Human Papillomavirus (HPV)
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What is human papillomavirus?
Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) in Canada.
There are many types of HPV. Some types cause genital warts, while other types don’t cause any symptoms. More aggressive forms of HPV are connected with cancer of the cervix or, less often, cancer of the anus, vulva, vagina, penis, and throat.
You may not know that your cervix or anus is infected with HPV until a Pap test shows abnormal cells. When you have a Pap test (or “smear”), your healthcare provider scrapes some cells from your cervix and looks at them under a microscope.
CAUSES & RISK FACTORS
How do you get HPV?
HPV is normally transmitted through sexual contact. This includes having oral, vaginal or anal sex with someone who has HPV.
A person who has HPV may not show any signs of the virus, as genital warts often take years to develop. In women, the warts may be on the cervix (the opening to the uterus or womb) and therefore not visible.
DIAGNOSIS & TESTS
How does my healthcare provider test for HPV?
Often HPV is discovered when a woman has a pelvic exam and Pap test. Pap tests are used to identify pre-cancerous cell changes caused by the HPV virus. If you have an abnormal Pap test, your provider need to do further examinations and tests. The exam and tests will help determine if HPV is the reason for the abnormal Pap test. HPV DNA testing is available in Canada but is currently not routinely available in Nova Scotia or PEI.
Males can be examined by their healthcare provider for genital warts caused by HPV and for signs of cancers of the penis, anus, and mouth and throat. If you have warts on your anus or penis, talk to your healthcare provider about having them removed and alert your sexual partner that you may have HPV.
What is the treatment for HPV?
Currently, there is no cure for HPV. If you have it, you’ll need to have regular and frequent Pap tests to keep watching for signs of cancer. Your healthcare provider may want you to have Pap tests more frequently to check the status of the HPV infection. In many men and women, HPV goes away on its own without causing any health problems.
Genital warts must be treated by your healthcare provider. Do not try to treat the warts yourself, especially with chemicals you can buy over the counter to remove warts that you would find on your hands. These chemicals are not supposed to be used for genital warts, as they can irritate the skin.
Is there a vaccine for HPV?
There is a vaccine (“quadrivalent”, Brand name Gardasil) that can prevent infection with 4 different types of HPV in young women. This vaccine targets the types of HPV that cause up to 70% of all cases of cervical cancer and about 90% of all cases of genital warts.
Gardasil 9 is also available in Canada, it prevents up to an additional 14% of anogenital cancers caused by an additional five HPV types.
There is another vaccine (“bivalent”, Brand name Cervarix) that can prevent infection with the types of HPV that can cause cervical cancer in women. It does not prevent infection with the types of HPV that can cause genital warts.
The National Advisory Committee on Immunization (NACI) recommends routine HPV immunization for the following groups of people:
- Girls and women ages 9-26
- Boys and men ages 9-26
These immunizations may be administered to individuals 27 years of age and older at ongoing risk of exposure to HPV. Discuss your options with your healthcare provider.
The immunizations are given as shots (injections in the upper arm) and require 3 doses. These immunizations may also be given according to a two dose schedule among healthy children as part of the school immunization schedule. The immunization is most effective if children receive it before they start having sex.
Studies are currently being done to test to see if the vaccine works for men and for women older than 26 years of age.
QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER
- What treatment is best for me?
- Is it possible to have sex with my boyfriend/girlfriend without giving him/her HPV?
- How can I avoid getting HPV?
- If I have HPV, am I at higher risk of getting another STI?
- How long will my treatment last?
- Are there any side effects of my treatment?
- Are there any support groups in my area?
- If my symptoms get worse, when should I call my healthcare provider?
- Should I have my child vaccinated against HPV?
FOR MORE INFORMATION
Government of Canada website
HPV Testing in the Evaluation of the Minimally Abnormal Papanicolaou Smear by BS Apgar, M.D., M.S., and G Brotzman, M.D. (05/15/99, http://www.aafp.org/afp/990515ap/2794.html)