‘Is HPV an STD?’ ask several patients, and indeed, human papillomavirus, or HPV, is one of the most common sexually transmitted diseases among humans. Nearly 80 million Americans have HPV, and about 13 million more will be diagnosed this year. It is expected that nearly every adult will contract HPV at some point in their lives. HPV transmission is widespread as the condition rarely becomes symptomatic and does not produce significant signs, save for a small minority of people. 

HPV transmission rates are variable depending on the site of contact with the infected part of the partner’s body. Despite the condition being widespread, the lack of understanding of the condition and low rate of symptomaticity leads to increased spread. There exist over 150 strains of HPV, among which 14 strains are oncogenic - strains that can cause cancer. Of these, HPV 16 and 18 are the most commonly detected high-risk, oncogenic strains. We discuss what causes HPV in females, the manifestations of HPV in men, the symptoms of the condition, and how it can be managed & prevented in the upcoming sections. 

What is HPV?

• Is HPV an STD?: HPV is a disease that can be transmitted via sexual intercourse, be it vaginal, oral, or anal. The condition is also contracted through sores, cuts, or bruises on the skin - this is a pathway for the virus to spread via skin-to-skin contact. The virus enters the internal parts of the body through these breaks in the skin, allowing the virus to cause an infection. 
• Human papillomavirus symptoms often appear only in a few individuals, as the immune system is capable of clearing out the virus on its own. 
• How long does HPV last in males and females? In about 90% of the infected individuals, the condition resolves by itself in two years due to the immune system’s response to the virus.  
• At least 40 HPV strains are known to cause sexually transmitted infections. 
• HPV is one of the most commonly transmitted diseases due to the lack of symptoms in most infected individuals. The infection is so common that nearly all sexually active adults are expected to contract it at some point in their lives. 
• High-risk strains of HPV are also linked to cancers of the cervix, vulva, penis, anus, mouth, and throat. 
• Despite most cases of HPV being asymptomatic, it can cause warts in some individuals. These are projections from the skin that can be varied in appearance, ranging from flat bumps on the skin to cauliflower-like growths. 

Human Papillomavirus Symptoms

Human papillomavirus symptoms entail the following: 

• Despite the infection not causing symptoms in 90% of the individuals, it still causes noticeable changes and specific signs in the people that do contract them. 
• When the virus is not cleared out by the body’s immune system, it causes warts in different parts of the body. This includes regions like the:
• Throat 
• Mouth 
• Penis 
• Vulva
• Cervix
• Anus 
• Human papillomavirus symptoms include variations of these warts. Some of the common noticeable manifestations are: 
• Genital warts: These warts can either be flat, cauliflower-like, or stem-shaped projections of the skin in and around the genital area. HPV symptoms in women usually involve the appearance of genital warts in the vulva, cervix, and vagina. Sometimes they might also appear around the anus. On the other hand, HPV symptoms in men involve genital warts appearing on the penis, scrotum, and around the anus. Despite mostly being painless, these warts can become itchy and tender. 
• Flat warts: These warts are flat in appearance and usually appear on the inner thighs as in the case of HPV symptoms in women. In children, these warts are a common observation on the face. 
• Common warts: Common to the hands and palms, these rough and raised projections are prone to bleeding and injury. Though most cases of common warts are uneventful, they can become unsightly and aesthetically displeasing. 
• Plantar warts: Plantar warts are common to both HPV symptoms in women and men. These skin projections appear on the balls of the feet and the heels. 
• Human papillomavirus infections caused by the high-risk type are also linked to cancers of the cervix, penis, vagina, anus, mouth, and throat. Since the types of HPV that cause warts are not usually linked with those that are cancer-causing, merely developing warts does not mean you will get cancer. 
• Cancers caused by HPV often show symptoms only in the advanced stages of the disease, so it’s important to get tested for the condition regularly in case you are at higher risk. 

HPV Transmission

• The HPV transmission rate is variable depending on the site and the extent of exposure to an infected individual. Skin-to-skin contact and the structural integrity of the skin, along with immunity, also have an important role to play in the transmission of the disease. 
• Male-to-female, female-to-male, male-to-male, and female-to-female HPV transmission is possible either through sexual or skin-to-skin contact. 
• Vaginal, anal, and oral sex are all linked to HPV transmission through heterosexual relations, in case you were wondering whether a man can give a woman HPV infections. 
• On the other hand, male-to-male HPV transmission is also significant, with symptoms often appearing around the anus and penis of the affected individuals. 
• Female-to-female HPV transmission occurs through genital contact, oral sex, and skin-on-skin stimulation. 
• HPV’s saliva transmission route is however quite unlikely, as the primary mode involves skin-to-skin contact or sexual modes of transmission. 
• As for HPV transmission rates and one-night stands, the risk of transmission hovers at about 20% for an uninfected individual that indulges in sexual contact with an infected person. 

