HPV (Human Papilloma Virus)

Human papillomavirus (HPV) is the most common sexually transmissible infection (STI). Most people who are sexually active will be infected with at least one type of HPV at some time.

There are more than 200 different types (strains) of HPV. Around 40 types of HPV can infect the genital area. This includes the skin on or around the genitals (vulva, penis, scrotum and anus), vagina, cervix (top part of vagina) and rectum (anal passage).

Two types of genital HPV (6 and 11) are considered low-risk and can cause genital warts. These are different to the HPV types that can cause warts on other parts of the body (like the hands or feet).

At least 14 other types of genital HPV are considered high-risk and in rare cases can cause cancer. Cervical cancer is the most common cancer caused by HPV. Others include cancers of the anus, vagina, vulva, penis and oropharynx (back of the throat).

HPV is mainly passed on during sexual skin-to-skin contact with someone who has HPV. Sexual skin-to-skin contact may be during genital-to-genital contact, vaginal, anal or oral sex or sharing sex toys.

Most HPV infections are passed on when a person does not have symptoms and they are unaware they have the virus.

Warts on other parts of the body (like the hands and feet) cannot be passed on to the genital area.

HPV can affect anyone who is sexually active. It can be passed on whether your sexual partner/s are the same sex as you or a different sex.

Most people with HPV do not know because they do not have symptoms. In most cases the immune system will clear the virus and a person will not know they were infected. Some people might have symptoms.

If you have been exposed to low-risk HPV you might have genital warts with symptoms such as:

a flesh-coloured lump or several lumps in the genital area
unusual itching or pain in the genital area
abnormal or irregular bleeding from the vagina or anus (especially after sex)
pain during sex.

Testing for genital warts is not a routine part of a sexual health screen. Usually, you will only be examined if you have symptoms.

If you have been exposed to high-risk HPV and you have a cervix, might have symptoms such as:
- abnormal or irregular bleeding or spotting from the vagina (especially in between menstrual periods or after sex)
- pain during sex.
If you have a cervix, cervical screening tests are the best way to know if you have been exposed to high-risk HPV.
The symptoms of low-risk and high-risk HPV can take weeks to years to develop, so it can be difficult to know when you were infected.

Low-risk HPV

Genital warts are diagnosed by a doctor or nurse, who will examine any lump or lumps you have noticed.

High-risk HPV

Currently, only people with a cervix can be tested for high-risk HPV. This is done with a cervical screening test.

You may choose to test for other STIs or BBVs at the same time you are being checked for HPV. More information on STI and BBV testing

Sexual Health Victoria (SHV) provides expert, confidential STI and BBV testing to Victorians. We also provide expert information, healthcare and support on a range of reproductive and sexual health matters. For more information on SHV clinical services, see our clinics or you can book an appointment online.

Once you have the virus, it stays in your body until it is cleared by your immune system. This can take months to years. There are several effective treatment options for the symptoms caused by HPV: genital warts and cervical cell changes. Genital warts caused by low-risk HPV can be treated with:

cryotherapy (liquid nitrogen) – to freeze the wart/s
creams or paints you can apply yourself
laser therapy or a minor surgical procedure to remove the wart/s.

Because treatment is aimed at the symptoms of HPV (genital warts), rather than the virus itself, warts can come back after treatment. Once your immune system has cleared the virus, the warts will resolve, regardless of treatment. Cervical cell changes caused by high-risk HPV may require:

more regular cervical screening tests
colposcopy
laser therapy or a minor surgical procedure to remove abnormal cells.

You may need to avoid sexual contact or use barrier protection (external condoms, internal condoms or dental dams), during treatment of HPV symptoms. Some creams or paints used to treat genital warts can affect the latex in condoms and cause them to break easily.

cryotherapy (liquid nitrogen) – to freeze the wart/s
creams or paints you can apply yourself
laser therapy or a minor surgical procedure to remove the wart/s.

more regular cervical screening tests
colposcopy
laser therapy or a minor surgical procedure to remove abnormal cells.

Most HPV infections are cleared by your immune system within 2 years.

In rare cases, untreated high-risk HPV infection can cause cancer.

