Genital  human papillomavirus (also called HPV) is the most common  sexually transmitted infection  (STI). There are more than 40 HPV types  that can infect the genital areas of males  and females. These HPV types  can also infect the  mouth and throat. Most people who become infected  with HPV do not even  know they have it.
         HPV  is not the same as herpes or HIV (the virus that causes AIDS).  These are all  viruses that can be passed on during sex, but they cause  different symptoms and  health problems.
         
         Most  people with HPV do not develop symptoms or health problems  from it. In 90% of  cases, the body’s immune system clears HPV naturally  within two years.
         
- But sometimes, certain types of HPV can cause genital warts  in males and females. Rarely, these types can also cause warts in the  throat -- a condition called recurrent respiratory papillomatosis  or RRP.
- Other HPV types can cause cervical cancer. These types can  also cause other, less common but serious cancers, including cancers of  the vulva, vagina, penis, anus, and head and neck (tongue, tonsils and  throat).
         The types of HPV that can cause genital warts are not the same as  the types that  can cause cancer. There is no way to know which people  who get HPV will go on  to develop cancer or other health problems.
         
Signs  and symptoms of HPV-related problems:
         Genital warts usually appear as a small bump or  groups of bumps  in the genital area. They can be small or large, raised  or flat, or shaped like  a cauliflower. Health care providers can  diagnose warts by looking at the  genital area during an office visit.  Warts can appear within weeks or months  after sexual contact with an  infected partner—even if the infected partner has  no signs of genital  warts. If left untreated, genital warts might go away,  remain  unchanged, or increase in size or number. They will not turn into  cancer.
         
Cervical cancer usually does not have symptoms  until it is  quite advanced. For this reason, it is important for women  to get regular 
screening   for cervical cancer. Screening tests can find early signs of  disease so  that problems can be treated early, before they ever turn  into cancer.
         
Other HPV-related cancers might not have signs or  symptoms  until they are advanced and hard to treat.  These include  cancers of the vulva, vagina,  penis, anus, and head and neck. For signs  and symptoms of these cancers, see 
www.cancer.gov.
         
RRP causes warts to grow in the throat. It can   sometimes block the airway, causing a hoarse voice or troubled  breathing.
         
         HPV is passed on through genital contact, most  often during  vaginal and anal sex. HPV may  also be passed on during oral sex and  genital-to-genital contact. HPV can be passed  on between straight and  same-sex partners—even when the infected partner has no  signs or  symptoms.
         A  person can have HPV even if years have passed since he or she  had sexual  contact with an infected person. Most infected persons do  not realize they are  infected or that they are passing the virus on to a  sex partner. It is also  possible to get more than one type of HPV.
         Very  rarely, a pregnant woman with genital HPV can pass HPV to her  baby during  delivery. In these cases, the child can develop RRP.
         
         HPV can cause normal cells on infected skin to turn abnormal. Most  of the time, you cannot see or  feel these cell changes. In most cases,  the body fights off HPV naturally and  the infected cells then go back  to normal. But in cases when the body does not fight off HPV, HPV can  cause visible  changes in the form of genital warts or cancer. Warts can  appear within weeks  or months after getting HPV. Cancer often takes  years to develop after getting  HPV.
         
         HPV (the virus). Approximately  20 million  Americans are currently infected with HPV. Another 6 million people  become newly infected each year. HPV is so common that at least 50% of  sexually active men and women get it at some point in their lives.
         
Genital warts. About 1% of sexually active  adults in the U.S.  have genital warts at any one time.
         
Cervical cancer. Each year, about 12,000  women get cervical  cancer in the U.S.
         
Other cancers that can be caused by HPV are  less common than cervical cancer. Each year in the  U.S., there are  about:
         
- 3,700 women who get vulvar cancer
- 1,000 women who get vaginal cancer
- 1,000 men who get penile cancer
- 2,700 women and 1,700 men who get anal cancer
- 2,300 women and 9,000 men who get head and neck cancers.  [Note: although HPV is associated with some of head and neck cancers,  most of these cancers are related to smoking and heavy drinking.]
         Certain populations are at higher risk for some HPV-related  health problems. This  includes gay and bisexual men, and people with  weak immune systems (including  those who have HIV/AIDS).
         
RRP is very rare. It is estimated that less  than 2,000 children get RRP every year in  the U.S.
         
         There are several ways that people can lower their chances of  getting HPV:
         
- Vaccines can protect males and females against some of the  most common types of HPV. These vaccines are given in three shots. It is  important to get all three doses to get the best protection. The  vaccines are most effective when given before a person's first sexual  contact, when he or she could be exposed to HPV.
- Girls and women: Two vaccines (Cervarix and  Gardasil) are available to protect females against the types of HPV  that cause most cervical cancers. One of these vaccines (Gardasil) also  protects against most genital warts. Both vaccines are recommended for  11 and 12 year-old girls, and for          females 13 through 26 years of age, who did not get any or all of the  shots when they were younger. These vaccines can also be given to girls  as young as 9          years of age. It is recommended that females get the same vaccine  brand for all three doses, whenever possible.
- Boys and men: One available vaccine  (Gardasil) protects males against most genital warts. This vaccine is  available for boys and men, 9 through 26 years of age.
 
- For those who choose to be sexually active, condoms may  lower the risk of HPV. To be most effective, they should be used with  every sex act, from start to finish. Condoms may also lower the risk of  developing HPV-related diseases, such as genital warts and cervical  cancer. But HPV can infect areas that are not covered by a condom - so  condoms may not fully protect against HPV.
- People can also lower their chances of getting HPV by being  in a faithful relationship with one partner; limiting their number of  sex partners; and choosing a partner who has had no or few prior sex  partners. But even people with only one lifetime sex partner can get  HPV. And it may not be possible to determine if a partner who has been  sexually active in the past is currently infected. That's why the only  sure way to prevent HPV is to avoid all sexual activity.
		 
	 
         There are ways to prevent the possible health effects of HPV,  including the two most  common problems: genital warts and cervical  cancer.
         
- Preventing genital warts: A vaccine  (Gardasil) is available to protect against most genital warts in males  and females (see above).
- Preventing Cervical Cancer: There are two  vaccines (Cervarix and Gardasil) that can protect women against most  cervical cancers (see above). Cervical cancer can also be prevented with  routine cervical cancer screening and follow-up of abnormal results.  The Pap test can find abnormal cells on the cervix so that they can be  removed before cancer develops. An HPV DNA test, which can find HPV on a  woman's cervix, may also be used with a Pap test in certain cases. Even  women who got the vaccine when they were younger need regular cervical  cancer screening because the vaccine does not protect against all  cervical cancers.
- Preventing Anal and Penile Cancers: There  is no approved screening test to find early signs of penile or anal  cancer. Some experts recommend yearly anal Pap tests to screen for anal  cancer in gay and bisexual men and in HIV-positive persons. This is  because anal cancer is more common in those populations. These tests are  not routinely recommended for anal cancer screening because more  information is still needed to find out if they are effective.
- Preventing Head and Neck Cancers: There is  no approved test to find early signs of head and neck cancer, but tests  are available by specialized doctors for persons with possible symptoms  of these cancers. [see www.cancer.org]
- Preventing RRP: Cesarean delivery is not  recommended for women with genital warts to prevent RRP in their babies.  This is because it is not clear that cesarean delivery prevents RRP in  infants and children.