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Human Papilloma Virus (HPV) and HIV/AIDS

April 28, 2017

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Table of Contents

What Is HPV?

Human papillomavirus (HPV) is the name of a large group of viruses. Certain types of HPV can cause warts on the hands, feet, mouth, or throat. About 30 to 40 types can cause infections in the genital area (the vulva, vagina, penis, buttocks, scrotum, and anus).

Genital HPV is a very common sexually transmitted infection or disease (STI or STD) worldwide. The World Health Organization (WHO) estimates that more than 290 million women were infected with HPV in 2013. HPV infection is responsible for more than half a million cases of cervical cancer each year, over 85 percent of which occur in the developing world.

Genital HPV types are often grouped as "low risk" or "high risk." Low-risk types can cause genital warts. High-risk types can cause cervical cancer or cancer of the vulva, vagina, anus, and penis. The types of HPV that can cause genital warts are not the same as the types that can cause cancer. However, if you have warts, you may have also been exposed to the types of HPV that can cause cancer.

Genital HPV is spread easily through skin-to-skin contact during vaginal or anal sex with someone who has the infection. Insertive or penetrative sex is not required for HPV to be spread between sexual partners. Condoms and other latex barriers do not totally prevent transmission. Most people with HPV do not know they have it because they do not develop symptoms, yet they can still pass it on to someone else.


Although most sexually active women and men will be infected with HPV at some time, nine times out of ten, the body's immune system clears HPV infection naturally (gets rid of the infection without treatment) within two years. Because HIV weakens the immune system, people living with HIV (HIV+ people) are more likely to be infected with HPV than HIV-negative people. One study found HPV in more than three out of four women living with HIV. Women living with HIV who have HPV are also more likely to have:

  • Difficulty clearing the infection naturally
  • HPV infections that were once under control and come back again
  • HPV that responds poorly to standard treatment; multiple therapies using different methods may be needed
  • Several types or strains of HPV at once
  • Infection with the "high risk" HPV types that can cause cancer
  • Higher risk of developing cervical and anal cancer when infected with the "high risk" types

If you have sex, it is important to be checked regularly by your health care provider for signs of HPV such as genital warts, cervical cancer, and anal cancer. For information on vaccines and routine screenings for HPV, see the section on Prevention of HPV below.

Genital Warts

Certain types of HPV can cause warts on the vulva (including the labia, or 'lips'), in or around the vagina or anus, or on the penis, scrotum, groin, or thigh. Warts can appear anywhere from a few weeks to a few months after you are exposed to HPV. They can even appear years after exposure.


  • Flesh-colored, pinkish, or white warts that appear as small bumps or groups of bumps. They can be raised or flat, different sizes, and are sometimes shaped like cauliflower.


  • Health care providers can usually identify genital warts by looking at them
  • Sometimes a biopsy is done (a sample of the suspected wart is cut off and examined under a microscope)
  • Some health care providers may use a vinegar solution to help identify flat warts with the naked eye; however, this test may sometimes wrongly identify normal skin as a wart


There is no cure for HPV, but genital warts can be treated by removing the wart if they do not go away on their own.

  • The following treatments must be done in a health care provider's office:
    • TCA (trichloracetic acid): A chemical is applied to the surface of the wart
    • Cryotherapy: Freezing off the wart with liquid nitrogen
    • Electrocautery: Burning off the wart with an electrical current
    • Laser therapy: Using an intense light to destroy the wart
    • Excision: Cutting out the wart
  • Some treatments can be done at home with prescription creams: Aldara or Beselna (imiquimod), Condylox (podofilox or podophyllotoxin), and Veregen (sinecatechins, or green tea extracts). Because Aldara and Beselna act on the immune system, it is important to talk with your health care provider about the best prescription wart treatment for you if you are living with HIV.
  • Do not use over-the-counter wart removal products to treat genital warts
  • Some wart treatments should not be used by pregnant women or women who are breastfeeding
  • Warts can reappear after successful treatment

If left untreated, genital warts may go away, remain unchanged, or increase in size or number. Some people decide not to have treatment right away to see if the warts will go away on their own. When considering treatment options, you and your health care provider may take into account the size, location and number of warts, changes in the warts, your preference, and the side effects of treatment.

Many women living with HIV, especially those with low CD4 cell counts, may not be able to get rid of genital warts using standard treatments. Several different treatments may be needed. For women living with HIV, one of the best ways to strengthen the immune system and help get rid of genital warts is to take HIV drugs. If you are already taking HIV drugs, it is important that you take them exactly as directed so that they can increase your CD4 count and fight off HPV.

For pictures of different sexually transmitted infections, including genital warts caused by HPV, please click here (note: some of these images are graphic).

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.


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