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Human Papillomavirus (HPV)


expandWhat is HPV?

HPV
  • HPV, or genital human papillomavirus, is the most common STI in the U.S.
  • 40+ types and affects both men and women
  • Can cause cervical, anal, and throat cancers as well as genital warts
  • Transmitted in any form of unprotected sex, including oral, anal, and vaginal
  • No treatment or cure, but there is a vaccine and ways to treat the health problems
  • Vaccine is a series of 3 shots within a 6 month period called Gardasil

expandHPV Risk Factors

  • All sexually active people are at risk for HPV- male or female!
  • It is estimated that 75-80% of all sexually active adults in the United States are infected.
  • Most of these people do not have symptoms, and do not know that they have it.
  • Anyone who is sexually active or plans to become sexually active is at risk, and at a higher risk if they:
      - Are male & have sex with other men
      - Have sex with multiple partners
      - Have unprotected sex
  • As of Spring 2013,
      - 5% of male UGA students and
      - 40% of female UGA students have been vaccinated

expandTransmission of HPV

  • HPV, regardless of the type, is usually spread by direct skin-to-skin contact during vaginal, anal or (rarely) oral sex with someone who has this infection.
  • Genital warts are most likely to be transmitted when symptoms (warts) are actually present, but sometimes warts are too small to see with the naked eye.
  • Warts on other parts of the body are caused by different types of HPV. People do not get genital warts by touching warts on their hands or feet

Types of HPV


expandGenital Warts

  • The types of HPV that cause raised external genital warts are not linked with cancer.
  • These are called "low-risk" types.
  • The genital warts appear as growths or bumps, and may be raised or flat, single or multiple, small or large.
  • Sometimes genital warts are so small that they cannot be seen with the naked eye.
  • When warts are present, the virus is considered active. When warts are gone, the virus remains latent in the skin cells and may or may not be contagious at this time.
  • Warts may appear within several weeks after sexual contact with someone who has a wart-type of HPV, or it may take several months or years to appear. This makes it hard to know exactly when or from whom someone got the virus.

expandCervical Changes

  • Other types of HPV can cause abnormal cell changes on the genital skin, usually on a female's cervix.
  • These types of HPV are linked with cervical cancer and are usually called "high-risk" types.
  • There are usually no symptoms for this type of HPV and women need to get regularly screened by a pap smear to detect these changes.
  • While they do not have symptoms, men can be carriers and unknowingly transmit HPV to their sexual partners.


Testing for HPV


expandTesting for Warts

  • If you have any bumps or growths, visit the University Health Center and have the area examined by a clinician.
  • To look for warts or other abnormal tissue, the clinician may put acetic acid (vinegar) on the genitals. This causes warts to turn white and makes them easier to see, especially if they are viewed through a magnifying lens.

expandTesting for Cervical Changes

  • Abnormal cervical changes on a female are detected through a pap smear.
  • The pap test is a screening to find abnormal cell changes on the cervix before they become cancerous.
  • During a pelvic exam, a small brush or cotton tipped applicator will be used to take a swab of cervical cells. These cells are then put in a container with liquid and sent to the laboratory for evaluation.

expandAbnormal Paps

  • If the pap smear shows abnormal cells, an HPV test may be performed to determine the type of HPV.
  • This test checks directly for the genetic material (DNA) of HPV within cells, and can detect the types connected with cervical cancer.

expandTesting Limitations

  • There is currently no testing available to determine if a male has a type of HPV that causes cervical changes.
  • There are no blood tests available to diagnose a person for HPV.


Treatment


expandHPV Treatment

  • HPV is a virus, and there is currently no cure. However, there are several treatment options available for both genital warts and cervical changes.
  • The goal of treatment should be to remove visible genital warts or the abnormal cells. No one treatment is best for all cases.
  • When choosing what treatment to use, the clinician will consider the type of HPV, patient preference, cost of treatment, convenience, size, location and number of warts, changes in the warts, location of abnormal cells, results of the pap smear, colposcopy, biopsy and HPV test, adverse effects, and their own experience with the treatments.

