Human Papillomavirus (hpv)

What is it?

The human papillomavirus (HPV) infection is a sexually transmitted infection (STI). HPV is a very common virus and is spread during sexual activity involving intimate skin-to-skin contact with an infected person. HPV can be passed even when an infected person has no signs or symptoms.

There are more than 100 types of HPV that can spread to the genital areas. Some types of HPV can cause anal and genital warts and others can cause cancer.

What are the symptoms?

In most cases, people infected with HPV do not have symptoms or health problems. Most HPV infections go away by themselves. For those who do develop symptoms, the most common are warts on, in, or around the vagina, penis and anus. In some cases, HPV infections can cause a variety of serious health problems, including cervical or anal cancers. It can also cause other cancers. Cancers caused by HPV infections develop very slowly and may not be diagnosed until years, or even decades, after a person initially gets infected with HPV.

How do I get it?

HPV is spread during sexual activity through skin-to-skin contact with someone who has HPV. While condoms may reduce the risk of getting HPV, the virus can still be spread through skin-to-skin contact from areas that are not covered by the condom. Female condoms may provide additional protection.

Remember—“symptom-free” doesn’t mean “infection-free.” Even if you feel perfectly fine, and do not notice any visible warts, you can still carry the virus and pass it on to your partner.

What can it do to me?

HPV is so common that, without immunization, at least 7 in 10 sexually active people will get HPV in their lifetime.

Genital warts caused by some types of HPV may look like a small cauliflower or may be flat, and are usually painless but treatment can cause discomfort. If HPV infection isn’t treated or doesn’t go away on its own, in some cases it can lead to cervical, vulvar, vaginal, anal and penile cancer. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Among gay men, bisexual men and other men who have sex with men, the risk of HPV infection and genital warts is about three times higher than for heterosexual males and the risk of anal cancer is 20 times higher.
Fortunately, infections from the most common cancer-causing types of HPV can be prevented with the HPV vaccine.

What are the tests?

There is no approved routine screening test for HPV-associated diseases other than cervical cancer.

The appearance of genital warts is one way HPV infection is diagnosed.
In women, HPV infection can be detected with routine cervical cancer screening (Pap test) and follow-up of abnormal results. Some people may only find out they have been infected with HPV once they’ve developed more serious problems from HPV, such as cancer.

What are the treatments?

There’s no cure for the HPV virus. However, there are treatments for the health problems that HPV can cause.

HPV-related diseases are more treatable when diagnosed and treated early. Prevention is always better than treatment.

For the most part, genital warts are painless, though treatments can be uncomfortable. Topical ointments, or liquid nitrogen (“cryotherapy”) are the most common treatments. In severe cases, lasers or surgery may be needed. Wart removal is largely cosmetic. The warts can come back until your body naturally clears the HPV infection.

Cervical pre cancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops.

The good news is that a vaccine is available to protect men and women from getting infected with some HPV types that pose the highest health risks. 

In Ontario, Grade 7 girls and boys receive the HPV vaccine for free as part of Ontario’s school-based HPV immunization program. This vaccine is also available for free to men who have sex with men. Eligible individuals include those who are 26 years of age or younger and who identify as gay, bisexual, as well as other men who have sex with men, including some trans people.  Ask your doctor or local public health unit if this vaccine is right for you.

Where can I get the vaccine?

The publicly funded HPV vaccine is highly effective for the prevention of cancers caused by HPV types 16 and 18 – and genital warts caused by HPV types 6 and 11.
The HPV vaccine is available for eligible individuals through your local public health unit. To locate your public health unit, please visit: Ontario.ca/healthcareoptions or Find a sexual health clinic in your area.

How can I prevent it?

The HPV vaccine works best when people are vaccinated before they become sexually active. However, the vaccine is still recommended for those who are already sexually active. A person who has been sexually active may not have been exposed to any or all the HPV types that are in the vaccine, so the vaccine will still offer some protection. If you are infected with one type of HPV, you can still benefit from the HPV vaccine. It can protect you against other strains of the virus.

It’s important to practice safe sex. Use condoms. This will lower the risk of getting HPV infection or other STIs.

Other tips for minimizing your risk

  • Protect yourself by using condoms on yourself, on your partner and even on sex toys. Keep in mind that the areas of the skin not covered by the condom are not protected and HPV can be spread through close skin-to-skin contact with someone who has HPV. Female condoms can provide additional coverage of exposed skin. Learn how to use them properly.
  • Have a doctor or sexual health clinic remove any warts on other parts of your body.
  • Routine Pap tests can ensure early detection and/or treatment of any abnormality of the cervix.

How do I tell my partner?

Discuss concerns about disclosing HPV infection to your partner with your sexual health clinic or your primary care provider. They may be able to provide you with additional information about the infection, and guidance specific to your situation. They may also be able to help you figure out how best to speak with your partner(s). Keep in mind that because many people can have HPV with no signs or symptoms, it is often difficult to determine who may have passed the infection to who, and when. Here are some tips on how to talk comfortably about it.

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