It is estimated that 75% of sexually active adults will have an HPV infection at some point in their life. Most infections clear up on their own and show no symptoms. This can make preventing HPV transmission difficult, since you don’t always know if you or your partners have HPV. This is why vaccination is important.
HPV is transmitted through skin-to-skin contact during sex even without the exchange of fluids. Whether oral, anal, frontal/vaginal, or any other contact between two bodies, skin-to-skin contact is all that it takes. This includes sharing sex toys that aren’t washed or have different condoms put on them before they’re shared.
BARRIERS (condoms, dental dams)
Using barriers like condoms and dental dams reduce the amount of skin that comes into contact during sex but do little to prevent HPV. This is because no barrier can cover all of the skin that comes to contact with others during sex, even of our genital area, which means that they provide only limited protection.
VACCINATION
Vaccination is the most effective way to prevent HPV.
Canada’s National Advisory Committee on Immunization (NACI) recommends the HPV vaccine Gardasil for:
- People of all genders and sexualities ages nine to 26
- For gay, bi, and guys who have sex with other guys ages 9 to age 45
- For women ages 9 to age 45
Although these recommendations don’t include gender diverse people, individual health care providers often have discretion to prescribe the vaccine to anyone who they think benefits.
Now that the Gardasil vaccine is available to more of us up to the age of 45 you can check out your options here.
It’s important to note that vaccination does not treat HPV infection- vaccination prevents future infections. That said, there are many different types of HPV and just because you have had one type of HPV infection does not mean you shouldn’t get vaccinated. Vaccination still guards against the types of HPV that you don’t have.
Gardasil is an HPV vaccine.
The current version of Gardasil is called Gardasil 9, since it prevents nine types of HPV. These nine types of HPV are out of the 17 that cause the most harmful and visible HPV infections. That include the two types of HPV that cause over 90% of genital warts, as well as seven kinds of HPV that can cause a number of cancers: 80-90% of anal cancers, over 90% of cervical cancers, and significant proportions of vaginal, and vulvar cancers (HPV types 16, 18, 31, 33, 45, 52 and 58). Although Gardasil 9 is not currently recommended to prevent against penile and mouth and throat cancers in Canada, research suggests that it can also help to prevent them and their precancerous conditions, too.
The Gardasil 9 vaccine is a series of three shots given over around six months (at two and six months from the first shot).
Gardasil 9 is not associated with any unusual negative side effects or reactions. Some people may experience side effects that aren’t uncommon for any vaccine, like soreness or swelling. Read more about these common side effects in Frequently Asked Questions.
Before Gardasil 9 we used what we now call Gardasil 4, which guarded against two cancer-causing types of HPV (16 and 18) and two wart-causing types of HPV (6 and 11). Gardasil 4 is no longer available in Canada.
Gardasil originally prevented the two types of HPV infection that result in most cases of anal and cervical cancers and the two types of HPV that cause over 90% of genital warts. This new formulation, Gardasil 9, provides the same level of prevention against those 4 types of HPV infection the first vaccine prevented, plus five more.
You might have gotten Gardasil 4 if you got vaccinated before Gardasil 9 was developed and approved for use in Canada in early 2015. Whether it’s worth being revaccinated with Gardasil 9 will depend on your body and health needs. The differences between Gardasil 4 and Gardasil 9 are most relevant to people with a cervix: these HPV types are responsible for 15-20% of cervical cancers, as well as 11% of anal cancers for those with a cervix (compared to 4% of anal cancers in people without a cervix). If you have been vaccinated against Gardasil 4 and are unsure whether you should also be vaccinated with Gardasil 9 you may want to talk to a doctor or trusted health care provider for their recommendation.
Currently in BC, if someone was vaccinated with Gardasil 4 and still qualifies under the provincial program for people under 27, they are not eligible to receive Gardasil 9 for free.
VACCINATION – CERVARIX
Cervarix is an HPV vaccine.
Cervarix is approved in Canada, and prevents two types of HPV (16 and 18) that are largely responsible for cervical and anal cancers (among others).
Gardasil 9 is the vaccine used in BC’s provincial free HPV vaccination program for people under 27 and is the vaccine you will get unless you specifically request Cervarix.
TESTING
Testing for HPV is not one of the tests we get in a typical STI screening in BC. Often, we won’t know if we have HPV unless we get visible symptoms like genital warts or, in rare cases, cancer or pre-cancerous conditions.
For genital warts, nurses and doctors can perform physical exams to see if a growth is a genital wart and how to treat it. Testing for cancers caused by HPV infection depends on a person’s body and the kinds of sex they have.
Nurses at HIM Health Centres can help you if you think you have an HPV-related condition: they can examine growths that might be genital warts. You can also consult them on you on HPV-related cancers and screening options.
It’s normal to feel worried or anxious about testing for STIs or, in this case, conditions caused by HPV. Sometimes, people feel anxiety or worry about having an STI, even if there aren’t any symptoms and results from relevant tests all come back negative. Check out SmartSexResource for tips on how to identify our worry or anxiety, and ways we can channel that energy in ways that are less harmful to our mental health.
TREATMENT
Treatment for HPV infection will depend on the type of HPV causing the infection. Most infections cause no symptoms and are taken care of by the body without treatment.
Treatment for HPV infections that can lead to cancer will depend on the type and where in the body it is. Find out more about HPV and cancer, including screenings and treatment.
The most visible symptom of certain HPV infections is genital warts, which can be treated. Genital warts will clear up on their own even without treatment, like most other HPV infections. Genital warts can also be treated directly.
The kind of treatment depends on the wart. Treatment could involve applying a prescribed topical cream, or a medical professional can help in freezing or burning the warts, or even removal by surgery or laser. Removing a wart does not cure the HPV that caused it; there is no treatment to cure the HPV infection itself.
Over-the-counter wart treatments aren’t designed to treat genital warts or the sensitive skin around the genitals.
