Image of plastic vaginal speculum used for HPV screening via pap smear test

HPV risk factors and prevention for men and women

Medically reviewed on October 19, 2022 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Human Papilloma Virus (HPV) is the most common sexually-transmitted infection in the U.S. While some types of HPV are harmless and go away on their own, others can cause long-term health problems. Protecting yourself, getting the HPV vaccine, and regularly testing for STDs can keep you safe and healthy.

The reality is that nearly all sexually active people will have an HPV infection at some point. The CDC indicates that each year about thirteen million individuals in the U.S. alone are infected. [1] And the American Cancer Society suggests that eight out of ten people will contract HPV at some point in their lifetime. [2]

This guide will break down the particulars of HPV infections, identify HPV risk factors, and ways for you to protect your sexual health through prevention.

What is HPV?

HPV is a catch-all term that describes more than 100 versions (or variants) of the same common virus that infects thinner skin tissues. More than 40 HPV types can infect the genital areas of men and women, including the skin of the penis, vulva (area outside the vagina), anus, and the linings of the vagina, cervix, and rectum. These types can also infect the lining of the mouth and throat.

Although it is the most common sexually transmitted infection, you might wonder, "Can you get HPV without having sex?" The answer is yes, but it doesn't happen that often. The risk of infection also depends on what kind of sex people have. Both men and women spread the HPV virus through skin-to-skin contact. Fourteen types of the HPV virus are classified as high-risk HPV strains because they can cause six different kinds of cancer in the following body parts and systems:

  • Cervix (cervical cancer)
  • Penis(penile cancer)
  • Anus (anal cancer)
  • Throat (oropharyngeal cancer)

What are the signs of an HPV infection?

HPV does not always cause visible symptoms, so the majority of people infected with HPV do not know they have the virus or could spread it to their partners. That said, two types of HPV cause bumps or warts on the skin. Some types of low-risk HPV can also cause warts on the lips, hands, or feet. Other HPV variants cause warts in the genital area that look like:

  • A flesh-colored flat or raised bump
  • A cauliflower-like growth
  • A cluster of flesh-colored bumps

Fortunately, warts are often harmless and can be treated with over-the-counter medicine applied to the wart surface. However, because the skin in the genital area is very thin and sensitive, over-the-counter treatments can cause pain, burning, or irritation. Therefore, it is best to have a healthcare provider examine any bumps or potential warts before trying to treat them yourself.

Unfortunately, many cancer-causing HPV strains do not cause any symptoms you would notice for many years. Cervical cancer, for example, can develop over ten years or more after the initial infection, and six times as many men as women carry and spread high-risk strains to sexual partners. In addition, while routine pap smears can help identify HPV in the cervix, there are no approved tests for people with a penis. Some healthcare providers may offer anal Pap tests for people who have a penis, but these are generally only done for HIV-positive people who have anal sex.

Who is at the highest risk for an HPV infection?

Although any kind of skin contact can transmit HPV, sexually-active individuals are at the highest risk for HPV transmission and infection due to increased contact with intimate areas of thin skin. Even genital-on-genital rubbing can spread the virus. The CDC indicates this population group, which spans all sexualities and genders, often includes:

  • Teenagers over the age of 14
  • Young adults under the age of 26

What are the risk factors for getting HPV?

Every sexually active individual is at risk for HPV infection. Research shows that some people might be at higher risk for HPV than others. Identified risk factors include: [5]

  • Becoming sexually active when you are younger than age 18.
  • Having many sexual partners over your lifetime or being with a partner with many sexual partners.
  • Having unprotected sexual contact or intercourse.
  • Transgender.
  • Being a man having sex with other men.
  • Having a partner with HIV.
  • Having an immune disease or are immuno-compromised (such as HIV, Lupus, or receiving cancer treatment)
  • Having another untreated infection, such as chlamydia or HIV, at the time of contact

Seven ways you can reduce your risk of HPV infection are:

  • Get the HPV vaccine.
  • Use barrier methods anytime you are skin-to-skin with intimate partners (condom, dental dam, nitrile gloves).
  • Have frequent, open, and honest conversations with all sexual partners about STDs and safe sex.
  • If you have a vagina and/or a cervix, have regular pap tests and HPV screening.
  • If you are having anal or oral intercourse and have a penis or are transgender, talk with your health care provider about having an anal pap smear, a test for HPV in your anus.
  • Test for STIs each time you have a change in partners and every time you notice any symptoms.
  • Quit smoking or chewing tobacco.
  • Eat a well-balanced, nutritionally-rich diet with anti-oxidants to boost immune system health.

