Human Papilloma Virus (HPV) and HIV/AIDS

Table of Contents

• What is HPV?
• Prevention of HPV
• Genital Warts
• Cervical Dysplasia and Cervical Cancer
• Anal Dysplasia and Anal Cancer
• Taking Care of Yourself

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 or feet. About 30-40 types can cause infections in the genital area (the vulva, vagina, penis, buttocks, scrotum, and anus).

Genital HPV types are often categorized 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 the most common sexually transmitted disease (STD) in the US. Over half of all sexually active men and women become infected with HPV at some time in their lives. Genital HPV is spread easily through skin-to-skin contact during vaginal or anal sex with someone who has the infection. 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.

In 90 percent of cases, the body's immune system clears HPV infection naturally (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 3 out of 4 HIV+ women. HIV+ women with 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 or cervical and anal cancer

Prevention of HPV

Vaccines

There are two Food and Drug Administration (FDA)-approved HPV vaccines: Gardasil and Cervarix. Gardasil is approved for females and males ages 9 to 26. Cervarix is approved for females ages 10-25. Both vaccines protect against types of HPV that cause the majority of cervical cancers and genital warts. A recent study also showed that Cervarix provides strong protection against HPV-related anal cancer in women. The vaccines do not protect against less common HPV types. Therefore, health care providers still recommend regular Pap tests to look for signs of cancer.

It is important for young people to get vaccinated before their first sexual contact (before they have been exposed to HPV). Pregnant women should not receive the vaccines, and people already infected with HPV are not protected by the vaccines. The safety and effectiveness of the vaccines in HIV+ people has not been determined. Speak to your health care provider about the HPV vaccine to see if it is right for you.

There are payment assistance programs for people who cannot afford the HPV vaccines; see the resource section of this sheet for contact information.

Routine Screenings

Regular pelvic and anal exams and Pap tests are very important. While they cannot prevent HPV-related problems, they can help catch warts and dysplasia (abnormal or pre-cancerous cells) before they progress and cause greater problems.

It has been found that many HIV+ women skip Pap tests. It is crucial that HIV+ women get routine Pap testing and follow up as needed to identify problems before cancer develops. Prevention is always better -- healthier, less painful, and less costly -- than treatment.

Condoms

Even though condoms do not fully protect against HPV, when used correctly they can help reduce the chances that HPV will be spread.

Not Smoking

Smoking has been shown to increase the chance of developing several types of cancer including cervical and anal cancers. If you smoke, it is a good idea to try and quit. Talk with your health care provider about stopping smoking -- there are many tools to help you quit. You can also find lots of information and support online (www.smokefree.gov/).