Written by Ashley Fang, Peer Reviewed by Xiaochen Liu, Edited by Courtney Coleman
Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) and can have low and high-risk effects on infected individuals (1). HPV can be contracted by anyone who has close skin-to-skin contact with someone who has HPV. It can be hard to track, as individuals may transmit the infection when they are asymptomatic, and it is possible for people to develop symptoms years after contact with someone who had HPV (2). While there are over 100 types of HPV, the majority of strains are harmless, though there are also strains that cause serious chronic illnesses. According to the Kaiser Family Foundation, HPV is not well-known among 70% of U.S. adults ages 18 and older, despite it being the most common STI (3). In this article, we aim to make a difference by informing the public about this widespread infection, providing details about the symptoms, trends, treatment, and prevention of HPV, as well as resources the public can use to become better prepared to address infections.
Symptoms and Diagnoses
In many cases, the immune system will manage the HPV infection before symptoms appear; however, individuals are still susceptible to low or high-risk strains of HPV. Low-risk HPV strains are typically associated with common warts, such as plantar and flat warts. These warts are rough, raised bumps that may appear on the hands, feet, or face, and can be painful (4). Another type of wart someone infected with HPV may develop are genital warts, associated with high-risk HPV strains. Genital warts can appear in the form of flat lesions and frequently develop on the vulva for women and the penis or scrotum for men. They may also appear around the anus or on the cervix. Genital warts may only itch and feel tender, but they can also cause extreme discomfort and pain (4). High-risk HPV strains can also give rise to cervical, penile, and anal cancer (4). Cancer screening, such as Pap tests for women, can help diagnose HPV (2). Doctors such as dermatologists can also diagnose an infection by examining warts, as well as conducting DNA tests to detect high-risk HPV linked with genital cancer (5). Applying a vinegar solution test to areas of the genitalia is also a viable diagnosis method, as if the solution turns white, HPV infection is known to be present (5).
Statistics
The population predominantly affected by HPV includes those in their late teens and early 20s. The prevalence of any oral HPV is significantly higher in men than women, but the prevalence of any genital HPV among men and women is very similar. In all forms of HPV (any and high-risk cases of oral and genital HPV), non-Hispanic black adults are more affected than other racial groups (3; see Figures 1 and 2).
Prevention and Treatment
As with other STIs, the most effective way to combat HPV is to minimize one’s exposure during sexual engagements by using condoms, and preventing infection in the first place by getting the HPV vaccine, Gardasil 9, recommended by the Centers for Disease Control (CDC). The HPV vaccine is recommended for all preteens ages 11-12, and everyone through age 26, if they are not vaccinated already (2). Dosage may vary, with children younger than 15 typically receiving 2 doses, and those 15 years or older, or immunocompromised individuals, receiving 3 doses if it is their first time acquiring the vaccine. Vaccination for those ages 27-45 is less beneficial, as at this age most have already been exposed to HPV, or are in long-term, monogamous relationships, which minimizes the risk of contracting HPV (2).
HPV vaccines are available at community health clinics, doctor offices, school-based health centers, and more (2). If your local physician does not stock HPV vaccines, you can always ask for a referral. Treatment for those who have already contracted HPV and exhibit symptoms includes surgical or laser removal, irritant medications, cryotherapy for warts, and chemotherapy for cancer (7). Consulting your physician or visiting the CDC website are always beneficial practices to be more informed on options regarding vaccines or after contracting an infection.
With HPV’s continued prevalence in society today, it is more important than ever to remain vigilant and be more well-informed to improve one’s own health, as well as the well-being of society.
References
1. Cates, Joan R, et al. “Human Papillomavirus: A Hidden Epidemic in the United States.” Population Reference Bureau (PRB), Population Reference Bureau, 1 May 2001,
https://www.prb.org/resources/human-papillomavirus-a-hidden-epidemic-in-the-united-states/.
2. Department of Health and Human Services. “Genital HPV Infection – Basic Fact Sheet.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Apr. 2022, https://www.cdc.gov/std/hpv/stdfact-hpv.htm.
3. McQuillan, Geraldine, et al. “Prevalence of HPV in Adults Aged 18–69: United States, 2011–2014.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 Apr. 2017, https://www.cdc.gov/nchs/products/databriefs/db280.htm.
4. Clinic, Mayo. “HPV Infection.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 12 Oct. 2021, https://www.mayoclinic.org/diseases-conditions/hpv-infection/diagnosis-treatment/drc 20351602.
5. Clinic, Mayo. “HPV Test.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 17 May 2022, https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355.
6. Institute, National Cancer. “HPV and Cancer.” National Cancer Institute, National Cancer Institute, 12 Sept. 2022, https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer.
7. Luria, Lynette, and Gabriella Cardoza-Favarato. “Human Papillomavirus.” National Library of Medicine, 24 Jan. 2022, https://www.ncbi.nlm.nih.gov/books/NBK448132/.
This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from ongoing research is constantly evolving. This post contains information that was last updated on November 21, 2022.
Ashley Fang is currently an intended Molecular and Cell Biology major undergraduate at UC Berkeley.
Xiaochen Liu is a fifth year PhD candidate in Epidemiology at UC Irvine.
Courtney Coleman is a master's degree candidate in biology at Harvard and Co-President of Students vs. Pandemics.
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