Genital human papillomavirus (HPV) is the most common of the STDs. There are over 40 types that can infect the genital areas of men and women, including the penis; vulva; anus; and the rectal, cervical, and vaginal linings. Genital warts (one type of HPV) are circumscribed, elevated skin lesions, usually seen on the external genitalia or near the anus. Approximately 20 million Americans are currently infected with HPV. Most persons do not realize they are infected or that they are passing the virus to their partner.
Genital HPV is typically spread from person to person during intimate sexual contact. A pregnant woman can pass HPV to her neonate during vaginal delivery. Genital warts have a prolonged incubation period of 1 to 6 months and grow rapidly in the presence of heavy perspiration, poor hygiene, or pregnancy.
Signs and Symptoms
Most individuals with HPV do not develop symptoms. However, some types of HPV (usually known as “low-risk”) are the cause of genital warts. Clients may be asymptomatic or may experience tenderness in the area of the wart. Genital warts appear as solitary or clustered lesions. In males, the warts typically occur at the end of the penis or in the perianal area. In females, the warts typically appear near the opening of the vagina, and they commonly spread to the perianal area. Other types of HPV (known as high-risk) can cause cervical cancer.
There is no test for HPV. It usually goes away on its own. The characteristic appearance and location of genital warts are usually sufficient for diagnosis. Cervical cell changes that can lead to cervical cancer can be identified on routine Papanicolaou (Pap) tests.
There is no cure for the virus; a healthy immune system can usually deter HPV naturally. Genital warts can be removed by topical medication, or carbon dioxide laser treatment, cryosurgery, electrocautery, or debridement may be attempted. Small warts may require no treatment. Cervical cancer is treatable when diagnosed early.
An ointment made of vitamin A and herbs may be topically applied to genital warts.
Encourage hand washing after the application of topical treatments. Recommend the use of condoms. Sexually active females are encouraged to have annual Pap tests. Encourage clients to know the sexual histories of their partners and to limit their number of sexual partners.
Low-risk HPV infection responds well to treatment. The prognosis is variable for high-risk HPV or cervical cancer. Spontaneous “cures” are rare, and the remainder of cases may be unresponsive to treatment.
Girls and women can be protected against many cervical cancers by the HPV vaccine. Tests are currently underway to determine if the HPV vaccine is also safe for boys and men. The Pap test can identify abnormal changes in the cervix so they can be removed before cancer develops. Some specialists recommend yearly Pap tests for men who practice anal intercourse that places them at greater risk for anal cancer.
Video: Natural History of HPV Infection