Human Papilloma Virus (HPV)

Human Papillomavirus (HPV) is the name of a very common, highly contagious group of viruses that can infect the genital and oral areas of any body. “Low risk” types of genital HPV can cause genital warts, and “high risk” types can cause abnormal cells that could lead to certain types of cancers (cervical, oral, anogenital) over time.  There are currently 2 different vaccines  available that protect against certain types of HPV: Gardasil 9 and Cervarix.

For more information on HPV, visit BCCDC’s HPV page.

Make an appointment at any of our clinics in Greater Victoria to find out more information on HPV, to be examined and treated for HPV, or to have a Pap test to check for pre-cancerous changes in the cervix.

Symptoms of HPV (including genital warts)

Most people will not have any symptoms with an HPV infection.

The few people who have symptoms may get visible genital warts or have pre-cancerous changes in the cervix, vulva, anus, mouth or penis. Genital warts are usually soft,  flesh-coloured painless growths. Genital warts can be raised or flat, single or multiple, small or large, and sometimes clustered together. They can appear in or around the vagina or anus, on the vulva, in the urethra, cervix, penis, scrotum, groin or thigh.

Other symptoms may include:

  • Itchiness
  • Discomfort during penetrative intercourse
  • Bleeding with intercourse

How HPV spreads

HPV is the most common STI in the world and the rates continue to rise.

  • it is estimated that at least 70% of sexually active people will have at least 1 HPV infection in their lifetime (PHAC, 2008)
  • many people infected with HPV do not have any symptoms and are unaware they are infected but can pass on the virus.
  • Every year in BC alone, approximately 150 women get cervical cancer and approximately 40 women die from the disease.

There are over 100 different types of HPV, and more than 40 of these are sexually transmitted. The genital types of HPV are most commonly spread through skin to skin genital contact with an infected person.

  • HPV can be transmitted during oral, vaginal and anal sex and through genital skin to skin contact (penetration not necessary) or by sharing toys.
  • HPV is extremely contagious and any sexually active person can get it
  • Most HPV infected people do not know they are infected (no symptoms) but can pass the virus to a sex partner
  • Many HPV infected people will clear the infection on their own within 18 months but in some people the virus may remain dormant in the body and the symptoms can return
  • Rarely, an infected person can pass it on to a baby during vaginal childbirth

HPV tests and diagnosis

  • Genital warts are diagnosed by visual inspection
  • People with cervixes (female  bodied people) are often diagnosed with high risk strains of HPV on the basis of abnormal Pap tests, therefore it is important for sexually active people with cervixes to get regular Pap tests beginning at the age of 25. Most people will continue screening every 3 years (or as recommended by health professional) until the age of 69.
  •  Pap tests (also called cervical screenings) are used to screen for pre-cancerous changes in the cervix, most of which are related to HPV; they are not used exclusively as diagnosis tool. When cervical screening is done every 3 years, you can reduce your risk of cervical cancer by 70%
  • HPV DNA testing for high risk strains of HPV is now available for people with cervixes (using a cervical swab) for a fee through Life Labs
  • Make an appointment to have a Pap test or to see a doctor about genital warts.

HPV treatment

  • there is no cure for HPV, however most people with healthy immune systems will generally clear the infection on their own within 18 months
  • treatments are directed towards the changes in skin or mucous membrane caused by HPV such as warts or pre-cancerous changes in the cervix
  • cervical changes are closely monitored and if necessary abnormal cells can be destroyed or removed
  • genital warts can be removed by treatments performed by a health care provider such as freezing or laser or by self applied medication. At ISHS, we can talk to you more about the treatment options available and provide LQN2 and prescriptions for topical treatments for you.

Preventing HPV

To reduce the risk of HPV:

  • get vaccinated against HPV (ideally before becoming sexually active. Those who are already sexually active can still benefit from vaccination because they may not yet have HPV infection and are very unlikely to be infected with all types (National Advisory Committee on Immunization).
  • practice good sex safety s including condoms and dams can reduce your risk, but the virus can still be spread through contact with an area that is not covered by the barrier
  • Get regular infection screening and regular Pap tests.
  • Limit your number of sexual partners may limit your exposure to HPV

Health Canada has approved 2 vaccines: Gardasil 9™ and Cervarix™ for protection against HPV. Please read below for more information on the different vaccinations available:

Gardasil 4™ or HPV4

Gardasil is the trade name of the vaccine that offers protection against 4 types of HPV; HPV 6 and 11 which cause 90% of gential warts and HPV 16 and 18 which cause most cases of cervical and anal cancers. Gardasil™ vaccine is a series of 3 injections given at 0, 2, and 6 months. In Canada it is currently indicated for people with cervixes (female bodied people) aged 9-45 years and people with testicles (male bodied people) aged 9-26.

Gardasil 9™ or HPV9

The Gardasil 9 vaccine helps prevent against  HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58. These 9 HPV types are known to cause approximately 90% of cervical cancers, 80% of cervical precancers, 75% of HPV-related vulvar, vaginal and anal cancers and precancers, and over 90% of genital warts.

The vaccine is indicated for people with cervixes aged 9 to 45 and for people with testicles aged 9 to 26. It is only funded for certain people.

The HPV9 vaccine is currently provided free to all students in grade 6 in BC. Those male bodied (born in 2006 or later) and female bodied who did not get the vaccine in grade 6 remain eligible for the free HPV vaccine if they start their vaccine series before their 19th birthday and complete it before their 26th birthday.

The Government of BC also provides the HPV9 vaccine free of cost to:

  • HIV positive individuals 9-26 years of age
  • Transgender individuals 9-26 years of age
  • Male bodied people 9 to 26 years of age who:
    • have sex with other male bodied people
    • are not yet sexually active but are questioning their sexual orientation
    • are street involved.

If you do not qualify for a free vaccine, it is available through prescription for a fee. Many extended health care plans cover a portion of the cost. Clients wishing to be immunized with Gardasil9 or Cervarix will be given a prescription to pick up their vaccine at a pharmacy and return for vaccination.

Depending on age, 2 or 3 injections are needed to complete immunization series. The ImmunizeBC site had more information available on HPV immunizations.

Contact our clinics if you have any questions about HPV or immunizations.

Cervarix or HPV2

Cervarix is the trade name of the vaccine that offers protection against 2 types of HPV; HPV 16 and 18 which cause most cases of cervical cancers. Cervarix™ vaccine is a series of 3 injections given at 0,1, and 6 months. In Canada, Cervarix can help protect young people with cervixes aged 10-25. Cervarix does not offer any protection against the types of HPV connected to genital warts or for those bodies with testicles.

Neither Gardasil9 nor Cervarix treat HPV-related diseases present at time of vaccination and do not protect against all HPV types. Routine cervical cancer screening is still necessary for people with cervixes who have received vaccinations.

More Information on HPV

For current statistics on HPV, check out the research on Sexualityandu.

For further reading, see our links and other resources.