By: You probably know the basics: HPV can potentially cause cervical cancer, most sexually active adults have been exposed, and many occurrences of the virus usually clear on their own. But there’s a whole lot more to understand about the most common STI in the United States.
1. There are more than 100 subtypes of HPV.
And by the time you hit 30, odds are you’ve been exposed to a lot of them. The good news? Only about 13 of the hundreds in existence have the potential to cause cervical cancer.
“There are some that are low-risk for causing cervical cancer and some that are high-risk,” Dr. Amanda Kallen, an OB-GYN specializing in reproductive endocrinology and infertility at Yale Medicine tells Sexual + Being. “The whole reason we care about HPV, as opposed to other viruses, is because HPV [can cause] the normal cells in the cervix to become cancerous. And so, the high-risk HPV types are more likely to cause those changes that lead to cancer eventually.”
Each subtype, be it low-risk or high-risk, is assigned a number.
“For [people with cervixes], when you get your Pap smear, a lot of times [the test] will just say you have high-risk HPV, and we actually stratify that out to either 16, 18, or 45,” Dr. Ranette Marshall, an OB-GYN practicing in Maryland, tells Sexual + Being. “Those are the ones that are most concerning, the ones that have a higher incidence of cervical cancer.”
2. Most people with HPV don’t know they have it.
According to the CDC, 79 million Americans are infected with the HPV virus, which spreads via sexual intercourse, anal sex, and oral sex. But unless it starts causing health issues — like genital warts or cancer — most people never realize they’re affected.
Unlike other STIs, there’s no quick test you can take to determine your status. Plus, a woman’s body may clear it before the next Pap smear, while men don’t have any way of screening. People may be asymptomatic completely, or symptoms may not appear for years down the line — but they can still spread the virus to others.
3. There is no treatment for HPV itself.
Like other viruses, HPV has to run its course — there’s no cure. And, most of the time, it comes and goes without much fanfare. However, if you contract a strain that either causes genital warts or cancer, your doctor will develop a treatment plan to address those specific concerns.
4. Condoms may not prevent you from getting it.
Because HPV spreads via skin-to-skin contact and can infect areas of skin that aren’t covered by a condom, you can still get HPV if you have sex with a condom with a person who has it.
But that doesn’t mean you should skip condoms altogether. They still do very well protecting against other STIs, includings HIV, and they can help lower your risk of contracting HPV.
5. There’s no way to know when you contracted HPV.
Typically, your body kills off the virus within a year or two of contracting it. Sometimes, though, a strain may stay dormant inside you for years. Because of this, Dr. Ranette says if you are ever diagnosed with HPV, there’s no way your physician can tell you when you got it or how long it’s been in your system. Your doctor also can’t tell you who you got the virus from; the only way you’d be able to know is if you’ve only had one partner.
6. You can still get the HPV vaccine even if you’re older than 26.
“It was an arbitrary number,” Dr. Marshall says of the vaccine’s original age range cap. “Especially [for] somebody that is not really sexually active. In 2018, the FDA actually approved [the vaccine] for men and women up to 45 because there are some strains of the HPV that are covered by the vaccine that may be beneficial.”
While the vaccine, specifically Gardasil 9, has been approved for the widened age range, some insurance companies may not cover it for people older than 26 because they don’t see it as useful for people who may have already been exposed. Your best bet? Talk things over with your doctor to decide if the vaccine is a good fit for you and whether you can pay out of pocket.
7. Getting vaccinated doesn’t mean you can skip out on Paps.
Both of our experts wanted to make this extremely clear: All people with vaginas must continue their Pap smears as directed by their doctors.
“Most of the vaccines have at least four [HPV strains] that it protects you against, most readily 16, 18, 33, and 35,” explains Dr. Marshall. “It doesn’t mean you’re not at risk for others. The biggest thing that people need to realize, if they were already sexually active before they got the vaccine, that doesn’t mean that they’re immune to having HPV because they could have already been exposed, and it could be laying dormant in their system.”
