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Traveler Summary

Key Points

  • Human papillomavirus (HPV) infection is a viral infection acquired through sexual contact.
  • Risk exists for unvaccinated, sexually active travelers.
  • Symptoms in both males and females include lesions in or on the skin, genitals, or mucous membranes.
  • Consequences of infection may include cancer of the cervix, vagina, penis, anus, or throat.
  • Prevention includes sexual abstinence; condoms are not fully protective.
  • HPV vaccine is routinely given to both females and males (whether or not they have been sexually active) as a 2- or 3-dose series over a period of 6 or 12 months, depending on age at series initiation.
  • Vaccine side effects are mild and include injection-site reaction, fever, and headache.
  • Vaccine protection is long lasting; no booster dose is recommended.

Introduction

Human papillomavirus (HPV) infection is the most common viral infection of the reproductive tract and the most common sexually transmitted infection (STI) in the U.S. HPV infections range from common, benign genital warts to cancers of the genital area, anus, and back of the throat (oropharyngeal) in men and women. Cervical cancer is the fourth most common cancer in women worldwide. Although treatments are available for the health problems caused by HPV, no cure exists for HPV infection itself.

Risk Areas

HPVs are common worldwide. In the U.S., approximately 79 million people are currently infected with HPV and another 14 million become infected each year. At least 50% of sexually active men and women become infected at some point in their lives.

Transmission

HPV is sexually transmitted through genital and skin-to-skin contact or oral sex. A pregnant woman with genital HPV infection can pass the infection to her newborn during delivery, although this is rare.

Risk Factors

Risk is highest for unvaccinated, sexually active males and females. Certain populations (e.g., men who have sex with men or persons with HIV) and immunocompromised persons may have a lower immune response to the vaccine.

Symptoms

Most people infected with HPV do not develop symptoms because the body's immune system clears HPV naturally within 2 years in the majority of cases. HPV infections that are not cleared may result in common, benign genital warts or warts in the throat.

Consequences of Infection

HPV infection increases the risk for developing cancer of the cervix (most common), vagina, penis, anus, or throat; identifying which cases will progress to cancer is not possible.

Need for Medical Assistance

Persons who develop symptoms of HPV infection should seek medical attention. No treatment exists for the virus itself, but treatments are available for diseases caused by HPV.

HPV vaccines are not intended to be used for treatment, and they only protect against the HPV types contained in the vaccines.

Prevention

Nonvaccine

The most effective way to avoid HPV infection, in addition to vaccination, is avoidance of sexual contact. Condoms are not fully protective.

Vaccine

HPV vaccine (Gardasil 9) is most effective when given at age 11 or 12 years. Ideally, the vaccine should be administered before potential exposure to HPV through sexual activity; however, persons who are sexually active should still be vaccinated.

Vaccination is not a substitute for regular cervical cancer screening in women. Duration of protection from HPV vaccination is long lasting; booster doses are not recommended.

Side Effects

The most common vaccine side effects are mild and include injection-site reactions, fever, and headache. More significant side effects are rare.

Persons with underlying medical conditions or who have concerns about the vaccine should speak to their health care provider before vaccine administration.

Timing

Gardasil 9 is given as a 2- or 3-dose series over a period of 6-12 months, depending on age at series initiation.

If earlier protection is needed, a 2- or 3-dose series over a period of 5 months (depending on age at series initiation) will provide protection for healthy persons.