HPV and genital warts symptoms and treatment

Human Papillomavirus infections (HPV infections) are passed on through skin-to-skin contact.

Genital HPV infections are very common and easy to catch. You can get HPV from: 

• vaginal, anal or oral sex without a condom or dental dam, with someone who has an HPV infection (even if they don’t have symptoms) 

• sharing sex toys that aren't washed or covered with a new condom each time they are used 

• close genital contact – this means HPV can be passed on even if there’s no penetration, orgasm or ejaculation. 

If you have HPV while pregnant you can pass the infection on to your baby at birth, but this is rare.  

There are a number of ways to decrease the risk of getting HPV. 

Vaccines 

Vaccines can prevent certain types of HPV that cause most genital warts and cervical cancer, as well as some other cancers. These are often offered to adolescent girls (and sometimes boys), men who have sex with men, transgender people and people with HIV. It’s best to have the vaccine before you start having sex, although sometimes you can get it later in life. Ask a healthcare worker to find out if you can get the HPV vaccine where you are.  

Condoms and dental dams  

Using a new condom or dental dam every time you have vaginal, anal or oral sex will help. But, HPV can affect areas not covered by a condom, so you’re not fully protected.  

Use a new dental dam or latex gloves for exploring your partner’s anus with your fingers, mouth or tongue. Using latex gloves for fisting will also help to lessen the risk.  

Always cover sex toys with a new condom for each partner and wash them after use.  

Sexual health check-ups  

Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, it’s even more important to use condoms and get tested regularly even if you don’t have any symptoms.   

Taking pre-exposure prophylaxis (PrEP), and other types of contraception (apart from condoms) won’t prevent HPV and other STIs.  

Often people don’t have any HPV symptoms, so you may not know if you have it. Symptoms can also vary depending on the strain of HPV.

One of the most common strains of HPV is genital warts. Many people with this strain of HPV don’t develop any symptoms and don’t know that they have it. Other people may get anal warts, penis warts and vagina and vulva warts.  

 Genital wart symptoms include:  

• one or more small, flesh-coloured or grey painless growths or lumps around your vagina, penis, anus or upper thighs  
• itching or bleeding from your genitals or anus  
• a change to your normal flow of pee (for example, sideways), that doesn't go away.  

The warts may be difficult to notice if they are internal (inside the vagina or anus).   

Symptoms of genital warts can appear weeks, months or years after you got the virus that causes them. If you have symptoms of genital warts, it’s important to visit a health clinic to have them checked.  

Different strains of HPV are tested for in different ways. 

A healthcare professional can quickly examine you to tell if you have genital warts (low-risk HPV).  

Women and some transgender men may also be invited for regular cervical screening. This checks for high-risk HPV (the type that causes cancer). Cervical screenings (or smear tests) check for abnormal cells on the cervix (entrance to the womb). Cervical screening tests for signs of HPV or abnormal cells on your cervix. If you have HPV or abnormal cells on your cervix, this doesn’t mean you have cervical cancer. But often the abnormal cells will be removed to prevent cancer developing.  

For men, there’s currently no reliable test for HPV infection. It is often very difficult to diagnose as there are no symptoms for high-risk HPV. Some people who are at a high risk of having anal HPV and of developing anal cancer may be offered an anal smear. This checks for abnormal cells in the anal canal. This group includes men who have sex with men or people with HIV. 

There's no treatment for the HPV virus, but most types of HPV don’t cause any problems and can go away by themselves.  

Genital warts treatment 

The treatment options depend on the type of warts you have and where they are located.  

Warts may be able to be removed using creams, freezing, heating or surgery. Your healthcare worker will advise which treatment is right for you. However, treatments for genital warts don’t always work. The sooner you seek treatment the easier they are to get rid of.

Although these treatments can remove the warts themselves, there's no cure for the virus that causes the warts. Some people’s bodies, however, are able to clear the virus over time.  

You should always check with a healthcare worker before using treatments for genital warts.  

Abnormal cells and cervical cancer  

If a cervical screening test shows you have abnormal cells on the cervix, it may be necessary to remove them so that they don’t develop into cancer. 

If they find that the cells are cancerous, cervical screening means that it’s often found at an early stage so it can be treated successfully with surgery.  

Having an STI such as genital warts can increase your risk of getting and passing on HIV. This is because having an STI makes it easier for HIV to get into your body and cause an infection. 

People with HIV can also be more likely to get genital warts or have more severe cases of genital warts. This is especially the case for people who aren’t on treatment or who have a lower CD4 count. You’re more vulnerable to infections if your immune system is weaker. 

If someone with HIV also has the HPV virus, their viral load will increase. This makes them more likely to pass on HIV during unprotected sex, even if they are taking antiretroviral treatment. However, if you have an undetectable viral load there is no evidence that HPV makes you more likely to pass on HIV. 

The risk of developing HPV-related cancers is higher in people with HIV who are not on effective treatment. This is because their immune system is often weaker. Being on antiretroviral treatment with an undetectable viral load reduces this risk. Having a higher CD4 cell count of over 200 can also lessen the risk of developing HPV-related cancers. 

If you are taking antiretrovirals it is important to discuss this with your healthcare professional. They can advise how treatment for HPV may interact with your HIV drugs. 

If you test positive for HPV, it’s important to tell any recent sexual partner(s) so they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do. It shows you respect them and want them to stay healthy.