Understanding HPV (the basics)

What is HPV infection?

Human papillomavirus (HPV) is the name of a group of viruses that cause infection on the skin surface. It is one of the most common viral infections. It is so common many experts believe HPV infection should be considered an inevitable consequence of normal sexual activity.

80% of unvaccinated adults will have an HPV infection at some point in their life. In most people, it causes no symptoms (you won't know you have it) so is therefore unavoidably shared mainly through sexual activity (direct skin-to-skin contact) with someone who is infected. HPV can be transmitted by penetrative as well as non-penetrative sexual contact (genital-genital, oral-genital, anal-genital, oral-anal).

It most people the virus is harmless and causes no symptoms.

In a few people, HPV infection can cause genital warts which are harmless and different from the types of HPV that cause abnormal cells or cancer.

In a few people, HPV infection can cause abnormal cells which can sometimes lead to cancers, including cervical, vaginal, vulval, anal and head and neck cancers and penile cancers.

What are the symptoms of an HPV infection?

In most people, HPV causes no symptoms and you won't know that you have it.

If HPV symptoms do develop, these may appear as warts on the genital area.

The interval between infection with HPV and the appearance of genital warts can vary from months to many years.

What are HPV genital warts?

HPV can cause genital warts in some people. Genital warts are growths or bumps on the skin around the genital area; vulva, vagina, cervix, penis, scrotum, urethra (urine opening), anus, groin or thigh. They may be raised warts or flat warts, single or multiple, small or large. Some HPV warts can cluster together forming a cauliflower-like shape.

Genital warts are harmless and different from the types of HPV that cause abnormal cells or cancer.

If left untreated, genital warts may go away, stay the same, or increase in size or number.

There are treatment options available for genital warts.

Transmission and risk

How do you contract HPV?

HPV is usually acquired by direct skin-to-skin contact during intimate sexual contact with someone who is infected. The virus can be transmitted by penetrative as well as non-penetrative sexual contact (genital-genital, oral-genital, anal-genital, oral-anal).

HPV can infect areas that are not covered by a condom, so condoms may not fully protect against HPV.

Sex partners tend to share HPV, even when both partners do not show signs of HPV. HPV can lie dormant for many years so there is no way to know which partner it came from or how long ago.

Having HPV does not mean that a person or their partner is having sex outside the relationship.

How serious is HPV?

In most people, the HPV virus is harmless and causes no symptoms and will not develop into warts, or pre-cancer or cancer.

In a few people, HPV causes genital warts, which is not a serious infection, has treatment options available, and usually disappears on its own.

However, some types of HPV that you can't see, can cause changes to skin cells which can sometimes lead to cancers in both men and women, including cervical, vaginal, vulval, anal, head and neck cancers and penile cancers.

HPV vaccination (and regular cervical screening for people with a cervix) offers the best protection against genital warts and HPV-related cancers. The HPV vaccine works best when given prior to HPV infection, i.e. before you become sexually active. For people who are already sexually active, the vaccine may still be of benefit as it will prevent the acquisition of new HPV infections for the strains that the vaccine covers.

Do condoms prevent HPV?

HPV is transmitted by direct skin-to-skin contact and therefore condom use during sexual intercourse can provide some protection against infection. However, as condoms do not cover the entire skin surface that comes into contact during sexual intercourse, they cannot offer 100% protection.

Testing and diagnosis

Can I get tested for HPV?

It is possible to test for some types of HPV. As of September 2023, the primary test for cervical screening in Aotearoa is an HPV test, done using a vaginal swab. This particular test is looking for specific, high-risk HPV types.

The purpose of the HPV test in cervical screening is to identify those at a higher risk of cervical cancer at an early stage.

HPV testing is generally not part of routine sexual health check ups. This is in part because in some people the virus is "hibernating" at levels that are not detectable by testing.

You, or your sexual partner/s may notice if you have visible genital warts, or sometimes they may be found during a physical examination by a health care provider.

Health implications

Does HPV cause cancer?

HPV is a common infection and often clears by natural immunity. In most people the virus is harmless and causes no symptoms (you won't know you have it) and will not develop into warts, pre-cancer or cancer. This means that having HPV does not mean that a person has (or will get) cancer.

In a few people, HPV can cause abnormal cells which can sometimes lead to cancers, including cervical, vaginal, vulval, anal, head and neck cancers and penile cancers.

Preventive vaccines are now available which provide protection from almost all HPV infections that cause abnormal cells.

Does HPV or genital warts affect fertility or pregnancy?

HPV in pregnancy has no link with miscarriage, premature labour, or other types of pregnancy complications. It is no hindrance to fertility or planning a family.

Genital warts very rarely cause problems during pregnancy and delivery. Because of changes in the body during pregnancy, warts can grow in size and number. Delivery by caesarean section is not required unless warts are blocking the birth canal, which is extremely uncommon. Rarely, babies exposed to HPV during birth may develop warts in the throat.

If you are pregnant and have genital warts, speak to your health care provider, as some methods of wart removal treatment are not suitable during pregnancy.

HPV in males

Can men get HPV?

All people are at risk of catching HPV. HPV is an extremely common infection and, without vaccination, 80% of adults will have an HPV infection at some point in their life. Infection with HPV is believed to occur quickly after sexual debut and the rate of infection in males does not appear to decline with age.

Studies have shown men who have sex with men (MSM) have a significantly higher risk of acquiring HPV-associated anal cancer.

How does HPV affect males?

In males, HPV can affect the anogenital area and also the throat, in the form of genital warts, penile cancer, anal cancer and oropharyngeal (throat) cancer.

While HPV is a very common STI, genital warts are uncommon, and HPV-related cancers are rare. Infection with high-risk HPV (hr-HPV) places you at risk of developing HPV-related cancers, however the likelihood of an infection progressing to cancer is unknown but thought to be low.

Tretment and cure

Can HPV be treated?

We ensure every dollar goes directly towards our programs and initiatives, with a focus on maximizing impact. A small portion covers essential operationa.Only genital warts and high grade cervical abnormalities are treated.

There is no treatment for HPV that is 'silent' i.e. has no symptoms.

The majority of HPV is naturally cleared by the body's immune system within 1 - 2 years.

Can HPV be cured?

There is no treatment to eliminate HPV itself. HPV is a viral infection which is usually dealt with by your body's immune system.

HPV can be prevented with a vaccine.

Prevention and vaccination

What is the HPV vaccine?

The HPV vaccine prevents human papillomavirus (HPV) types that cause several cancers, including cervical, vaginal, vulval, anal, head and neck cancers and penile cancers.

The HPV vaccine also prevents HPV types that cause genital warts in both females and males and will prevent most cases of genital warts.

Vaccination prior to becoming sexually active gives you the best chance of preventing HPV infection. For people who are already sexually active, the vaccine may still be of benefit as it will prevent the acquisition of new HPV infections for the strains the vaccine covers.

The HPV vaccine (Gardasil 9) is licensed for use in New Zealand and provides immunity against 9 HPV types. The vaccine is currently available in New Zealand FREE to males and females aged between 9 years and their 27^th birthday. The vaccine can also be purchased by people outside of the funded groups.

How can I avoid getting HPV or genital warts?

Preventive vaccination against HPV is available. HPV vaccines are highly effective at preventing almost all genital HPV infections, including genital warts, and preventing HPV-related cellular changes or cancer developing.

As HPV is transmitted by direct skin-to-skin contact, condom use during sexual intercourse can provide some protection against HPV infection. However, as HPV may be present in areas of skin not covered by condoms, they cannot offer 100% protection. Condoms are recommended with all new or casual sex partners.

Frequently asked questions