expandGenital Wart Treatment

  • Cryotherapy (freezing off the wart with liquid nitrogen). This can be relatively inexpensive and must be done by a trained clinician.
  • TCA (trichloracetic acid) is another chemical applied to the surface of the wart.
  • Cutting off warts. This has the advantage of getting rid of warts in a single office visit.
  • Electrocautery (burning off warts with an electrical current)
  • Laser therapy (using an intense light to destroy warts).This is used for larger or extensive warts, especially those that have not responded well to other treatments. Laser therapy can also cost a lot of money.
  • There are also several at-home prescription creams. These creams are self-applied, safe, and easy to use.

expandAbnormal Cervical Cell Treatment

  • Sometimes treatment may not even be necessary for mild cervical changes. These cells may heal on their own, and the clinician will just want to monitor the cervix.
  • The goal of any treatment will be to remove the abnormal cells which may also remove most of the cells with HPV.
  • Treatment options include cryotherapy (freezing the cells with liquid nitrogen), LEEP (Loop Electrosurgical Exision Procedure), or conization (cone biopsy).


HPV Linked Cancers


expandAnal Cancer

  • Anal cancer is a rare occurrence that has been strongly linked to high-risk types of HPV.
  • Abnormal cell changes in the anal area are more common among individuals who engage in receiving anal sex.
  • Abnormal changes in the anus have also been reported in some females who have a history of severe cervical changes.
  • Treatment is available for anal cell changes and anal cancer.

expandPenile Cancer

  • Cryotherapy (freezing off the wart with liquid nitrogen). This can be relatively inexpensive and must be done by a trained clinician.
  • Penile cancer is extremely rare in the US, and HPV is not always the cause.
  • There are some cases of cell changes on the penis, which are caused by high-risk types of HPV, but most males do not ever experience symptoms or health risks if they get one or more high-risk types of HPV.

expandVulvar Cancer

  • HPV has been linked with some, but not all, cases of cell changes on the vulva (outside female genital area) and with vulvar cancers.
  • Treatment options are available for both vaginal or vulvar cell changes, depending on how mild or severe the cell changes are in this area.

expandPreventing HPV

  • Any person who is sexually active may come in contact with this common virus.
  • Ways to reduce your risk include not having sex with anyone or having sex only with one partner who has sex only with you.
  • If someone has visible symptoms of genital warts, he or she should not have sexual activity until the warts are removed.
  • Condoms used correctly from start to finish for each act of sex may provide some protection.
  • Because HPV is transmitted skin-to-skin, and condoms do not cover the entire genital region, it is still possible to transmit the virus.
  • Gardasil is the HPV vaccine available for both men and women.

Source: This information was adapted from the American Social Health Association' webpage www.ashastd.org



HPV Vaccine -- Gardasil


expandGardasil Basics

Get Vaccinated! Join the war against HPV
  • Gardasil is available at the University Health Center for both men and women.
  • Gardasil is effective against four types of HPV (types 6, 11, 16, and 18).
  • Types 6 and 11 cause 90% of cases of genital warts and types 16 and 18 cause 70% of cases of cervical cancer.
  • The vaccine is approved for males and females, 9 through 26 years of age.
  • The vaccine has undergone vigorous efficacy, safety, and immunogenicity trials and has been approved by the FDA.

expandCommon Misconceptions

  • I don't need the vaccine because I'm not sexually active...
    Be prepared and protect yourself before you have sex
  • I'm too old to get it...
    CDC recommends up to age 26, but you can get the vaccine at any age
  • It's not offered...
    The University Health Center offers the Gardasil vaccine to both men and women, and it is covered under the student health insurance plan
  • I hate shots or I heard it was painful...
    The shots hurt less than chemotherapy or the stigma of genital warts
  • My parents won't let me...
    If you are over 18, you do not need your parent's permission to get vaccinated

expandSafety

  • The safety and side effects of HPV vaccines have been rigorously tested and examined for years.
  • The most common side effects are fainting, pain and redness at site of injection, dizziness, nausea, and headache.

expandCost

  • The vaccine is a series of 3 shots within a 6 month period, and not all the shots must be administered by the same clinic.
  • UGA student health insurance plan fully covers the HPV vaccine, Gardasil.
  • Most other health insurance covers it as well, but check with your primary care provider.
  • If you choose not to use health insurance, each shot costs $156 at the University Health Center.

To make an appointment for the HPV vaccine, Gardasil, call 706-542-5575.

For more information, please visit the following websites:
www.cdc.gov/hpv
www.gardasil.com