When the immune system clears infection with a type of HPV, you usually develop immunity to that type. However, you can still be infected with any of the other different types of HPV. Safer sex, including regular STI (and BBV) testing is the best way to lower your risk of getting HPV.

If you have been diagnosed with HPV you are not obligated to let your sexual partner/s know, although you may choose to inform them.

There are some great websites to support you informing your sexual partner/s via a phone call, text message, letter or email. There are ways of doing this either personally or anonymously.

Let Them Know
The Drama Downunder - for men who have sex with men
Better to know – for Aboriginal and Torres Strait Islander people

You may be notified that a sexual partner of yours has been diagnosed with an STI or a BBV. Notification may be in person or via a phone call, text message, letter or email. You too may have an infection and be unaware as you may not have symptoms. See your doctor or nurse to discuss ways to lower the chances of passing it on, get tested and treated.

People who are pregnant or breastfeeding can be infected with the same STIs and BBVs as people who are not pregnant or breastfeeding.

If you are infected with HPV during pregnancy, it usually does not cause any health complications for you and your baby. Genital HPV may be passed to the baby during birth, but this is rare. HPV infection during pregnancy is not associated with miscarriage, premature (early) birth, low birth weight or other pregnancy complications.

During pregnancy, suppression of the immune system and hormonal changes can increase the symptoms of HPV infection (genital warts and cervical cell changes). You are more likely to develop genital warts or cervical cell changes in response to HPV infection and wart growth or cell changes may be more rapid and warts may grow larger. Most symptoms of HPV infection will resolve when immune function returns after delivery.

If the decision is made to treat genital warts (caused by low-risk HPV) during pregnancy – cryotherapy can have a poor response and some prescribed creams or paints are not recommended. Treatment of cervical cell changes (caused by high-risk HPV) can usually be delayed until after delivery.

If you are pregnant or breastfeeding and considering treatment for an STI or BBV, ask your doctor, nurse or midwife about the possible effects of the treatment and/or medicine on your baby or breastfeeding.

If you have had a previous infection with HPV, resulting in treatment to your cervix, it is recommended you discuss this with your doctor, nurse or midwife. You may require additional monitoring or care.

If you are planning a pregnancy or already pregnant, testing for genital warts is not a routine part of health care. Cervical screening tests are recommended (if due) and generally safe during pregnancy. It is recommended you and your sexual partner/s have other STI and BBV screening tests, even if you have been tested in the past. You can speak to your doctor, nurse or midwife for more information.

You can lower your risk of getting STIs and BBVs by using barrier protection (external condoms, internal condoms or dental dams) correctly during any type of sex (vaginal, anal or oral sex) and when sharing sex toys. Barrier protection is not 100% effective at preventing STIs and BBVs. You can also lower your risk of getting a BBV by:

not sharing injecting equipment, razors, nail clippers
only getting tattoos and piercing in regulated places
talking to your doctor or nurse about HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) if you are at risk of HIV exposure.

You can also lower your risk of getting an STI or BBV by both you and your sexual partners having regular STI and BBV testing. To get an STI or BBV test at Sexual Health Victoria, see our clinics or you can book an appointment online.

There are two vaccines to prevent infection with some types of HPV.

Gardasil 9 can prevent infection with nine HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58) that cause most genital warts and genital cancers.

Until February 2023, Gardasil was given as a 2-dose course for those aged under 15 years and a 3-dose course for those aged 15 years and older. It is now known that a single dose of any type of Gardasil vaccine is effective in preventing common types of HPV infections in those aged 25 years or younger.

Gardasil is given as part of the school immunisation program at the age of 12-13 years.

Medicare card holders of all genders aged 25 years or younger who have not had a Gardasil vaccine of any type are eligible for a free vaccination.

Those aged 26 years or older are not eligible for free Gardasil 9 and still require a 3-dose course.

Cervarix can prevent infection with two HPV types (16 and 18) that cause most cervical cancers. It does not prevent infection with HPV types that cause genital warts.

The HPV vaccine does not protect against all types of HPV. After the vaccine, you may still get HPV which causes genital warts or cervical cell changes.

You can discuss your vaccine options with your doctor or nurse.