What is HPV?
How do I get HPV?
Why haven't I heard of HPV?
What does HPV do to my body?
Pap smear? What is it?
Is there a cure for HPV?
Are my feelings about HPV ok?

What are genital warts?
Where do they show up on my body?
Can they come back after they're gone?
Are genital warts dangerous?
Is there a cure for genital warts?

Abnormal (unusual) Cell Changes (Dysplasia) (treatable with medication)
What is Dysplasia?
How do I find out if I have abnormal cell changes?
When should I get a Pap smear?
Should I be afraid of getting cancer?
I heard about a vaccine? What is it really?
Gardasil®? Should I use it?
Can I get HPV from the vaccine?

HPV and Penile and Anal Cancer (treatable, but not curable)
What are Penile and Anal Cancer?
What are the signs for Penile Cancer?
What are the signs for Anal Cancer?
Is there a cure for Anal or Penile Cancer?
How can I reduce my risk of getting HPV?
How do I learn more about HPV?


What is HPV?
HPV, or Human Papillomavirus, is the name of a group of viruses that has more than 70 different types. HPV is sometimes called the wart virus because some types of HPV cause warts on the hands, feet or genitals.

The types of HPV that cause visible warts (ones you can see) on the genitals (vagina, penis), vulva (entire outer female genital area), scrotum (balls) or anus (butt hole) are different types than the HPV that cause warts on the hands and feet. People may have HPV and not have any warts that they can see. Some types can make the cells on the cervix (lower part of the uterus that connects to the top of the vagina) or in the anus change and, in some cases, turn into cancer over many, many years if you don't get treated.

How do I get HPV?
HPV and genital warts are spread when you have sex with someone who already has the virus. You can get HPV as long as you are having sex. You may not know right away if you have HPV. Genital warts do not always appear right away and many people never get any cervical or anus changes. Some people may see warts:

• Within several weeks after having sex with a person who has HPV.
• Within several months after having sex with a person who has HPV (this is MOST common).
• Within several years after having sex with a person who has HPV.
• NEVER (and they may never know they have HPV).
• And since genital warts may not appear until weeks, months or years after you got them,
  it may be hard to know exactly when you got the virus and who passed it on to you.

Why haven't I heard of HPV?
HPV and genital warts are very common. HPV is the most common STI in the United States, but

• Many people don't know they have it.
• Many people give it to their partners without meaning to.
• You may not know right away that you have HPV or genital warts.
  

Some people will know they have HPV when:

• They see warts or bumps in their genitals or their sex partner's genitals.
• Their doctor or nurse sees warts that are inside the vagina or in the anus found during an exam of their body.
• They find something wrong in their Pap smear. When something is wrong in the Pap smear it could mean that they have HPV.

What does HPV do to my body?

• Sometimes HPV lives in the skin without causing ANY warts or other skin changes that can be seen at all. This is called latent (or hidden) HPV.
• Some people get growths that they can see or bumps in the genital area. These are visible genital warts.
• Some people have tiny changes on the skin that can't be seen with the eye. This is called sub clinical HPV. Doctors and nurses can find these by looking at the skin with special instruments that magnify the skin (make what they look at appear larger).
• Some girls have cell changes on their cervix that should not be there, which is found by a Pap smear.

Pap smear? What is it?
A Pap smear is a test made to find cells that don't look the way they are supposed to on the cervix before they turn into cancer (precancerous changes). Precancerous changes are caused by HPV.
The Pap smear is simple and quick, and most girls feel fine during the test. The doctor uses a small wooden spatula and a brush to take cells off the cervix. They put the cells on a microscope and look at them to make sure nothing is wrong.

If the cells don't look normal, your doctor or nurse may repeat the Pap smear in a few months.
Often, the next Pap smear will be normal. Or, they may ask you to come in to look at your cervix with a special lens that makes the cells look bigger called a coloscopy (this looks like a pair of binoculars with a bright light).

Is there a cure for HPV?
No. HPV is a virus (grows inside you and makes you sick) and there is no direct treatment for the virus. But warts or other cell changes caused by the virus can be treated. There are some treatments for mild Cervical Dysplasia (changes in cervical cells). Most people never have a problem with HPV because their body's immune system (fights against disease and sickness in the body) keeps the virus from ever becoming a problem. HPV can be treated and controlled if you do show the signs of having the virus.

