Human Papillomavirus (HPV)
Human papillomavirus (HPV) is a common STI which usually shows no symptoms, and your immune system can fight the infection off over time, but it can sometimes cause serious illness. There are over 150 different strands of HPV, some are considered low-risk and others high-risk. Anyone, having any kind of sex with other people, regardless of bodies, genders or sexualities, can have and transmit HPV. HPV can only be detected from a cervical screening test, so if you don’t have a cervix, you can’t actually be tested for HPV.
Persistent HPV infection (when your body does not fight off HPV) can occur with high-risk types of HPV, which can lead to cancer. HPV is responsible for almost all cases of cervical cancer and genital warts, and a majority of other cancers including anal, vaginal and mouth and throat.
Protecting yourself against HPV
Vaccination is one of the most significant prevention tools to protect you against HPV infection. The Gardasil vaccine is commonly used as a HPV vaccination, and protects you against 9 strands of HPV which are associated with cervical cancer and genital warts. The Gardasil vaccine is part of the National Immunisation Program, and is primarily delivered through school immunisation programs in Year 7. It is recommended to get this vaccine when you are 12 or 13 years of age, but if you miss out during this time, you can catch up for free up to the age of 26. You can visit your doctor to find out more about getting the HPV vaccine.
Practicing safer sex is another way to protect you against HPV infection. Condoms and dental dams should be used when engaging in any kind of sexual activity, along with washing your hands and washing your toys.
Testing and screening for HPV
Because HPV often shows no symptoms, it can be difficult to know if you have a HPV infection. Sometimes HPV infection will cause genital warts to develop, but when you get HPV infection in places like the cervix or back of the throat, it is unlikely that you will know unless something goes wrong. It is very important to get tested for HPV regularly.
The only way that HPV infection can be detected is through a cervical screening test, meaning that only people with a cervix can get tested. Previously, the pap smear was used to test for cancerous cells in the cervix and was required every 2 years. The cervical screening test is now able to test for the presence of HPV infection before it becomes cancerous and is required every 5 years from the age of 25 to 74.
You should get a cervical screening test every five years if you have a cervix, are aged between 25 and 74 and have had any type of sexual contact. Anybody with a cervix, including transgender men and nonbinary folk needs to get tested, regardless of what sexual activity you are participating in, and with whom. HPV can be transmitted even if you aren’t having sex with men, or if you’re not having penetrative sex.
If you have an intersex variation and you’re not sure if you have a cervix, you can see a trusted doctor who can do an examination and help you find out if you do. If you’ve had a hysterectomy (where they remove the uterus) sometimes they remove the cervix, but sometimes it is kept at the top of the vagina. You will have to check with your doctor to find out if you will need to keep having your cervical screening tests regularly.
You should still get tested even if you:
- Have had the HPV vaccines,
- Are not currently sexually active,
- Have had the same partner for a long time or only had one partner,
- Are gay, lesbian, bisexual, or transgender,
- Are pregnant,
- Have been through menopause,
- And feel healthy and have no symptoms.
For people that don’t have a cervix, it is important to stay in tune with your body and remain vigilant with testing for other STIs. You can also check for anal lesions which may be a sign of HPV infection. This can be done by inserting your finger up your anus and feeling for any unusual warts or lesions.
Cervical Screening Tests
When it comes to cervical screening tests, it helps to find somewhere you feel safe and supported and trust the doctors. To access cervical screening tests, you can visit your doctor, an Aboriginal and Torres Strait Islander health practitioner or worker, a gynaecologist or a nurse trained in cervical screening. This can be at a community or women’s health centre, a sexual health clinic, an Aboriginal Medical Service or Aboriginal Community Controlled Health Service and is covered by Medicare once you are 25 years old.
Your health professional will take a sample of cells from your cervix to check for HPV infection. This is done by putting a speculum into your vagina and collecting the sample from your cervix using a small brush. You might experience some discomfort, but you can ask for a different sized speculum to reduce the chance of experiencing pain during this test.
Self Collected Cervical Screening Tests
Self-collection is now an option for everyone requiring cervical screening. This allows you take a sample from your vagina (rather than your cervix) using a swab. Currently, this must be done through your doctor or healthcare provider rather than at home. At your appointment, you will be given a private space, a swab, and instructions on how to collect your sample. A self-collected cervical screening test is just as safe and accurate at detecting HPV as a clinician-collected sample.
Genital warts present as small cauliflower or broccoli- like warts around the genitals or anus and can be white or skin-coloured. If you notice these warts, see your doctor to discuss treatment options. These treatment options might include freezing or burning to remove the warts, or a cream. The cream that is prescribed for genital warts is very different to over-the-counter wart cream you can find at a chemist, so it is important you see a doctor to discuss your options.
HPV & Cervical Cancer
Almost all cases of cervical cancer are caused by persistent infection with some high-risk types of the HPV. Around 8 out of 10 women will become infected with genital HPV at some time in their lives, although most women who have the HPV infection never get cervical cancer. Cervical cancer can result from persistent infection of high-risk strains of HPV over 10 to 15 years.
HPV & Other Cancers
In addition to cervical cancer, HPV is responsible for 90% of anal cancers, 78% of vaginal cancers, 60% of mouth and throat cancers, and 25% of vulvar cancers.
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