Living Well With HPV: 5 Steps for Safer Sex

More than half of all men and women who are sexually active will be infected by the human papillomavirus (HPV) at some time in their lives.

But “most women and men with the virus will never know they have it,” says Vanessa Cullins, MD, MPH, a board-certified obstetrician-gynecologist and the former vice president for medical affairs at Planned Parenthood Federation of America.

Most people infected with HPV do not develop any symptoms or health problems from the virus because the body’s immune system is able to fight off the infection.

“For the overwhelming majority of people, having an HPV infection has no impact on their lives,” Dr. Cullins says.

Still, some people do develop genital warts, which are caused by certain types of HPV, and some women learn they have HPV after an abnormal Pap smear, in which cells from the cervix are examined for cancerous or precancerous changes, or after an HPV test of cervical cells.

For others, the first indication of an HPV infection is a diagnosis of anal, vulvar, vaginal, penile, or oropharyngeal cancer. Signs of cancer may include redness, irritation, sores that don’t heal, abnormal bleeding, itching, pain, and lumps. If you experience any of these symptoms in your genital or anal regions, mouth, or throat, see a doctor promptly to get it checked out.

Screening tests for detecting HPV infection in the anus, vulva, vagina, penis, mouth, and throat are less common or unavailable. While the CDC does not recommend routine screening for HPV in these areas — or for men in general — HPV testing can be done on anal samples and anyone at higher risk (including people with HIV or men who receive anal sex). If you are concerned about contracting HPV in one of these areas, talk to your doctor about which tests are available and recommended for you.

How to Lower Your Risk of HPV Infection and Transmission

If you know you’re infected with HPV — or even if you don’t know — what should you do to safeguard yourself and your sexual partner from HPV transmission?

First, assume you will be living with some type of HPV virus at some point in your life. “Everyone who is sexually active, vaccinated or not, should make this assumption,” Cullins says.

Then consider these steps to help protect yourself and anyone with whom you have intimate contact.

1. Get Vaccinated and Encourage Your Partner to Get Vaccinated

The U.S. Centers for Disease Control and Prevention recommends that all boys and girls get the HPV vaccine at age 11 or 12 — likely before they’ve been exposed to sexually transmitted strains of the human papillomavirus. While that is the traditional age to get vaccinated, the HPV vaccine is still recommended for everyone age 26 and younger.

And even if you didn’t get the vaccine before age 26, it may not be too late. In 2018, the U.S. Food and Drug Administration (FDA) expanded its approval of the HPV vaccine used in the United States — Gardasil 9 — to include adults up to age 45, vastly increasing the number of people eligible to receive the vaccine and the protection it provides.

However, it’s important to note that FDA approval of the vaccine does not guarantee that health insurance will cover the cost of it, so adults ages 27 to 45 who are interested in being vaccinated against HPV should check with their insurer first to make sure they’re not faced with surprise medical expenses.

Gardasil 9 protects against the two HPV strains that cause most genital warts, types 6 and 11, as well as against seven cancer-causing types of HPV, including HPV types 16 and 18.

An earlier form of Gardasil protected against just four types of HPV: types 6 and 11, which cause warts, and types 16 and 18, which raise the risk of cancer.

Another HPV vaccine, Cervarix, is no longer available in the United States but is used elsewhere in the world. It protects only against HPV types 16 and 18.

The HPV vaccine has been found to be both safe and effective, and when possible, it should be your first-line strategy for preventing HPV infection.

RELATED: HPV Vaccine Offers Cancer and Genital Wart Prevention

2. Use Condoms When Having Sex

HPV is spread by direct contact, so you should use condoms every time you have sex — from start to finish. Consistent use of condoms will reduce your risk for HPV transmission, but it will not completely eliminate it. The virus can be on areas of the skin not covered by the condom. You should use condoms or dental dams for vaginal, oral, or anal sex, and never reuse condoms.

3. Get Regular Medical and Dental Checkups

The U.S. Preventive Services Task Force (USPSTF) recommends that women start getting screened for cervical cancer at age 21. Between ages 21 and 29, according to the USPSTF, women should have a Pap test every three years to look for early signs of cancer.

For women ages 30 to 65, the USPSTF recommends screening with Pap tests alone every three years, or a combination of Pap tests and HPV tests every five years.

Nearly all cases of cervical cancer are caused by HPV infection, and it is typically curable if found early.

Those with HIV and men who receive anal sex may benefit from anal exams, anal pap smears, and HPV testing to help detect precancerous or cancerous anal conditions.

While there are no equivalent screening tests to detect precancerous conditions of the genitals, mouth, or throat, “routine preventive dental and medical care is one of the best prescriptions for ongoing health,” Cullins says.

4. Learn to Identify HPV Symptoms

Know the symptoms of HPV-related infections so you can be on the lookout for them in yourself and your partner.

HPV can cause genital warts, which usually appear as a small, flat bump or groups of bumps in the genital area. If not treated, genital warts can grow larger.

If you or your partner is being treated for an HPV-related infection, you should refrain from having sex until treatment is completed.

RELATED: HPV Warts: The Misunderstood STD

5. Practice Good Genital Hygiene

After having sex, urinate to rinse any germs from your urethra, and wash your genitals with soap and water. This can help clean away bacteria or viruses before they have time to infect you.

Additional reporting by Ingrid Strauch.