Sorry to be the one to break it to you, but odds are you either have, have had, or will have at least one type of HPV at some point in your life. And I don't just mean cis women—I'm talking all sexually active people. According to the Centers for Disease Control and Prevention, HPV—more formally known as human papillomavirus—is the most common STI, with nearly 80 million people currently infected in the US, which is about one in four. Since I'm not a doctor, I think the best way to deliver the information would be in shit-sandwich format (good news, bad news, good news).
How will I know I have it?
You probably won't. The good news is that most of the time, HPV goes away on its own, without causing any health problems. About 90 percent of cases affecting the genital tract are asymptomatic and resolve within two years. The bad news is that there are more than 40 types of HPV—some of which can cause genital warts or even cancer. You should probably see your healthcare provider if you notice any bumps or clusters of bumps that can join together to form a cauliflower shape. On the bright side, genital warts are treatable with prescription medicine. Plus, the type of HPV that causes them is not the same as the type that causes cancer—so you're unlikely to be saddled with both.
Okay this is really more like a shit club-sandwich, so bear with me.
What's the worst-case scenario?
Some types of HPV cause changes in your body that lead to cancer over several years or even decades. HPV is responsible for most cervical cancers—as well as some cancers of the vulva, vagina, penis, and anus. It can even cause cancer of the back of the throat, base of the tongue, and tonsils. People with weakened immune systems are at a higher risk of developing cancer from HPV. And only women over 30 get HPV tests to screen for cervical cancer. For younger women, routine Pap tests are the best screening tool, according to the National Cervical Cancer Coalition.
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How do I protect myself?
Using a latex condom helps prevent the spread of HPV, which is transmitted during vaginal, anal, and oral sex. But because HPV can infect areas not covered by condoms, they won't fully protect you. HPV can also be transmitted when an infected person has no signs or symptoms. And since you could develop the symptoms years afterwards, it can be difficult to know when the infection occurred.
Science to the rescue
In 2009, a vaccine—Gardasil—was introduced to prevent the nine types of HPV that cause most cancers and genital warts. The CDC recommends it for everyone ages 9 to 26, the earlier the better. If you're over 26, your health insurance won't cover it. But it's difficult know if it's worth the out-of-pocket cost of $150 to $200 per dose (three doses are usually required) because a Pap for women simply indicates anything "abnormal," an HPV test only diagnoses infections of the cervix, and, sadly, there is no test for men. As part of the Merck vaccine patient assistance program, Gardasil is offered free to people ages 19 to 26 who qualify based on income levels.
So far, the HPV vaccination has yielded positive results for public health. A study by the National Center for Health Statistics released in 2016 found that since the vaccine's first introduction in 2006, prevalence of the four HPV types targeted has decreased by 64 percent among women aged 14 to 19 and 34 percent in the 20 to 24 bracket. It's estimated that 63 percent of girls and 50 percent of boys nationally have received at least one dose of the vaccine to date. The goal is to have 80 percent to receive all recommended doses by 2020.
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