Myth

I’m on the pill so we don’t need condoms.

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Human Papillomavirus (HPV)

HPV stands for human papilloma virus. There are more than 100 types of HPV. Some types produce warts — plantar warts on the feet and common hand warts. Some affect the genital sex organs.

About 40 types of HPV can infect the genital area — the vulva, vagina, cervix, rectum, anus, penis, or scrotum.

• Some types may cause genital warts. These are called low-risk types.
• Some types may cause cell changes that sometimes lead to cervical and certain other genital
  and throat cancers. These are called high-risk types. They
  do not usually have visible symptoms.
• Most types seem to have no harmful effect at all

How many people have genital HPV infections?

Genital HPV infections are very common among sexually active people. At any time about 20 million people in the U.S. have them. Between 10 and 15 million have high-risk types that are associated with cervical cancer. HPV is so common that about three out of four people have HPV at some point in their lives. But most people who have it don't know it.

Although most HPV infections go away within eight to 13 months, some will not. HPV infections that do not go away can "hide" in the body for years and not be detected. That's why it is impossible to determine exactly when people became infected, how long they've been infected, or who passed the infection to them.

If you have HPV, you should not be ashamed or afraid. Most people who have ever had sex have HPV at some point in their lives.

Does HPV cause cervical cancer?

Yes, high-risk types of genital HPV are linked to cervical cancer. Most HPV infections go away by themselves and don't cause cancer. But high-risk HPV that does not go away over many years increases the risk of cervical cancer. Abnormal cells can develop when high-risk types of HPV don't go away. If these cell changes are not detected and treated and persist for many years, they can lead to cervical cancer.

Most women recover from HPV infections with no health problems at all, and many women develop immunity — a natural protection — against different types of HPV that they have been exposed to. It is not fully known why some women develop long term HPV infection, precancerous abnormal cell changes, or cervical cancer. But we do know that women who have damaged immune systems are at higher risk, although most who get cervical cancer have normal immunity. It is also known that cigarette smoking increases the risk of cervical cancer.

How do genital herpes infections spread?

Vaginal and anal intercourse spread genital HPV infections. In some cases, other kinds of skin-to-skin contact, including sex play, such as body rubbing and oral sex, may also transmit HPV.

How can I reduce my risk of genital HPV infections, including those that cause cervical cancer?

You can reduce your risk if you:

• practice abstinence
• have only one partner who has no other intimate partners
• have sex play that does not include vaginal or anal intercourse
• use condoms every time
• get the HPV vaccine!!

The HPV Vaccine--Gardasil

The HPV vaccine, brand name Gardasil, is given in three separate injections over the course of six months. It protects against two types of HPV that cause 90 percent of all genital warts and two types of HPV that cause 70 percent of all cervical cancer.

The U.S. Food and Drug Administration approved the use of the HPV vaccine for girls and women from agenine to 26. The vaccine has also been shown to be effective for older women and young men.

At PPSEV, we participate in the Virginia Vaccines for Children program, which means uninsured girls age 18 and under can receive the vaccine for free through the state. We also partipate in the Merck Assistance Program, helping uninsured/underinsured women age 19-26 receive the vaccine for free.

How well do condoms protect against HPV?

Condoms can reduce the risk of HPV infection if they are used every time. But they are not as effective in preventing HPV as they are in preventing some other infections, such as HIV, gonorrhea, chlamydia, and trichomoniasis, because HPV may be present in skin that is beyond the area covered or protected by a condom.

Are there any symptoms of high-risk HPV infection?

High-risk types of HPV do not cause any symptoms. Most women feel fine even when they have cell changes in their cervix and during the early stages of cervical cancer.

Once cervical cancer has developed, abnormal vaginal bleeding, especially during intercourse, increased discharge, and lower abdominal pain may be warning signs. Of course, most women with these signs do not have cervical cancer, but if you have any of them, you should see your clinician.

How can I protect myself against cervical cancer?

You can protect yourself by having regular Pap tests. HPV testing, in certain situations, is also a way to protect yourself. Read below to find out more about when HPV testing is a good plan.

Regular Pap tests can help find very early precancerous conditions, which are easily treated to prevent cancer from developing. Most sexually active women should have a Pap test every year. Some may need them more frequently. Women over 30 who have had three or more normal Pap test results in a row, or one normal Pap test and a negative HPV test may not need to be tested as frequently. Talk with your clinician about how often you should have Pap tests.

What happens if I have abnormal Pap test results?

A number of different tests and/or treatment may be prescribed. You may be advised to

• Repeat the Pap test.
• Have other tests.
• Take medication.
• Have a colposcopy and biopsy.

Be sure to complete the prescribed treatment(s) and test(s).

If early precancerous cell changes or suspicious growths are found, you will need more testing. Moderate to severe precancerous changes require colposcopy and biopsy to make a diagnosis. If confirmed, these cell changes usually need to be removed by one of the following treatments:

• cryotherapy — abnormal tissue is frozen off
• laser surgery — abnormal tissue is destroyed with a laser beam
• LEEP — abnormal tissue is removed using a thin wire loop that carries an electrical current

Discuss your options with your clinician. Also consult a cancer specialist (gynecological oncologist) if cancer is found.

Who should have the HPV test?

Routine HPV testing is not recommended for women under the age of 30 unless they have an abnormal or unclear Pap result. This is because HPV is very common and cervical cancer is rare at this age, and most HPV infections go away by themselves without causing any health problems. For women age 30 or older, a test for HPV can be done at the same time as a Pap test. If both test results are normal, a woman has a very low risk of developing cervical cancer. She will not need a Pap and HPV test for three years. Some women age 30 or older see this choice as more appealing than having a Pap test each year.

Doesn't a Pap detect HPV?

A Pap test does not detect HPV itself. A laboratory technician uses a microscope to look at a sample of cervical cells for signs of abnormal changes that may be caused by HPV.