What are the risk factors for cervical cancer?

The cervix, a narrow canal that connects the vagina and uterus, is a common site for HPV infection transmitted through sexual activity. HPV is the leading cause of cervical cancer.

However, additional factors can increase your risk for cervical cancer, such as:

  • Smoking – Smoking tobacco makes it harder for your immune system to fight off the HPV virus and can even increase the rate at which high-risk strains cause cancerous changes in the cells of your cervix.
  • Having multiple sexual partners – Having multiple sexual partners can increase your exposure to the virus. If you’re sexually active, speak with your healthcare provider about preventative measures you can take for safe sex.
  • Having HIV/AIDS or another health condition that impacts your immune system – A healthy immune system can fight off the HPV virus and defend against some of the cancer-causing changes the virus causes in the cells of your cervix.
  • Multiple full-term (37 weeks) births Women with three or more full-term pregnancies have an increased risk of developing cervical cancer. However, researchers believe this risk is more related to the number of sexual partners than actual pregnancy. Still, talk to your healthcare provider about HPV and pregnancy, especially if you have a history of HPV infection and are considering pregnancy. Many people worry that HPV can cause infertility, but most people with a history of HPV infection can have uncomplicated pregnancies. [6]
  • Chlamydia infection – Current or prior chlamydia infections, a treatable sexually transmitted disease (STD) affecting men and women, has been shown to increase the length of time that people stay infected with high-risk (cancer-causing) HPV strains. [7]
  • Genetics – Cervical cancer can run in families. Some inherited (genetic) conditions also cause more cancer in some families, including cervical cancer.

Still, HPV is at the top of the list for causes of cervical cancer and oropharyngeal cancer. CDC estimates that each year HPV causes 36,000 of the 45,000 new cases of cancer in the cervix, vagina, vulva, penis, anus, rectum, and oropharynx. [8]

Other Cancers Caused by Human Papillomavirus Infection

HPV can also infect people’s mouths and throats. HPV causes about seventy percent of oropharyngeal cancers (cancer of the mouth, neck, and throat) in both men and women. Possible signs and symptoms include a lump in the neck and sore throat. Oral HPV can be transmitted through oral sex, kissing, smoking, alcohol, and having sex with a sexual partner already infected with HPV. [9]

Anal cancer is another possible form of cancer related to HPV infection. Estimates suggest that HPV causes over 90% of anal cancer cases. This form of cancer is 2x as common in women as it is in men.

Additional cancers related to HPV include penile cancer, vaginal cancer, and vulvar cancer.

What you need to know about HPV prevention

Because there is so far no cure for HPV, preventing infection in the first place is a safe bet. The good news is that usually, if your body’s immune system is healthy, most people are able to get rid of the HPV infection on its own within two years. This is true of both low-risk and high-risk HPV types. The bad news is that during the time before your body clears HPV, you can pass the virus to others. In addition, because HPV may not have any symptoms, you could be unaware you’re infected. However, there are several ways to reduce your risk of getting infected or accidentally infecting a sexual partner. You can:

  • Get the HPV vaccine –The U.S. Food and Drug Administration (FDA) approved three HPV vaccines that are more than 90 percent effective in preventing HPV-related cancers. If ten children receive the complete HPV vaccination series, only one will become infected with HPV over a lifetime of sexual activity.
  • Use protection – Barrier methods include condoms, dental dams, internal condoms, and latex or nitrile gloves. These barrier methods lower the risk of HPV transmission but do not prevent it altogether.
  • Get tested – Regular testing for sexually transmitted diseases (STDs) keeps you and your partner(s) safe and healthy. Routine gynecological examinations, pap smears, and testing for STDs like chlamydia are crucial for women. STDs like chlamydia and gonorrhea don’t always cause symptoms and are a major cause of chronic pelvic pain and infertility.

