Human papilloma virus (HPV)
The human papilloma viruses (HPVs) are a group of common infections. It can affect the skin and the moist lining inside parts of the body (mucous membranes). The virus is most common inside the mouth, throat, genital area and anus.
There are more than 100 types of HPV. Some can cause warts and verrucas. Others increase the risk of developing different type of cancer. These types are called high-risk HPV.
Most people will have HPV at some point in their life. Usually, the virus does not cause any damage and there are no symptoms. Most people do not know they have it.
Most types of HPV are not linked to cancer. But some types of high-risk HPV can increase the risk of:
It is important to remember that most people infected by high-risk HPV do not develop cancer. Usually, the body’s immune system gets rid of the virus.
But for some people, the immune system does not get rid of the infection. We do not know exactly why that is. If the virus stays in the body for longer, it may cause damage to cells. Over a long time, these abnormal cell changes may develop into cancer.
HPV spreads from person to person on the skin during sex. The virus can live on the skin around the whole genital area.
It passes easily from person to person during any type of sexual contact, including skin-to-skin genital contact, or sharing sex toys.
Using a condom or other barrier contraception may reduce your risk of HPV infection, but it does not offer complete protection.
HPV can affect all sexual orientations and anyone who has ever been sexually active. This includes if you:
- have had one sexual partner or more
- are in a long-term relationship with only one person.
Your risk of having HPV may be higher if you:
- started having sex at a younger age
- have had a lot of sexual partners
- have HIV.
We do not know everything about how HPV spreads. Although it is shared easily between sexual partners, there may be other ways of spreading the virus too. It is also thought that the virus sometimes stays inactive in the body. This may be for weeks, months or years after infection. This may mean it can become active again years after you have it.
Finding the cause of the infection
Some infections that are passed on during sex can be linked to one sexual partner. But HPV is very common and easily passed between partners. We also do not know all the ways that HPV can spread. It is not possible to know exactly how or when a person got HPV.
Having HPV does not show who you have had sex with, or what type of sexual contact you have had. Even couples in a long-term relationship can be affected by HPV. Having HPV is not a sign that partners have had sex with someone outside the relationship.
It is thought that HPV takes years, or even decades, to cause the damage to cells that develop into cancer. Infection with HPV is likely to happen many years before cancer is diagnosed.
Are sexual partners at risk?
If you have HPV or an HPV-related cancer, you may worry that a partner’s health has been affected by HPV too. This is very unlikely.
HPV is a common infection and easily spread during sexual contact. Your partner has probably already been exposed to the virus. Their immune system is likely to have got rid of any infection already. This will protect them from the damaging effects of HPV. Changing your sex life is not likely to reduce your partner’s risk of HPV.
Partners of people affected by an HPV-related cancer rarely develop an HPV-related cancer themselves.
Partners should still take part in any screening they are offered. This can include:
- Cervical screening
This is for anyone who has a cervix. It is important even if you have had the HPV vaccination. People who have a cervix include women, trans men and non-binary people born with a cervix. We have more information about having cervical screening.
- Anal cancer screening
This is sometimes offered to people who have a higher risk of developing anal cancer. If you or your partner are worried about your risk of anal ask your GP, local sexual health clinic or HIV clinic for advice.
A vaccine can be used to help prevent HPV infection. This is usually given as two or three injections over several months. The vaccine helps your immune system protect you from getting HPV. This reduces the risk of cancers caused by HPV. Vaccines cannot treat or get rid of HPV infection if you already have it.
The NHS offers the HPV vaccine to the following people:
- Children aged 12 or 13
This age group gets the vaccine because they are less likely to be sexually active or have HPV already. It is usually given at school but can also be given at a GP clinic.
- Men who have sex with men
This group has higher risks from HPV infection, such as anal cancer. The vaccine is available at sexual health and HIV clinics for men up to the age of 45. There is not yet much research into people over 45, but the vaccine may be less effective as it is likely they will have been exposed to HPV already.
Sexual partners of someone who has been vaccinated will have a lower risk of HPV.
Other people may have the vaccine because they have higher risks from HPV infection. For example, if you have HIV you are more likely to get HPV infection. This means you have a higher risk of developing HPV-related cancer. Your GP, local sexual health or HIV clinic can give you more information.
The HPV vaccine is also available privately. Ask your GP for more information.
If you are sexually active, there is no sure way to avoid getting HPV. Many people carry the infection without knowing. There is a test for HPV, but this is only helpful in certain situations.
You can lower your risk of getting HPV by having fewer sexual partners. Using a condom or other type of barrier contraceptive every time you have any type of sex may help reduce your risk. But this does not get rid of the risk completely.
Your immune system
If you get HPV, your body’s immune system will usually get rid of it. Having a healthy lifestyle can help your immune system work well. Smoking makes your immune system weaker. If you smoke, you are more likely to get HPV or develop an HPV-related cancer.
We have information to help you give up smoking.
To test for high-risk HPV, a sample of cells is collected from the affected area of the body. The sample is then sent to a laboratory and checked for signs of HPV.
HPV testing is used:
Anal cancer screening
HPV testing is sometimes used as part of anal cancer screening. This means using tests to find abnormal cell changes that are more likely to develop into anal cancer.
Anal cancer screening is sometimes offered to people who have a higher risk of developing anal cancer, such as:
- men who have sex with men
- people with HIV.
We do not know yet whether anal cancer screening is effective at preventing anal cancer. These tests are not widely available in the UK. Your GP, local sexual health or HIV clinic can give you more information.
There are no treatments to get rid of HPV infection. In most people, the immune system will get rid of the virus naturally.
If you find out you have HPV through cervical or anal screening tests, you may be offered ongoing screening. If you develop abnormal cell changes, you may be offered treatment to remove or destroy these cells.
We have more information about treating abnormal cell changes of the cervix.
Finding out you are affected by high-risk HPV can be stressful and difficult to cope with.
You may feel frustrated that there is no treatment to get rid of the infection. Or angry if it has caused cancer. Some people feel ashamed or embarrassed because HPV infection is related to sex.
It is natural to have mixed emotions, including feeling uncertain or lonely. You may have questions or worry what others will think. There are not always clear answers, but ask your GP, cancer doctor or nurse for more information if there is something you do not understand.
Everyone has their own way of coping with difficult situations. You may want to talk about it with:
If you would like more information about the sources we use in our HPV information, please contact us at firstname.lastname@example.org
Palefsky JM. Human papillomavirus infections: Epidemiology and disease associations. (Internet), last updated Dec 2020. Available from www.uptodate.com (accessed March 2020).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.
You can read more about how we produce our information here.