The Facts About HIV and Human Papillomavirus (HPV)

Common STD Associated with High Rates of Anal and Cervical Cancers

Colorized electron micrograph of human papillomavirus (HPV).. Photo credit: BSIP/UIG via Getty Images.

Human papillomavirus (HPV) is one of the most common sexually transmitted diseases in the United States. Some estimates place the incidence rate at one million new cases each and every year, with prevalence of 20-40% among sexually active women.

Because HPV can have few or no symptoms, a majority of those infected may not even be aware that they have the virus. Worse yet, the consequences of infection can sometimes be severe, no more so than in men and women with HIV.

What is HPV?

HPV is a family of viruses that cause genital warts in men and women. The virus is also known to cause cellular changes that can lead to cancer of the cervix in women, as well as high rates of anal cancers (especially in gay men).

Cervical cancer today kills around 5,000 women per year in the U.S., with an incidence rate six times higher in women with advanced HIV. Similarly, anal cancers, while considered rare in the general population, occur at nearly 35 times the rate in gay men—and even more so in HIV-positive gay men.

Epidemiological research has  shown that HPV is a major risk factor for the development of both invasive cervical cancer (ICC) and anal cancer. Early detection through yearly Pap tests and anorectal exams is considered critical for the successful treatment of this potential life-threatening malignancies.

How is HPV Spread?

HPV is spread through sexual contact. Genital warts resulting from HPV infection can be found around the anus, vulva or cervix ion women and around the anus and the shaft of the penis in men.

Visible warts are usually harder to see in women, mainly because they can be internalized with little, if any, irritation or pain.

However, not everyone infected with HPV will develop warts. It should be noted that while the risk of transmitting the virus is highest when there are visible warts, transmission can be spread when no outward signs of HPV at all.

HPV can also lay dormant for years. This can mean that, even in long-term monogamous relationships, genital warts or cervical changes can occur without an obvious infectious event. Because of this, men and women should be screened for HPV if ever there there are cervical changes or appearances of wart in and around the genitals.

How Do I Protect Myself?

Because genital warts can occur on the scrotum, anus or other hard to protect areas, condoms and spermacides are not always 100% effective in preventing HPV infection. With that being said, safer sex practices can significantly reduce the likelihood infection. Condoms are key to this, providing the most effective protection from HPV and other sexually transmitted infections.

HPV vaccinations are also available for children and younger adults, with current U.S. guidance endorsing the use in the following groups:

  • All children who are 11 or 12 years of age
  • Teenage boys and girls who did not start or finish the HPV vaccine series when they were younger
  • Young women through the age of 26
  • Young men through the age of 21
  • MSM through the age of 26
  • Men with HIV who did not start or finish the HPV vaccine series when they were younger

What to Do If You Have HPV

For women diagnosed with HPV, it;s important to get yearly Pap tests to ensure early detection of any cellular changes to cervical tissues. Similarly, high-risk gay or bisexual men should request an annual anal Pap test to identify any structural changes to anorectal cells.

Additionally, if you have HPV:

  • Always inform your doctor about any abnormal vaginal bleeding or flank pain, or any bleeding, pain or unresolved itching from the anus or rectum.
  • Advise your sexual partner that you have HPV in order to make informed decisions about sexual practices.
  • Always use condoms during anal, vaginal, or even oral sex (most especially if warts are visible).
  • Suggest that your sexual partner get a complete medical evaluation and HPV screening.


U.S. Centers for Disease Control and Prevention. "HPV Vaccines: Vaccinating Your Preteen and Teen." Atlanta, Georgia; accessed December 7, 2015.

Association of Reproductive Health Professionals (ARHP). "Managing HPV: A New Era in Patient Care." Washington, D.C.; published June 2009.

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