HPV, or human papillomavirus, includes over 200 related strains and is primarily transmitted through skin-to-skin contact. Although not all of these strains are spread through sexual contact, many of them are, making HPV the most common sexually transmitted infection (STI) in the United States.

As an STI, HPV can be spread through vaginal, anal, and oral sex, as well as non-penetrative activities involving contact between the hands and genitals. Other types of prolonged intimate contact, such as holding hands, can cause the virus to spread. Sharing contaminated personal items such as sex toys can also spread HPV. Note that some types of HPV can cause warts on the hands or feet; this strain, often seen in children, is not necessarily transmitted sexually.

HPV is not transmitted through blood or body fluids. Nearly everyone will have HPV at some point in their life, often without realizing it. The virus is so common that it’s possible to unknowingly pass it to others. Although there is no cure for HPV, the body’s immune system typically clears the infection. In the case it doesn’t, or when someone is immune compromised (e.g., HIV positive) the infection can lead to more serious complications. Prevention through vaccination and monitoring persistent infections is important, as some high-risk strains can lead to complications, including cancer.

The HPV vaccine, commonly known by its brand name Gardasil, has been available in the U.S. since 2006. It’s considered one of the most significant breakthroughs in cancer prevention.

A recent study published in the Journal of the American Medical Association (JAMA) highlights the vaccine’s life-saving potential. Researchers found that cervical cancer mortality among U.S. women under 25 has dropped dramatically to less than 1 per million annually—a 50% reduction over the past decade.

Learn more about this study in Episode #49 HPV, Sexy Gifts, and Mediocre Oral

Gardisil 9: What’s included?

As of 2024, Gardasil 9 is a vaccine that protects against nine types of HPV:

• Types 6 and 11: Low-risk types that cause most genital warts

• Types 16, 18, 31, 33, 45, 52, and 58: High-risk types that cause most precancerous lesions and cancers The vaccine is approved for both males and females. The dosing schedule depends on age.

• Ages 9–14: Two doses.

• Ages 15–45: Three doses.

To maximize effectiveness, it’s important to vaccinate early.

Do I still need to worry about HPV if I’m vaccinated?

While the vaccine protects against the majority of high-risk HPV strains, it doesn’t cover all 200+ types. It also won’t treat a current infection or cancer, so regular cervical cancer screenings and testing for certain high-risk demographics are still important. As for lesser-risk strains and those that cause warts, the vaccine protects against 90% of the HPV strains that cause genital warts.

What If I was vaccinated but still got HPV or an abnormal pap?

If you’ve tested positive for HPV after vaccination, it may feel concerning, but it’s not uncommon. You may have been exposed to HPV before receiving the vaccine, or you contracted a strain not covered by the vaccine. In most cases, HPV clears up on its own, especially if you’ve been vaccinated. If you’ve had normal pap smears since testing positive, it’s a sign your body fought off the infection or that no abnormal cervical changes occurred. If you’re still worried, discuss your concerns with your gynecologist. Ask about HPV-specific testing or whether more frequent pap smears might be beneficial.

Listen to the in-depth answer in Episode #49 HPV, Sexy Gifts, and Mediocre Oral

If I already had HPV, is it worth getting vaccinated?

Yes! Even if you’ve had HPV, the vaccine can protect you from other high-risk strains you haven’t encountered. The CDC recommends the vaccine for individuals up to age 45.

Why isn’t HPV testing part of routine STI screenings?

HPV is extremely common, and most infections resolve naturally. Routine testing could lead to unnecessary worry or overtreatment. Instead, pap smears focus on detecting abnormal cervical cells that might signal early cancer development. Oral and rectal swabs are becoming a common practice for testing certain high-risk groups.

Is there a cure for HPV?

There’s no cure for the virus itself. Treatments focus on managing symptoms, such as removing warts or treating abnormal cervical cells. Prevention through vaccination has already been shown to reduce mortality from cervical cancer.

Reframing the HPV Vaccine

The HPV vaccine has faced unnecessary stigma because of its association with sexual health. Some parents hesitate to vaccinate their children, worrying it might encourage early sexual activity. However, the HPV vaccine isn’t just about sexual health; it’s a cancer-prevention vaccine.

Key Takeaways

• HPV is the most common STI in the U.S. Although it is an STI, other types can cause warts on the hands or feet and are spread through skin-to-skin contact.
• While most infections clear on their own, certain strains can cause genital warts or cancers of the cervix, throat, and rectum.
• The HPV vaccine, Gardasil 9, protects against nine high-risk strains and has significantly reduced cervical cancer mortality.
• Even if vaccinated, routine cervical cancer screenings remain important.
• If you have questions or concerns about HPV, talk to your doctor. Taking steps to prevent HPV is an investment in long-term health for you and your loved ones.