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HPV and genital warts symptoms and treatment

Human papilloma virus (HPV) is a common viral infection that can affect your skin. Nearly everyone will get HPV at some point in their lives.  

It is passed on through any skin-to-skin contact of the genital area; vaginal, anal or oral sex; and sharing sex toys. Most strains do not cause any problems but some can cause genital warts, while other types can lead to cancer.  

A vaccine is available to prevent certain types of HPV that cause most cases of genital warts and cervical cancer. It is most effective if given before having sex for the first time.  

What is the human papilloma virus (HPV)?

Human papilloma virus (HPV) is the name for a group of viruses that affect your skin and the moist membranes of your body. These include the cervix (entrance to the womb), anus, mouth and throat. 

There are a number of different strains of HPV. Most have no symptoms, go away by themselves and don’t cause any health problems. Some types can cause genital warts or lead to cervical, anal and other cancers.  

How do you get HPV?

HPV infections are passed on through skin-to-skin contact. This is often through a cut, abrasion or small tear in your skin. 

Genital HPV infections are very common and easy to catch. You can get HPV from: 

  • vaginal, anal or oral sex without a condom or dental dam, with someone who has an HPV infection (even if they don’t have symptoms) 

  • sharing sex toys that aren't washed or covered with a new condom each time they are used 

  • close genital contact – this means HPV can be passed on even if there’s no penetration, orgasm or ejaculation. 

If you have HPV while pregnant you can pass the infection on to your baby at birth, but this is rare.  

How do you prevent HPV?

There are a number of things that can help decrease the risk of getting HPV. 

Vaccines are available to prevent certain types of HPV that cause most cases of genital warts and cervical cancer, as well as some other cancers. These are often offered to adolescent girls, men who have sex with men and people with HIV. It’s best to have the vaccine before you start having sex, although it’s sometimes possible to get the vaccine later in life. Ask a healthcare worker to find out if you can get the HPV vaccine where you are. 

Using a new condom or dental dam every time you have vaginal, anal or oral sex will help. But, HPV can affect areas not covered by a condom, so you’re not fully protected. 

Use a new dental dam or latex gloves for exploring your partner’s anus with your fingers, mouth or tongue. Using latex gloves for fisting will also help to lessen the risk. 

Always cover sex toys with a new condom for each partner and wash them after use. 

Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, it’s even more important to use condoms and get tested regularly even if you don’t have any symptoms.  

Taking pre-exposure prophylaxis (PrEP), the contraceptive pill or any other type of contraception – apart from condoms – won’t protect you from HPV and other STIs. 

What are the symptoms of HPV?

HPV infections often have no symptoms, so you may not know if you have it. Where symptoms do appear these will vary depending on the strain of HPV. 

One of the most common strains of HPV is genital warts. Many people with this strain of HPV will not develop any symptoms or know that they have it. 

 Symptoms of genital warts include: 

  • one or more small, flesh-coloured or grey painless growths or lumps around your vagina, penis, anus or upper thighs 

  • itching or bleeding from your genitals or anus 

  • a change to your normal flow of pee (for example, sideways), that doesn't go away. 

The warts may be difficult to notice if they are internal (inside the vagina or anus).  

Symptoms of genital warts can appear weeks, months or years after you were in contact with the virus that causes them. If you have symptoms of genital warts it’s important to visit a health clinic to have them checked. 

How do I test for HPV?

Different strains of HPV are tested for in different ways. 

A healthcare professional can quickly examine you to tell if you have genital warts (low-risk HPV). 

For cancer-causing HPV (high-risk HPV) in women, genital HPV testing is often part of cervical screening. This screening checks for abnormal cells on the cervix (entrance to the womb). Cervical screening isn't a test for cancer – it's a test to check the health of the cells of the cervix. If you have changes in the cells on your cervix, this doesn’t mean you have cervical cancer. In some cases the abnormal cells need to be removed so they can't develop into cancer. 

For men, there’s currently no reliable test for HPV infection. It is often very difficult to diagnose as there are no symptoms for high-risk HPV. Some people who are at a high risk of having anal HPV and of developing anal cancer may be offered an anal smear. This checks for abnormal cells in the anal canal. This group includes men who have sex with men or people with HIV. 

How is HPV treated?

There's no treatment for the HPV virus and most infections do not cause any problems. Treatment is needed if HPV causes problems like genital warts or changes to cells in the cervix. 

Genital warts (low-risk HPV): the sooner genital warts are treated, the easier they are to get rid of. The warts can be removed using creams, freezing or heating. This depends on the type of warts and where they are located.  You should always check with a healthcare worker before using treatments for genital warts. 

Although these treatments can remove the warts themselves, there's no cure for the virus that causes the warts. Some people’s bodies, however, are able to clear the virus over time. 

Cancer-causing HPV (high-risk HPV): if a cervical screening test shows you have abnormal cells on the cervix, it may be necessary to remove them so that they don’t develop into cancer. 

There are two advantages of being screened early. Firstly, to identify and remove pre-cancerous lesions caused by HPV. These are removed to prevent invasive cancers from developing. Early screening also means that cervical cancers can be found at an early stage, when they can usually be treated successfully with surgery. 

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What should I do if I have genital warts during pregnancy?

It’s possible for pregnant women to pass genital warts on to their babies during childbirth, but this is rare. Talk to your healthcare worker if you are pregnant and think you might have genital warts. They will be able to advise you which treatment to use. Not all treatments available are suitable for pregnant women.  

Is there a link between HPV and HIV?

Having an STI such as genital warts can increase your risk of getting and passing on HIV. This is because having an STI makes it easier for HIV to get into your body and cause an infection. 

People with HIV can also be more likely to get genital warts or have more severe cases of genital warts. This is especially the case for people who aren’t on treatment or who have a lower CD4 count. You’re more vulnerable to infections if your immune system is weaker. 

If someone with HIV also has HPV, their viral load will increase. This makes them more likely to pass on HIV during unprotected sex, even if they are taking HIV drugs (antiretrovirals). However, if you have an undetectable viral load there is no evidence that HPV makes you more likely to pass on HIV. 

The risk of developing HPV-related cancers is higher in people with HIV who are not on effective treatment. This is because their immune system is often weaker. Being on HIV treatment (antiretrovirals) with an undetectable viral load reduces this risk.  Having a higher CD4 cell count of over 200 can also lessen the risk of developing HPV-related cancers. 

If you are taking antiretrovirals it is important to discuss this with your healthcare professional. They can advise how treatment for HPV may interact with your HIV drugs.  

How do I tell my recent sexual partner(s) I have HPV?

If you test positive for HPV, it’s important to tell any recent sexual partner(s) so they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do. It shows you respect them and want them to stay healthy. 

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