What Causes HPV in Females?

• HPV and its symptoms are caused by any of the various disease-causing strains of the virus in women, just as they do in men. 
• Most women do not experience any symptoms after contracting the virus, however, some women might notice human papillomavirus symptoms such as warts around their genitals, mouth, or anus. 
• It’s important to reach out to your doctor in case you notice any of the above-mentioned symptoms. 
• Regular screening is essential in case your doctor detects a high-risk strain of HPV that can cause anal, cervical, or oral cancer. 
• In certain cases, HPV can even be transmitted from the mother to the fetus during pregnancy. However, due to the child’s immune system, the virus is often repulsed. In certain rare instances, the child can contract HPV and this can lead to a serious condition called respiratory papillomatosis. 
• This involves the appearance of warts in the back of the throat and on the lining of the airway. 

HPV in Men

• Like most women, the vast majority of men too, do not experience any symptoms after contracting HPV. 
• So, how long does HPV last in males that do contract the virus? The condition is often self-limiting and is resolved by the body’s immunity in about 2 years like their female counterparts. 
• Symptomatic cases result in penile, anal, scrotal, and oral warts. 
• High-risk strains are prone to cause penile, anal, oral, and throat cancer in males. 
• Individuals that indulge in frequent anal sex with multiple partners alongside immunocompromised men are at higher risk of contracting high-risk HPV strains. 

How to Test for HPV in Men & Women

• In the case of women, it is recommended that they get their first PAP smear by the age of 21 irrespective of sexual activity. 
• Health authorities recommend testing every three years until women turn 29. 
• Women are recommended a PAP smear every 3 years between the ages 30 and 65, and also a specific HPV test every 5 years to determine the presence of high-risk HPV strains. 
• Women can also choose to do a combined PAP smear and HPV test every 5 years, however, individual tests tend to be more specific in their results. 
• PAP smears analyze the nature of the cells collected from the cervical tract for any abnormalities. On the other hand, HPV tests are based on the detection of viral DNA in the specimens. 
• How common is a false positive HPV test, though? Based on medical experts’ opinions, up to 30% of women can turn up false-positive results for high-risk strains on the DNA tests. 
• For men, however, there exists no specific HPV test unlike in the case of their female counterparts. Penile, scrotal, and anal testing is often not recommended by doctors for routine examinations. 
• More recently though, anal PAP smears are being performed on men that routinely indulge in anal sex. 

HPV 16 & 18 Symptoms

• HPV 16 & 18 are the most common high-risk types of the condition and lead to cancer in several individuals.
• While these strains often do not cause warts unlike their low-risk counterparts, cancerous transformation can cause serious symptoms such as:
• Wasting 
• Weight loss 
• Pelvic pain 
• Increased susceptibility to other infections 
• Bleeding & spotting from the vagina
• Difficulty in urinating 
• Obstruction of the anal tract 
• Blood in urine 
• Swollen feet and legs 
• Painful sexual intercourse 
• What percentage of HPV turns to cancer?: About 3% of all detectable cancers in women and 2% of all detectable cancers in men are caused by HPV. These cancers are caused by high-risk HPV strains. 

Human Papillomavirus Treatment

• While there exists no definitive cure for the virus, there exist prevention strategies and symptomatic treatments to aid infected patients. 
• Prevention often includes using protection during sex - which includes condoms and dental dams. 
• Being open about one’s sexual health history with a partner is equally important. 
• Gardasil 9 - the FDA-approved vaccine is often administered between the ages of 11 & 12 in two doses spaced 6 months apart. People getting vaccinated after the age of 15 are recommended to take a 3-dose schedule, with each dose spaced 6 months apart. The vaccine has now also been approved for individuals up to the age of 45. 
• Doctors can remove warts using electric current, liquid nitrogen, or conventional surgeries, however, warts are known to return later on. 

Conclusion

Understanding human papillomavirus symptoms are integral to tackling an important public health challenge. Despite its mostly benign nature, HPV strains of the high-risk variety can still cause life-threatening cancers and must be mitigated.