“Even if someone’s had an abnormal Pap smear, [the vaccine] can still be effective because that abnormal Pap smear might have been caused by one kind of HPV, but you can still be protected from the others,” says Dr. Kallen. “So, it’s good for protection, but it doesn’t replace a Pap smear.”
*Note: Gardasil 9 protects you against subtypes 6, 11, 16, 18, 31, 33, 45, 52, and 58.
8. An abnormal Pap doesn’t mean you have cervical cancer.
Unlike other forms of cancer, the cervical kind is slow growing and can take 10 to 20 years to develop, so definitely stay current with your Paps. The earlier you catch problems, the more you’ll be able to do to fix them. But don’t assume that an abnormal Pap means you have cancer.
“There are several steps of abnormal on the way before you get to cancer. So, most of the time, an abnormal Pap smear isn’t indicating cancer, but it’s indicating some abnormality on the spectrum there that should be watched,” says Dr. Kallen. “Nobody dies from an abnormal Pap smear. What people die from is cervical cancer, especially advanced-stage cervical cancer, and people get to that, most of the time, because they haven’t kept up with Pap smears, with a few exceptions.”
9. Pregnant with HPV? You can still give birth sans C-section.
Just keep up with your prenatal visits to monitor things all the way around, and you and your baby should be good to go.
“[HPV] doesn’t really affect the pregnancy itself,” says Dr. Marshall. “You can conceive or have a vaginal delivery; it doesn’t dictate anything else, unless you have severe — like a really high-risk cervical cancer that kinda invades inside your cervical canal — but that’s rare.”
10. HPV screening for men doesn’t exist — but the virus can affect their health, too.
While women have Pap smears (and Pap smears with HPV co-tests), there is no similar screening for men and boys. Still, they can be carriers of the virus, spread it to others, and potentially experience health issues, such as genital warts and certain cancers.
“I think part of the reason to offer a test like that to men would be to prevent a bad outcome of some kind of cancer, and that risk isn’t there for men like it is for women,” Dr. Kallen explains. “HPV is linked to anal-rectal cancers in men, but the prevalence of those is lower.”
Men are also at risk for developing oral cancers related to HPV, and these cancers are most often caused by the high-risk HPV strain 16, Dr. Marshall explains. “In 2002, the increased frequency [of oral cancers in men] was related to HPV HR 16, accounting for 50–80% of oral cancers in the world,” she says. “Another reason why boys and men should be vaccinated, as well.”
11. When it comes to research, the medical community knows a ton about HPV.
“A lot of people don’t realize the research behind HPV is very sound,” says Dr. Marshall. “[They] get very nervous of having their Pap smears spread out because with all this technology with HPV, we’re not screened annually like we did way back before.”
But rest assured: If you’ve consistently had normal screenings and your doctor says you don’t have to come back for another three to five years, you’re safe to do just that.
“The likelihood for somebody to get HPV later on in life that [has] never had abnormal Pap smears or HPV is rare, unless they change their sexual partners or patterns,” Dr. Marshall explains.
And while all of this info may seem a bit overwhelming, there’s no cause for alarm. You can continue to live your best sex life — with proper precautions in place, of course.
“HPV is this kind of thing, it’s just there, and we’re probably all exposed at some point,” says Dr. Kallen. “As long as you’re on top of [your] health as far as keeping up with the screening, you should catch it [before it turns into cancer].”
Andrea Butler
Her friends call her “Ms. Correcto,” as Andréa Butler lives for editing and writing. Adept at crafting witty turns of phrase, as well as informative, clever, and compelling copy on various topics, she has penned articles for sites, such as LivingSocial, Onboardly, Talbot Digital, Xickle, Rachel Ray, and more over the past 10 years. She currently enjoys the life of a freelancer, writing all day in her pjs.
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