HPV, the Most Common Sexually Transmitted Infection: What It Is, How It Spreads, and What It Means if You Test Positive

🔶What is HPV?

HPV (human papillomavirus) is the most common sexually transmitted infection (STI). Most people who get HPV clear the virus on their own within two years and don’t have symptoms – but because some types can lead to cancer or genital warts, it’s helpful for everyone to know about HPV prevention and treatment.

The good news is that the HPV types most likely to cause cancer and genital warts are now preventable with the Gardasil 9 vaccine, which is already making a big difference[archived link] for today’s teens and young adults in the US and other high-income countries. But many people 30 or older around the world didn’t get the vaccine because it wasn’t widely available when they were growing up, and in some countries it’s still not available. Some of these unvaccinated people may test positive during routine Pap screenings, and this post includes information about what a positive test means and what happens next. (Learn about Pap screenings and HPV tests here [archived link].)

🔶How Common is HPV?

HPV is extremely common. Nearly everyone who is sexually active will get HPV at some point in their lives. Most people won’t have symptoms and may never know they were infected. Most HPV infections resolve on their own without any health problems. That’s part of what makes HPV so widespread: it’s often invisible.

🔶How Does HPV Spread?

HPV spreads through intimate contact, including vaginal, anal, or oral sex, and external genital or anal contact. It can be passed between people of any gender combination in sexual partnerships, with or without intercourse. You might see trusted sources like the CDC say that HPV spreads through “skin-to-skin” or “genital skin” contact and wonder what that means. HPV can spread through contact between the external parts of the genitals, like the vulva, penis, scrotum, and perineum, the area between the genitals and the anus. HPV can be passed through contact with these areas during all kinds of sexual activity.

It doesn’t spread through other types of contact, like hugging, holding hands, or kissing.

🔶Types of HPV

There are more than 200 types of HPV.

Some are called low-risk types because they are low risk for cancer, but can cause genital warts, which aren’t dangerous but can be uncomfortable or upsetting for some people. Low-risk types HPV-6 and HPV-11 cause most genital warts.

Other types are considered high-risk because they can lead to cancer. High-risk types include HPV-16 and HPV-18, which are responsible for the majority of HPV-related cancers. Other high-risk types, including 31, 33, 45, 52, and 58, are less common and generally less likely to cause cancer than HPV-16 and HPV-18. However, these types still pose a significant risk and are included in the Gardasil 9 vaccine to help provide broader protection.

Many HPV types don’t cause any health problems that we know of, and some cause minor skin issues in other parts of the body, like common warts on the hands or feet. Types that cause common warts on the hands and feet, as well as those that cause no noticeable symptoms, spread through casual, non-genital contact with people or surfaces.

HPV test results often highlight HPV-16 and HPV-18 separately because they carry the highest cancer risk. Other high-risk types may be reported as a group rather than individually, depending on the specific test and lab practices.

🔶How Does HPV Affect the Body?

About 90% of HPV infections are cleared by the immune system [archived link] within two years, and unless they cause genital warts, they do not cause any noticeable changes or problems.

However, if a high-risk HPV infection continues, it can change cells in ways that may become cancer if not found and treated. HPV can cause cancers of the:

Cervix, vagina, and vulva
Penis
Anus
Back of the throat (including the base of the tongue and tonsils)

In the U.S., HPV causes about 38,000 cases [archived link] of cancer each year in people of all genders.
Worldwide, HPV is responsible for more than 600,000 cancer cases annually, according to the World Health Organization.

🔶HPV Prevention

HPV vaccination (Gardasil 9) prevents the most common high-risk types. For young people, the HPV vaccine is the best way to prevent HPV-related cancers. It’s recommended for ages 9 – 12, with catch-up through age 26, and considered on a case-by-case basis up to age 45. If you’re 45 or younger, have not been vaccinated, and think you might benefit from the vaccine, talk with a trusted clinician. Check out this recent TNG post for more info about getting vaccinated after age 26.

The vaccine is highly effective and can prevent most cancers caused by HPV. According to the CDC, it has the potential to prevent more than 90% [archived link] of HPV-related cancers.

