While you may have heard of genital warts, you’ve probably never heard of Human Papillomavirus (HPV). Despite the fact that HPV is considered to be the most common sexually transmitted disease (STD) and is the most common STD on the ASU campus, many do not even know what it is.
“I don’t know what [HPV] is but I’ve heard about it,” said one ASU student. “I know what a few [STDs] are—you know like syphilis, gonorrhea, herpes and genital warts and things that like—I know how you can get them.”
HPV is the name given to a group of more than 100 types of viruses. Of these, at least 30 are sexually transmitted in both men and women and at least 14 can lead to cancer. While HPV is recognized as the major cause of cervical cancer in women it has also been linked to penile and oral cancer as well.
HPV can be transmitted through skin-to-skin contact and can lead to genital warts that may or may not be visible. While the body’s immune system is sometimes good enough to fight off HPV, and sometimes infections caused by the virus may disappear without any treatment, the “high risk” HPVs that lead to flat, abnormal growths in the genital area and on the cervix, can lead to cervical cancer if left untreated.
However, regular Pap smears to look for abnormalities in the cells of the cervix and the vagina can allow for treatment and removal before cancer has a chance to develop. Anne Ryan, a nurse practitioner at the ASU Student Health Center, takes Pap smears on a daily basis. She says HPV “is the most common if not the cause of abnormal Pap smears in young women.”
While HPV can lead to genital warts that are visible as well, visible warts generally do not lead to cancer and can be treated with certain gels or creams. These warts may appear as soft, moist pink or flesh-colored swellings. Or they may show up in clusters that resemble cauliflower-like bumps.
“The ones that we can’t see with just our naked eye are the ones of concern,” said Ryan. “Those are the ones that are measured on a Pap smear.” And if they’re identified on a Pap smear, we do a colposcospy.”
The hidden polyps hinted at by the Pap smear can be revealed by a lighted magnifying instrument called a colposcope, used to examine the vagina and cervix. The procedure is simple and painless and only lasts about 10 to 15 minutes.
In addition, many doctors also test for the specific type of HPV causing an infection. The test can detect high-risk HPVs even before changes can be seen on the cervix. While there is no cure for the virus, these tests allow for early detection so that the damaged cells can be removed surgically.According to Dr. Gary Septon, health center chief of staff, the change from normal cervical cells to precancerous ones, usually takes many years. Even among women with high-risk HPV, only a small percentage will actually develop cervical cancer if these cells were not removed. Nevertheless, risk factors like age and smoking may contribute to the development of cervical cancer.
“This is something that happens over a period of years,” said Septon. “Generally there’s a long enough latent period that you have time to treat the changes before it develops into cancer.”
This is why routine screening is so important. The American Cancer Society recommends that all women begin cervical cancer screening about 3 years after they begin having vaginal intercourse or when they are 21.
While having multiple sexual partners increases the risk of getting HPV, Ryan says that she has seen people who are newly sexually active with HPV.
“HPV is a viral infection. The most common source of it is sexual contact but people can develop that without ever being sexually active as well,” said Ryan. “We don’t always know what the source is.”
For individuals that are newly sexually active, Ryan said that the sexual activity may be more “casual” or “experimental” in terms of short-term relationships.
“I think if you’re newly sexually active you don’t’ always have that sense of consequence of the action,” she said.
While, condoms can help protect against other STDs, HPV infection can occur in areas that are not covered by a latex condom. In addition, an individual that does have HPV may not have any symptoms or visible warts, but can still transmit the virus to their sex partner.
It is difficult to determine whether a partner who has been sexually active in the past is currently infected. In fact, according to the Centers for Disease Control and Prevention (CDC), while at least 50 percent of sexually active individuals acquire genital HPV infection at some point in their lives, most people who have a genital HPV infection do not even know they do.
Also, while testing samples of cervical cells, is an effective way for “high risk” HPVs to be identified in women, there is currently no HPV tests available for men.
While a long-term, mutually monogamous relationship can help prevent genital HPV infections, according to the CDC, abstaining from any form of genital contact with another individual is the best way to avoid getting genital HPV. “I think that [students] need to be aware of who they’re interacting with in an intimate way,” said Ryan. “I just feel like we almost need to get this info to even younger girls. It just seems like women are exposed to intercourse at an earlier age.”
“People are very emotional about herpes still,” she added. “But herpes don’t cause cancer.”
Recently, a potential vaccine for two “high-risk” HPVs, has been found to be effective. Further research is being done on this vaccine and for a vaccine that would include protection against other strains of the virus.
According to Septon, this will take care of the most common form of HPV.So the infection “won’t be entirely prevented, but it will take care of most.”
