently no treatment for the HPV virus itself. However, abnormal cell changes caused by HPV can be monitored and treated if necessary.
For mild cell changes, your doctor may recommend just watching and retesting in 6-12 months. For moderate or severe changes, outpatient procedures can remove the abnormal cells. These include:
- Cryotherapy (freezing)
- LEEP (removing tissue with a thin wire loop carrying an electrical current)
- Laser ablation (burning off abnormal cells with a laser beam)
Treating abnormal cells can prevent progression to cervical cancer. Even if some abnormal cells remain, cervical cancer develops very slowly, allowing for early detection and treatment.
How can I prevent HPV?
The best way to prevent HPV infection is to get vaccinated. The CDC recommends HPV vaccination for girls and boys starting at ages 11-12. The vaccine is most effective when given at younger ages before exposure through sexual activity. However, vaccination can still benefit young women up to age 26 and young men up to age 21.
The HPV vaccine protects against the strains most likely to cause cancer and genital warts. However, the vaccine does not treat existing HPV infections. Other prevention tips include:
- Use condoms correctly every time you have sex. But be aware condoms don’t fully protect against HPV.
- Limit your number of sex partners.
- Avoid sexual contact with someone who has visible genital warts.
- Don’t smoke. Smoking makes HPV more likely to persist and progress.
Should I change my sexual habits after a positive HPV test?
A positive HPV test is not an indication to change your monogamy or sexual habits. However, there are some steps you and your partner can take to prevent spreading HPV:
- Consider using condoms since HPV spreads through skin-to-skin contact.
- Do not have sexual contact until any visible warts or symptoms are gone.
- Follow up with your doctor for any abnormalities requiring treatment.
- Get retested for HPV if recommended by your doctor.
- Get vaccinated if you haven’t already, to prevent future infections.
HPV is not like other STIs and does not necessarily imply sexual promiscuity or infidelity. It is best not to feel ashamed or accuse your partner. Simply take reasonable precautions until the infection clears.
Should I tell my partner(s) about a positive HPV test?
Telling partners about an HPV infection is a personal choice that is not medically necessary. Since HPV is extremely common and rarely causes health problems, disclosure is not needed.
If you had recent partners prior to your positive HPV test, they have likely already been exposed. And since most people clear the virus naturally, your partners may have already done so or will likely clear it without complications.
That said, informing partners allows them to undergo screening at the recommendation of their doctor. If you wish to tell partners, have a straightforward discussion emphasizing that HPV is not a major health threat for most people. Avoid accusatory language and remember that HPV can lie dormant for a long time.
Will HPV affect my fertility and chances of pregnancy?
HPV alone should not affect fertility or chances of future pregnancy. The abnormal cell changes caused by certain HPV strains can be monitored and treated. This preserves the cervix and allows pregnancy.
Women who receive treatment for abnormal cervical cell changes are still able to get pregnant and deliver vaginally. Even procedures that remove larger amounts of cervical tissue rarely cause fertility or delivery problems.
The only scenario in which HPV might affect fertility is if high-grade lesions progress to advanced cervical cancer. This is very unlikely if you continue getting regular Pap tests and follow up on abnormal results.
Does HPV increase my risk of other cancers?
Certain strains of HPV can infect areas other than the cervix and increase your risk of other cancers:
- Oropharyngeal cancer – HPV transmitted through oral sex can cause some mouth and throat cancers.
- Anal cancer – Linked to high-risk HPV infection.
- Penile cancer – Uncircumcised men infected with HPV have an increased risk.
- Vaginal and vulvar cancers – Associated with high-risk HPV types 16 and 18.
However, these other HPV-associated cancers are all much rarer than cervical cancer. Continue with your normal cancer screening based on your age and gender. Let your doctor know about your HPV infection so they can evaluate your other cancer risks.
Does a positive HPV test mean I will develop cervical cancer?
No, testing positive for HPV does not mean you will definitely develop cervical cancer. Many women have HPV infections that go away naturally. Only infections with high-risk HPV strains that persist for many years gradually have a chance of triggering cervical cancer.
The purpose of HPV testing along with your Pap smear is to detect any problems and treat them early before they progress. With routine screening and follow up, cervical cancer is highly preventable. The American Cancer Society estimates there will be only 14,480 new cases of cervical cancer in the U.S. in 2022.
Your doctor will monitor you closely if your HPV test is positive along with abnormal cervical cell changes. Prompt treatment can remove the abnormal cells before they ever turn into cancer. Cervical cancer develops very slowly, allowing time for detection.
Conclusion
Having HPV may feel frightening, but most HPV infections are harmless and resolve spontaneously. Abnormal cell changes caused by HPV can be monitored and treated effectively. While a positive HPV test requires some extra follow-up, it does not mean you will develop cancer. Progress to cervical cancer is very unlikely with appropriate screening.
Continue getting regular Pap tests and HPV testing as recommended. See your doctor promptly for any treatment of abnormal cells. Take reasonable precautions to prevent spreading HPV. But otherwise, a positive HPV test does not warrant major lifestyle changes or high levels of concern. Maintaining your health with proper screening and follow-up provides excellent protection against cervical cancer.