Since the vaccine was introduced in 2006, HPV infections and cervical pre-cancers have dropped significantly:

Among teen girls, infections from the main HPV types that cause cancer and warts have decreased by 88%.
Among young adult women, those infections have decreased by 81%.

In groups of young adults who were part of long-term studies, protection has lasted at least 12 years with no sign of decreasing. The vaccine also reduces genital warts and cervical pre-cancers.

Condoms also lower the risk of getting or spreading HPV, though they don’t offer full protection since HPV can spread through areas not covered by condoms.

🔶Testing & Treatment

The good news is that it usually takes ten years or more for HPV infections to cause cancer, and treatment is available for precancerous areas, especially to prevent cervical cancer. Like any cancer, early detection and treatment makes a difference if cancer does develop.

Routine HPV testing is typically done as part of routine cervical cancer screening, a Pap test. Even though some types of HPV can lead to cancer, having HPV does not mean someone has cancer.

If someone tests positive for a type of HPV other than HPV-16 or HPV-18 and has a normal Pap (no abnormal cell changes), the recommendation is usually to repeat testing in 12 months. If the type is HPV-16 or HPV-18 (and sometimes others like HPV-45), or the Pap is abnormal, a colposcopy is usually recommended.

❓What is a colposcopy? A colposcopy is a close examination of the cervix, vagina, and vulva using a magnifying device to spot changes that may need treatment. Biopsies can be taken during the exam to help detect abnormal cells early. If a biopsy is abnormal, further treatment to prevent cancer may be recommended.

There is also treatment available for genital warts. If genital warts are not treated, they sometimes go away on their own, but they can also linger and more may appear. If you develop genital warts, a trusted clinician can talk with you about which of several treatment options might be best for you.

🔶If someone tests positive for HPV, how long have they had it?

HPV can lie dormant for years – sometimes even decades – and may reactivate after previously testing negative. A positive result doesn’t necessarily mean there was a recent exposure, either for the person who tested positive or their partner. While a positive HPV test can understandably cause stress within a monogamous relationship, it doesn’t mean that either partner has had recent sexual contact with someone else.

🔶Other Kinds of Testing

There’s no routine HPV test for the penis or mouth, which can be frustrating for people without a cervix. Anal HPV testing is available in some places – especially sexual health clinics – for cisgender men and trans women who have sex with men, and sometimes for people living with HIV. There’s no oral swab for HPV, but dentists check for visible changes during exams. Regular dental visits can help catch early signs of HPV-related oral cancers. (This recent TNG’s post on HPV & oral cancer has more info.

🔶After Testing Positive: Can Anything Help Clear the Virus?

There’s no medical treatment for HPV itself, but many people want to know what they can do to support their body’s ability to clear the virus. Clinicians often recommend healthy habits like eating well, getting enough sleep, and not smoking – all of which support immune health.

You may see home remedies online or other advice about how to clear an HPV infection and wonder if they actually work. Research is ongoing to learn more about ways of clearing infection, but so far, there isn’t enough evidence for us to recommend specific treatments.

🔶The bottom line.

HPV is extremely common and usually doesn’t cause lasting problems, but it’s still important to protect young people from future cancer risk by getting them vaccinated. If you test positive, you’re not alone, and there are clear next steps. The most important thing is to stay informed, keep up with screening, and know that there’s a lot of support (and science) on your side.

🔶Further Reading:

From the U.S. CDC:

About Genital HPV Infection – Fact Sheet [archived link]

About HPV – Another Fact Sheet with vaccine info [archived link]

Info and Treatment Guidelines for Genital Warts [archived link]

CDC STI Treatment Guidelines, 2021 [archived link]

Cancers Associated with Human Papillomavirus [archived link]

Cervical Cancer – info on screening, testing, prevention, symptoms, and statistics [archived link]

HPV and Men [archived link]

Health Effects of Cigarettes: Cancer [archived link]

Other trusted sources:

National Cancer Institute’s Cervical Cancer Causes, Risk Factors, and Prevention