Human Papillomavirus (HPV) is actually a group of over 200 viruses that can infect skin anywhere on your body. However, our focus is on the 40+ subtypes of HPV that can infect the genital area, especially the 15 subtypes that can cause precancerous cells in the cervix and the vulva, vagina, anus, penis, mouth and throat.
The cervix, or neck of the womb, is the area most often infected and most likely to develop precancerous cells and, after several years, cancerous cells. HPV 16 and, to a lesser extent, HPV 18 and 45 are the main culprits. Approximately 70% of all cervical cancers are caused by HPV 16 and 18.
HPV is usually transmitted by skin-to-skin contact; this can be genital-to-genital or mouth-to-genital/anal contact. Penetrative sex is not necessary to transmit the virus, and even fingers and sex toys can transmit the virus in some instances.
Most people are unaware that they carry the virus and pass it on unknowingly to their intimate partners. It is true that the more sexual partners one has had, the higher the chances are of carrying HPV, but even people who have only ever had one sexual partner (this includes unwanted sexual contact, abuse or incest) can carry HPV and not know it.
Additionally, using condoms is not entirely protective because the virus can be spread from skin not covered by the condom. It is essential to realise that almost all sexually active people have had HPV at some stage in their lives, and it is, therefore, very difficult to avoid.
Once you have it, no treatment can remove it, which is why there is a drive to vaccinate children as young as 9 years of age against HPV before they have had any sexual contact whatsoever. This is also why it is vital for sexually active women under 30 to have regular screenings of their cervix with a Pap smear and women over 30 to have one every 3-5 years.
Fortunately for most people, HPV infections are transient, like the common cold, and your immune system can eradicate it with time. This is also why transient HPV infections in young people, even with high-risk HPV, usually only need monitoring rather than treatment. Therefore, the critical concern is the persistence of high-risk HPV rather than transient infections.
Women who smoke cigarettes, use nicotine or are exposed to second-hand smoke are at higher risk of persistent HPV infections and cervical precancer and cancer. Therefore, quitting smoking is imperative to boost your body’s natural ability to eradicate the virus.
Other women at high risk of HPV-related disease are women who have a compromised immune system. This may include being on immune suppressants for autoimmune diseases like lupus or rheumatoid arthritis or on medicines to prevent rejection of a transplanted organ, like a heart or kidney.
Women living with HIV/AIDS are also particularly vulnerable, so women must check their HIV status annually and receive antiretrovirals, if appropriate, to boost their immunity against HPV.
Vaccination against HPV is also highly recommended for anyone with a lowered immunity.