Scientists attribute the increase in HPV cases in part to changes in sexual behavior (namely, sexual activity starting at an earlier age and/or with multiple partners) in recent decades. Genital warts are highly contagious, spreading by sexual or other intimate bodily contact, and a person can be infected with the virus and spread it even though no warts are visible. Though HPV is most prevalent among young people as well as the poor, it occurs among all ages and all classes. The warts are soft, flat, irregularly shaped growths that appear on, in, or around the genitals, as well as in the mouth and throat. They may increase in number and size. Small warts often cannot be seen by the naked eye, so doctors use a special magnifying instrument called a colposcope.
The virus may remain dormant for years, so genital warts can be hard to get rid of. It’s generally recommended that they be removed surgically (via laser or freezing), but that doesn’t necessarily mean that the virus has been eradicated from the skin. Even after warts have been removed, an infected person may still be able to transmit the virus. And the warts often recur.
Though the warts are benign, HPV is believed to be a precursor of genital cancers, notably of the cervix and possibly the penis. Most women with cervical cancer are infected with HPV, but only a relatively small proportion of HPV-infected women eventually develop a related cancer. How prevalent the virus is, and how it contributes to malignancies, are open questions that will be resolved only by intensive research. It’s important to remember that not all warts are caused by HPV, and not all papillomaviruses have been linked to cancer. Nevertheless, early identification of HPV is important in identifying women at high risk for cervical cancer. Once diagnosed with HPV infection, a woman must have periodic Pap smears (for the early detection of cervical cancer) for the rest of her life. Avoiding other sexually transmitted diseases is also important.
For more on preventing STDs, see our issue of April 1990. Unless you are in a long-term, monogamous relationship, don’t assume your partner is free from HPV. Always use a condom, even though it may not offer complete protection against HPV.