You should go to the doctor or clinic if:

• You notice any weird growths, bumps or skin changes on or near the penis, vagina, vulva, anus, scrotum or groin.
• If you see a bump that wasn't there before or your skin just doesn't look the way it usually does.
• Your sex partner(s) tells you that he or she has genital HPV or genital warts.
• You are a girl and having sex.
• You are guy and having sex.
  

Are my feelings about HPV ok?
Yes. Many people feel ashamed, fearful, confused, less attractive or less interested in sex. They feel angry and some people are afraid that they will get cancer, or that they will never be able to find a sexual partner again. These feelings are normal and many people have the same ones. It is still possible to have a normal life with HPV.

If you feel his way, talk to a friend, family or your doctor. There are also support groups that may be able to help.

Genital warts (curable with medication)

What are genital warts?
The genital warts (that you can see) are small, hard reddish bumps in the genital area. They may be:

• Flat (smooth on the skin)
• Raised (like a bump or skin growth)
• Single (only one wart)
• Multiple (more than one in the same area or many areas)
• Small or large

Where do they show up on my body?
Guys/Men

• Penis
• Scrotum
• In or around the anus
• Groin (where the genital area meets the inner thigh)

Girls/Women

• Vulva (entire outer female genital area)
• In or around the vagina
• In or around the anus
• Groin (where the genital area meets the inner thigh)
• Cervix (neck of the uterus (womb) that connects the uterus and the vagina inside a girl's body). The cervix in teen girls has usually not grown all the way. This can make it easier for a teen woman to have cell changes from HPV and to get other STIs.

Can they come back after they're gone?

• When you have warts, the virus is still there.
• When warts are gone, the virus is latent (sleeping) in the skin cells - you may or may not be able to pass it on.
• A healthy immune system is usually able to get rid of the virus or stop it over time.

Are genital warts dangerous?
No. The types of HPV that cause raised or "cauliflower"-shaped warts are not the same types that cause cervical, penile (penis) or anal cancer, but if you have genital warts, you may have also come into contact with the types of HPV that can cause cervical cancer. Like any other girl having sex, a girl with genital warts should have a Pap smear every year.

Is there a cure for genital warts?
Some people are never bothered by genital warts and are never treated for them. Sometimes the immune system will control the HPV and the genital warts may go away by themselves.

If genital warts are itching, burning or bleeding, or you just want to do whatever you can to get rid of them, there are several ways to treat them.

• Podofilox™ is a liquid or gel that you can put on yourself at home for genital warts on the outside of your body. It doesn't cost much and it's safe and easy to use. You have to get a prescription for the liquid.
• Imiquimod cream you can put on yourself at home for genital warts and warts near the anus. It is safe, it works and it's easy to use. The cream does not hurt your skin and doesn't cause scarring like some other treatments.You have to get a prescription for the cream.
• Cryotherapy (freezing off the wart with a chemical) is cheap, but a doctor or nurse has to do this treatment.
• Trichloracetic acid (TCA) is another chemical that a doctor or nurse puts on the wart.
• Laser therapy (using a strong light to destroy warts) or surgery (cutting off warts) is good because you can getthe warts off in one visit to an office, but it's expensive and you need a well trained doctor.
• The drug interferon is used sometimes, but there are cheaper treatments that work just as well and have fewer problems.
  **BE CAREFUL: NEVER USE TREATMENTS MADE FOR WARTS ON THE HANDS AND FEET TO GET RID OFGENITAL WARTS.

Some things to think about before getting any treatment for genital warts:

• If you are pregnant or think you might be, tell your doctor or nurse so a treatment can be chosen that won't hurt you or the baby.
• Ask your doctor or nurse to tell you about the treatment, including how much it costs and the good things about it.
• Be sure you know what to do after you have the treatment done, like what to do about any itching, burning or pain, and when to come back to the office or clinic.
• Be patient, most people have to be treated more than once or your doctor or nurse may have to try more than one treatment.
• Some doctors or nurses may tell you not to have sex while having treatment. This is to protect the treated areas of skin and help it heal.
• It's OK to ask the doctor or nurse questions. They are there to help you and explain what is happening if you have any questions.

