HPV: Human Papilloma Virus

HPV, or the Human Papilloma Virus, is a virus that infects cells of the skin. There are over 100 types of the HPV virus, some more common than others. HPV is transmitted by skin-to-skin contact, and so is easily passed on by rubbing, stroking, and touching during sex. Some types of HPV, particularly HPV-6 and HPV-11, cause genital warts. Other types of HPV, such as HPV-16, can lead to cancer. In men, the cancers caused by HPV include cancers of the penis, anus, mouth, and throat.

HPV is the most common sexually transmitted infection in Canada. In fact, 75% of sexually active adults will be infected with at least one type of HPV in their lifetime. However, most people with HPV do not develop symptoms. This may be because the virus, once inside the skin cell, may become inactive, or your immune system may get rid of the infection before symptoms develop.

Sexually transmitted HPV are divided into 2 groups, low-risk and high-risk. Low risk HPV includes HPV-6 and HPV-11, which cause genital warts. Genital warts look like warts that occur elsewhere on the body. They are typically firm bumps on the skin that may have a cauliflower-like appearance. They are often found along the edge of the head of the penis or on the shaft. Warts can also develop around the anus as well as inside the anus.

High-risk HPV, particularly HPV-16, can lead to cancer. Getting a high-risk HPV does not mean you will get cancer, but it increases your risk. Cancers associated with high-risk HPV include cancers on the penis, anus, mouth, and throat.

There are no medications that are effective against HPV. Treatment is directed at getting rid of infected cells. Genital warts are often treated by freezing them with liquid nitrogen. Freezing kills the infected cells and causes the wart to shrink and fall off. Freezing with liquid nitrogen is relatively painless, but almost always requires multiple treatments. The key to success is to be more persistent than the wart. Usually freezing warts on a weekly basis will do the trick, but keep going back and getting them treated until they are gone. Topical creams are also available to treat warts. These creams cause inflammation where they are applied and so can cause local destruction of infected skin cells. Be sure to use these creams exactly as directed.

Condoms will offer some protection, but the best way to avoid HPV is to be vaccinated against it. Gardasil-9 is a vaccine that protects against the most common types of HPV. It protects against HPV-6 and HPV-11, and so prevents getting warts on your penis and around your anus. It also protects against 7 of the most common HPV types linked to cancer. The vaccine is given as an injection in your upper arm. You will likely receive 3 doses, the second 2 months after the first, and the third 6 months after the first.

Gardasil is very safe. Like any vaccine, you may experience minor and temporary pain, redness, or swelling at the site of the injection. Rarely, people may also get a fever or headache after the injection that goes away on their own. If you have had an allergic reaction to vaccines in the past or if you have a bleeding disorder, you may not be able to receive the vaccine.

The Gardasil vaccine is provided free in Ontario to all boys and girls in grade 7, and to men who have sex with men age 26 years and under. The Canadian National Advisory Committee on Immunizations states Gardasil should also be considered for all men who have sex with men regardless of age. If you are over 26 years of age and have health insurance, your insurance may pay for it.