HPV-What’s All the Fuss About?

If you are over 30, your pap smear is now being screened for HPV (Human Papillomavirus), and if you are under 26, you are being encouraged to get vaccinated for HPV.  If you have ever had an abnormal pap smear, you are tested for HPV automatically.  Why?  What is the fuss about?  Why is HPV so important?

What is HPV?

Well, we now know (and we didn’t know this in the past) that it is HPV (human papillomavirus) that is the cause of cervical cancer.  This virus is also responsible for other types of cancers, i.e. throat, vaginal, vulvar, anal, rectal, and penile cancers.  There are approximately 40 types of HPV strains that affect the genital region, but only 2 of these strains (named 6 & 11) have any symptoms.  These 2 strains cause venereal warts, also known as “condyloma” in medical speak.  Most people who have HPV do not have symptoms.  It is estimated that approximately 80% of all sexually active adults have been exposed to HPV at some time in their life.  It is the most common sexually transmitted disease.  Even having only one partner in life and using condoms still does not guarantee that you won’t be exposed to the virus.  So why might you catch this viral infection even if you are careful?  HPV is a skin virus.  This means it lives on skin cells on the outside of the genital area and not just on the penis or in the vagina.  Direct skin to skin contact, not just intercourse, can cause it to be transmitted.  Oral sex, vaginal sex, & anal sex all equally expose individuals to the disease, but so can intimate skin to skin contact.

How do I know if I have HPV?

We have a test for it.  All women over the age of 30 are routinely screened for high risk strains of HPV with the pap smear.  If the virus is active, you will test positive for the virus, even if the pap smear is normal.  If the virus is inactive, it will not be present on the pap smear.  Although there are approximately 40 strains of HPV, only a few are considered “high-risk”.  This means that if these strains are present, there is more potential for cervical cells to become abnormal and progress to precancerous changes.  For example, 2 strains (named 16 and 18) are responsible for two-thirds of all the cancers that I have mentioned.  You may also have been exposed to HPV, have it lying inactive in your body, have a history of normal pap smears, and you will test negative for the presence of the virus.  HPV only shows up when it is “active” or “infecting” the area tested.  This is why it is so important to have regular screening if you have ever been sexually active.  The good news is that most women will be able to suppress the virus through the normal immune system response within 2 years.  We also know that smoking will increase the risk of abnormal changes progressing to cancer, so another reason to consider quitting.

Does the HPV vaccine prevent infection?  Am I eligible to get vaccinated?

The vaccines (there are 2 different ones) prevent infection from the most dangerous HPV strains (#16, 18), and one of the vaccines (Gardisil) also prevents infection from the strains the cause venereal warts.  The vaccine is available for women and men younger than age 26.  It is actually recommended to start vaccinations prior to sexual intimacy for peak protection, therefore it is being offered anytime from age 11 forward.  If you have already been exposed to one of these HPV strains, the vaccine will not protect you against the one you have been exposed to, but will protect against the others.  If you are over age 26, the vaccines are not currently available to you.  Condom use is always recommended, but again is not 100% protective against HPV.  The more sexual partners you have, the greater the risk of exposure.

Linda C. Lassonde, APRN

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