Remember:
None of the treatments listed above is a cure for HPV (although the treatment of warts may help your immune system fight warts), and warts can return even months later after treatment. Most of the time, warts never come back.

Abnormal (unusual) Cell Changes (Dysplasia)
(treatable with medication)

What is Dysplasia?
Dysplasia just means the cells on the cervix have changed in some way. HPV causes these changes. The types of HPV that cause the cell changes are considered very high risk, which means there is a good chance they cause cervical cancer.

How do I find out if I have Dysplasia?
Doctors and nurses test for abnormal cell changes in a Pap smear. A Pap smear is usually part of a yearly pelvic exam. In a pelvis exam the doctor or nurse checks the outside of the genital area. They also use their hands to feel the shape of the reproductive organs to make sure they feel normal.

When should I get a Pap smear?
According to the American Cancer Society, a girl should get her first Pap smear by age 21, or within three years of having sex - which ever happens first. Having a Pap smear every year can help the doctor find cell changes early and there is a better chance you won't get Cancer.

Should I be afraid of getting cancer?
Just because you have cervical dysplasia, it does not mean you will get cervical cancer. It means that your doctor will want to closely look at her cervix every so often and maybe do treatment that can avoid cancer.

HPV is a very common virus, and most girls with HPV do not get cervical cancer. Cervical cancer is slow-growing and usually takes years to come along. This is why getting a Pap smear each year is important; your doctor can catch any problems before they get worse.

I heard about a vaccine? What is it really?
A vaccine copies the virus so that you cannot get it. It protects against HPV 6, 11, 16, and 18. Gardasil® is the vaccine used against HPV.

Gardasil®? Should I use it?
It is up to you whether or not you use the vaccine. Here are some facts to help your decision.

• Gardasil® works to prevent HPV types 6, 11, 16, 18 between 95-100% of the time.
• Some girls had a few problems like fever, redness or some pain where they get the shot.
• There are three shots. Once you get the first shot, you need a second shot two months later. You need to get a third shot six months after you get the first shot.
• It is new so doctors don't know how long you will be protected.
• It is best for girls ages 9-26.
• It will not cure or treat HPV if you already have HPV, but it may help you to not get any other type.
• It is best to get the shot before you start having sex.

Can I get HPV from the vaccine?
No. The vaccine doesn't have the HPV virus in it. Talk to your doctor if you think you might want Gardasil®.


HPV and Penile and Anal Cancer (treatable, but not curable)

What are Penile and Anal Cancer?
The same types of HPV that cause cervical cancer can also cause abnormal cell changes in the anus and the penis.

What are the signs for Penile Cancer?
The signs are:

• Changes in color, skin thickening, or a build-up of tissue on the penis.
• A growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful and bleed.
• There may be no signs until the cancer is worse.

What are the signs for Anal Cancer?
The signs are:

• Anal bleeding (any amount).
• Pain around the anal area.
• Itching in the anal area.
• Fishy smelling liquid coming out the anus.
• Lumps around the anal area.

Is there a cure for penile or Anal Cancer?
No. There is no cure for penile or anal cancer, but they can be treated. Ask your doctor about what type of treatment is best for you.

How can I reduce my risk of getting HPV?
Get Tested
Keep up with your health by going to your doctor's office and getting a Pap smear every year to see if anything is wrong with your cervix. This can help your doctor catch any changes before they can turn into Cancer.

Limit Number of Partners
If you are going to have sex, have one partner and ask about their sexual history. The fewer people you have sex with the safer you will be.

Protect Yourself
Always use a condom when you are having sex to help strengthen the chances of not getting HPV.

How do I learn more about HPV?

Visit:
The American Social Health Association (ASHA)
http://www.ASHAstd.org

Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov

U.S. Food and Drug Administration
http://www.fda.gov

If you are having trouble dealing with HPV you can visit http://www.ashastd.org/hpv/hpv_community.cfm
for an HPV support group to listen to and help you deal with your feelings

For Information, you can call:
Centers for Disease Control and Prevention (CDC): 1-800-342-2437
AIDS Hotline: 1-800-227-8922
Hotlines are open 24 hours a day, 7 days a week.