Human Papillomavirus, or HPV, has become the most common sexually transmitted infection. Frighteningly prevalent, in fact, as an estimated 50 percent of all sexually active adults will have contracted the virus at some point in their life, while about half of college-aged individuals are currently infected with genital HPV, according to Emily Gibson, director of Western's Health Center. Often conveyed by the mass media as an STI (Sexual Transmitted Infection) epidemic, most of the 20 to 40 million Americans that are infected with the virus will not suffer any serious repercussions.
So what is there to worry about HPV and what is there to know about the virus?
The majority of HPV infections produce no symptoms and end up healing without treatment. However, the virus can have adverse repercussions, particularly in the genital area.
There are over 100 strains of the virus, only about 30 to 40 are sexually transmitted; however, it is from these sexually transmitted strains that the genital area of men and women may become infected, according to Gibson. Of the sexually transmitted strains of HPV, about 10 different types can cause genital warts, with strains 6 and 11 being the most common, according to Rutgers University's medical website.
Though genital warts can be embarrassing and potentially dangerous if gone untreated, these strains are considered low-risk strains of HPV and can easily be diagnosed and treated. As mentioned before, about 50 percent of the sexually active population carry strains of genital HPV—the strains that cause genital warts. However, many people may carry the wart-causing strain without ever developing warts. Similarly, many may carry the virus for weeks, months, or even years before developing warts, making it almost impossible for most to pinpoint an exact source of infection. There are estimates between 500,000 to 1,000,000 cases of genital warts diagnosed a year, according to Planned Parenthood.
Treatment of genital warts may vary from topical treatments, to liquid-nitrogen freezing, to laser removal, depending on the severity of the condition. Western's health center performs diagnosis and liquid-nitrogen freezing and can prescribe topical treatments for genital warts; according to Gibson, Western's health center does not perform laser treatment but will refer students in need of such treatments to an according specialist.
However, though genital warts may seem horrible, cervical cancer is worse. Certain high-risk strains of HPV, specifically strains 16 and 18, are now believed to be the cause of up to 70 percent of all cervical cancer, and along those lines, almost all cases of cervical cancer are caused by HPV.
“Over a typical college career approximately 60 percent of sexually active women will become infected. While it is assumed that a similar number of men are also infected, there are no good statistics as it is harder to test for HPV in men than women,” the Rutgers medical website says.
High-risk HPV in women can be diagnosed through the normal Pap smear procedure. Abnormal Pap smear results are often caused by HPV infection. If a woman is determined to have a high-risk strain of HPV, the woman should then have a colposcopy, a procedure similar to a Pap smear where the cervix can be examined in close detail through use of a colposcope. The physician will be able to determine the presence of HPV cells on the cervix at this point and may choose to take a biopsy from the cervix to test for cervical cancer or the presence of pre-cancerous cells. If cells have developed on the cervix that the physician feels need to be removed, they will perform a procedure to remove any, depending on the condition. Western's health center has the capacity to perform three colposcopies per week.
However, one should take into account that very few women diagnosed with high-risk HPV develop cancer, and many cases of high-risk HPV also heal without treatment over time.
Still, is there any way to prevent all the doctor appointments and anxiety? Well, unfortunately, HPV is transmitted through skin-to-skin contact. This means that while condoms might help, it is believed that condoms do not prevent the spread of HPV.
“The best practice is to delay or avoid risky sexual contact to reduce the chance of being infected or transmitting a silent infection,” Gibson said. “Latex barriers are not 100 percent effective but are better than using no barriers. Monogamous and exclusive long term relationships are key to decreasing the incidence of all HPV.”
However, the Gardisil vaccine for HPV has recently become widely available to women and helps protect against two strains of HPV responsible for 90 percent of genital warts (types 6 and 11) and two other strains that cause 70 percent of cervical cancer (types 16 and18), said Gibson. The vaccine is available at the health center and is administered in a series of three injections. The cost is $125 per injection. Unfortunately, there is no vaccine for men, nor any standard test to detect HPV strains in men.
And as Gibson advises, “Females who are sexually active may also benefit from the vaccine. But they may get less benefit from the vaccine since they may have already acquired one or more HPV types covered by the vaccine. Few young women are infected with all four of these HPV types. So they would still get protection from those types they have not acquired. Currently, there is no test available to tell if a girl/woman has had any or all of these four HPV types.”
All figures come from Emily Gibson, M.D. and the Planned Parenthood website, unless otherwise attributed.