HPV Prevalence in the United States
Human papillomavirus (HPV) is extremely common, with an estimated 80% of sexually active women acquiring genital HPV by age 50 years. 1 This high prevalence makes HPV the most common sexually transmitted infection in the United States.
Overall Prevalence Data
- In the United States, approximately 26.8% of females aged 14-59 years have detectable HPV infection at any given time 2
- Highest prevalence is among women aged 20-24 years (44.8%) 2
- An estimated 6.2 million new HPV infections occur annually among persons aged 14-44 years 1
- Of these new infections, 74% occur among those aged 15-24 years 1
Age-Specific Prevalence
HPV prevalence varies significantly by age:
- Ages 14-19 years: 24.5% 2
- Ages 20-24 years: 44.8% (peak prevalence) 2
- Ages 25-29 years: 27.4% 2
- Ages 30-39 years: 27.5% 2
- Ages 40-49 years: 25.2% 2
- Ages 50-59 years: 19.6% 2
There is a statistically significant trend of increasing HPV prevalence with each year of age from 14 to 24 years, followed by a gradual decline through age 59 2.
Cumulative Risk of Infection
- Modeling estimates suggest that >80% of sexually active women will acquire genital HPV by age 50 1
- In a prospective study of college women, the cumulative probability of incident infection was 38.9% by 24 months after first sexual intercourse 1
- HPV acquisition occurs rapidly after sexual debut, with HPV 16 being the most commonly acquired type (10.4%) 1
Prevalence of Specific HPV Types
- Overall prevalence of vaccine-preventable types (6,11,16, and 18) is 3.4% 2
- HPV-6: 1.3%
- HPV-11: 0.1%
- HPV-16: 1.5%
- HPV-18: 0.8%
Risk Factors for HPV Infection
The most consistent predictors of HPV infection are:
- Number of sexual partners (lifetime and recent) 1
- 14.3% prevalence among women aged 18-25 with one lifetime partner
- 22.3% prevalence with two lifetime partners
- 31.5% prevalence with more than three lifetime partners
- Early onset of sexual activity 1, 3
- Partner sexual behavior 1
- Immune status 1
- Other risk factors include tobacco use, marijuana use, and alcohol use 3
HPV in Men
- HPV infection is also common among men 1
- Among heterosexual men in clinic-based studies, prevalence of genital HPV infection often exceeds 20% 1
- Prevalence is highly dependent on anatomic sites sampled and method of specimen collection 1
Public Health Implications
The high prevalence of HPV has significant public health implications:
- HPV is a necessary cause of cervical cancer and precursor lesions 1
- HPV types 16 and 18 account for approximately 68% of squamous cell cancers and 83% of adenocarcinomas 1
- Prevention strategies include HPV vaccination, consistent condom use (which can reduce HPV infection by approximately 70%), limiting sexual partners, and regular screening 3
The extremely high prevalence of HPV underscores the importance of vaccination before sexual debut and regular screening according to age-appropriate guidelines to reduce the burden of HPV-related diseases.