From the Guidelines
Human papillomavirus (HPV) is primarily spread through direct skin-to-skin contact, most commonly during vaginal, anal, or oral sex with someone who has the virus. HPV can be transmitted even when the infected person has no signs or symptoms, and condoms may not fully protect against it since the virus can infect areas not covered by condoms 1. The virus can also spread through non-sexual skin-to-skin contact in some cases, though this is less common. Pregnant women with HPV can occasionally transmit the virus to their babies during delivery, resulting in rare cases of respiratory papillomatosis in infants.
Key Points to Consider
- HPV is highly contagious because it infects the skin and mucous membranes, and many people don't realize they're infected since symptoms often don't appear 1.
- Regular screening, practicing safer sex, and HPV vaccination are the most effective ways to prevent HPV transmission and related health problems 1.
- The transmission of oral and genital HPV appears to be highly correlated with sexual activity, including early onset of sexual activity and increasing number of lifetime sexual partners 1.
- Oral infection also appears to be correlated with increasing number of oral sexual partners and possibly with open-mouth kissing 1.
- There is an increased risk of transmission of HPV associated with higher-risk behaviors, such as current tobacco use, marijuana use, and alcohol use 1.
Prevention and Screening
- HPV vaccination is recommended for 11- and 12-year-old girls and for females aged 13–26 years who did not receive or complete the vaccine series when they were younger 1.
- The quadrivalent HPV vaccine can be used in males aged 9–26 years to prevent genital warts 1.
- Regular Pap tests are recommended for women, regardless of vaccination or genital wart history 1.
From the Research
HPV Transmission
- HPV is primarily transmitted through skin-to-skin or skin-to-mucosa contact 2
- Sexual transmission is the most documented route, but non-sexual courses, such as horizontal transfer through fomites, fingers, and mouth, skin contact, are also possible 2, 3
- Self-inoculation is described in studies as a potential HPV transmission route, as it was certified in female virgins, and in children with genital warts without a personal history of sexual abuse 2
- Vertical transmission from mother to child is another HPV transfer course, possibly through the amniotic fluid, the placenta, or via contact with maternal genital mucosa during natural birth 2, 3
Modes of Transmission
- Anogenital contact and penetrative and non-penetrative sex are primary modes of transmission for genital warts caused by HPV types 6 and 11 4
- Skin-to-skin contact, including non-penetrative sexual activities, can also transmit HPV 3
- There is no evidence to support waterborne transmission of HPV, although HPV DNA has been detected in water environments 2
Prevention
- Vaccination is an effective way to prevent HPV transmission, with vaccines such as Gardasil and Cervarix highly effective in preventing infection with the most common high-risk HPV types 2, 3
- Safe sexual practices, such as consistent and correct condom use and limiting the number of sexual partners, can also reduce the risk of HPV transmission 3