HPV vaccines 101

There are currently three FDA-approved vaccines available in the U.S. The vaccines protect against infection with the most common and high-risk (cancer-causing) types of HPV.

The CDC encourages children as young as age nine to get the vaccine. Teens and young adults aged 15 through 26 who did not receive prior vaccinations should get “catch up vaccines.” The HPV vaccines are most effective in preventing HPV infection when they are given before children become sexually active.

Two doses are required for children ages 9 through 12, who will receive the second dose before age 15. However, three doses are required for people: [10]

  • Ages 9 to 14, who did not receive their second dose within five months of their first dose.
  • Ages 15 to 26, who start the series later (catch-up vaccines). Immunocompromised individuals, such as those actively receiving treatment for a tumor, organ transplant, or HIV infection.

The CDC does not recommend vaccination for people older than 26, because they have likely already been exposed to HPV.

Side effects and risks of the HPV vaccine

After your vaccine, you may experience nausea or dizziness, low-grade fever, headache, and pain or redness at your injection site.

Individuals who should not get the vaccine include those who:

  • Are over 26 years of age – According to the CDC, this age group has likely already been exposed to HPV. Consider consulting a healthcare professional to access lifestyle and identify alternative preventative recommendations.
    • Have allergies to components of the HPV vaccine – The U.S. vaccine contains yeast, which is often cited as an allergen.
  • Are pregnant or nursing – While no direct harm from receiving the HPV vaccine during pregnancy has been reported, check with your healthcare provider before getting the HPV vaccine if you are pregnant.

Prioritize Prevention With Everlywell

While HPV is ubiquitous in most sexually-active people, you can take steps to reduce your risk of infection and cancer risk. Having a healthy and safe sexual relationship is an integral part of your overall wellness. Learning more about the various STDs, such as HPV, the vaccines, and the tests available, will help you take better care of yourself and those you care about.

Everlywell’s sexual health products provide both male and female-identifying individuals with quick, in-home, affordable testing options.

As you learn more about your sexual health and well-being, you can count on Everlywell to put your health first.

Can you get HPV without having sex?

HPV and pregnancy: key points to know

Can HPV cause infertility?

Can you get cervical cancer without HPV?

UTI vs. STD: Differences in symptoms

References

  1. Basic information about HPV and cancer. CDC. Updated October 3, 2021. URL. Accessed September 29, 2022.
  2. HPV vaccination and cancer prevention.American Cancer Society (ACS). URL. Accessed September 29, 2022.
  3. HPV and cancer. National Cancer Institute (NCI). Updated September 12, 2022. URL. Accessed October 12, 2022.
  4. HPV in men: an update. National Center for Biotechnology Information. National Library of Medicine. URL. Accessed October 12, 2022.
  5. Chelimo C, Wouldes TA, Cameron LD, Elwood JM. Risk factors for and prevention of human papillomaviruses (HPV), genital warts and cervical cancer. J Infect. 2013;66(3):207-217. doi:10.1016/j.jinf.2012.10.024 Accessed October 12, 2022.
  6. Risk factors for cervical cancer. American Cancer Society. Updated January 3, 2020. URL. Accessed September 29, 2022.
  7. The role of Chlamydia trachomatis in high-risk human papillomavirus persistence among female sex workers in Nairobi, Kenya. National Center for Biotechnology Information. National Library of Medicine. URL. Accessed October 11, 2022.
  8. How many cancers are linked with HPV each year? CDC. Updated December 13, 2021. URL. Accessed September 29, 2022.
  9. Oropharyngeal cancer treatment: Adult Treatment (PDQ). National Cancer Institute. Updated October 14, 2021. URL. Accessed October 11, 2022.
  10. HPV vaccine schedule and dosing. CDC. Updated November 1, 2021. URL. Accessed October 11, 2022.
  11. HPV vaccination: What everyone should know. CDC. Updated November 16, 2021. URL. Accessed September 29, 2022.
  12. Moscicki AB, Palefsky JM. Human papillomavirus in men: an update. J Low Genit Tract Dis. 2011;15(3):231-234. doi:10.1097/LGT.0b013e318203ae61 Accessed September 29, 2022.
  13. Oral contraceptives and cancer risk. National Cancer Institute (NCI). Updated February 22, 2018. URL. Accessed October 11, 2022.
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