HPV (Human Papilloma Virus)

HPV—or Human Papilloma Virus if you want to sound smart—is the most common sexually transmitted infection (STI) out there. There are more than 100 types of HPV and about 40 can be passed on through sexual contact. This means that if you are sexually active and have had multiple partners, you will most likely have an HPV infection at some point in your life—it’s that common.

There are a few types of HPV that can cause genital warts and a handful of rare types that are linked to causing throat, penis or anal cancer in guys. But for the most part, HPV infections are harmless and you won’t show any symptoms of having them. Your body will get rid of them on its own.

So how do you know if you have HPV or not? Well for cisgender guys, there’s no routine test. You would really only know if you have one of the types that causes warts (or the above mentioned cancers).

If you end up contracting HPV that develops into warts, don’t worry too much. The types of HPV that cause warts are mostly harmless to the rest your health. In the business of STIs, genital warts are described as “cauliform” in shape—basically meaning they often look bumpy like the top of cauliflower. HPV warts are usually flesh-coloured or darker in colour, and can be found anywhere down there—on your penis, under your foreskin, at the base of the penis, around your pubes, or around your anus. For trans guys they can also be found in or around your front hole.

HPV particularly impacts gay, bi, and other guys into guys. Men who have sex with men are more likely to have HPV – and to develop anal cancer – when compared to men who only have sex with women. It is also important to note that HIV positive gay and bisexual men are at even greater risk of developing anal cancer as a result of HPV (about 100 times more likely when compared to the general population)

Warts are either treated with prescription creams, frozen off with liquid nitrogen spray or, in extreme cases, may require surgical removal. If you do have warts and are in the middle of treatment, some tips are not to shave or scratch the area where the warts are (it helps them spread) and definitely do not use any sort of over-the-counter wart treatment on your genitals  (it’s not meant for genital warts and you’ll end up causing yourself a lot of pain).

HPV is passed on through any type of sexual activity that involves skin-to-skin contact. The risk of transmission can be reduced—but not eliminated completely—by using barriers like condoms or dental dams for oral and anal, or frontal sex. There is also a vaccine available called Gardasil 9 that you can get that provides immunity against HPV (aka resistance against the virus). Gardasil 9 protects against 9 types of HPV—those most likely to cause cancer and the ones most likely to cause genital warts.

As of 2014, HPV vaccines are offered to all grade five students in Alberta, regardless of gender. It’s likely that, if you’re reading this, you missed out on that opportunity. Fortunately, since February of 2018, Alberta Health and Alberta Health Services have started distributing the HPV Vaccine (Gardasil 9) free of charge for the following populations:

  • Men who have sex with men between 17 and 26
  • Trans women between 17 and 26

Given that the vaccine consists of a series of three injections, which can cost up to $500 in total, if you didn’t receive the vaccination in school and you meet the new coverage criteria, this can significantly reduce your cost. Right now, you can access the vaccine at any Alberta Public Health or STI clinic (call ahead to make sure they have some on-hand). You can search for a Public Health Centre near you here. Even if you’re above 26 and don’t qualify for 100% public coverage under the current criteria, you might still want to consider getting vaccinated, as recent evidence demonstrates that HPV vaccination could be of benefits to all adults. Many private insurance plans will cover a portion of the vaccine, significantly reducing it’s cost.

But what if I’ve already had warts/HPV? Well, you can still benefit from getting vaccinated! HPV vaccines boost your antibodies for the HPV strain you may already have and helps lower future incurrence rates. It also protects you against those strains you do not have. For example, the newest version of the vaccine, Gardasil 9, gives you 20% more coverage against cancer causing streams than the previous vaccine (Gardasil 4).

Finally, for trans guys who have a cervix, it’s important to find out if you need a pap test (a test that examines the cells on the cervix for any abnormalities that might be related to cervical cancer). Have a discussion with a healthcare provider and follow the screening guidelines. Usually these tests start at age 21 or 3 years after your first sexual contact, whichever comes later, and then every year until your family doctor suggests to change that interval.  For people living with HIV, it is also a good idea to discuss regular anal pap tests with your HIV physician. Because HIV affects your immune system, you could be at a higher risk for developing anal cancers. Getting screened can catch precancerous changes as early as possible.

This content was created in partnership with HIV Edmonton. To learn more about HIV Edmonton and the programming they offer, click on the link below:

  1. Public Health Canada. Human Papillomavirus Prevention and PHV Vaccines: Questions and Answers. http://www.phac-aspc.gc.ca/std. Accessed February 21 2016.
  2. Canadian Cancer Society. Human Papillomavirus. cancer.ca/en/cancer-information. Accessed February 21 2016.
  3. Chin-Hong, P., Vittinghoff,E., Cranston, R., Buchbinder, S., Cohen, D., Colfax, G., Da Costa, M., Darragh, T., Hess, E., Judson, F., Koblin, B., Madison, M., and J. Palefsky. Age-Specific Prevalence of Anal Human Papillomavirus Infection in HIV-Negative Sexually Active Men Who Have Sex with Men: The EXPLORE Study. The Journal of Infectious Diseases. 190:2070–6. 2004.
  4. Wolters Kluwer UpToDate. Epidemiology of human papillomavirus infections. Uptodate.com. Accessed February 21 2016.
  5. Gay Men’s Sexual Health Alliance. PRIMED2. 2015.
  6. Toward Optimized Practice. Alberta Cervical Cancer Screening Guidelines. http://www.topalbertadoctors.org/cpgs/919105. Accessed February 21 2016.
  7. Smyczek, P., Singh, A., and B. Romanowski. Anal intraepithelial neoplasia: review and recommendations for screening and management. International Journal of STD & AIDS 24(11) 843–851. 2013.