HPV testing is done using a small sample of cells, most commonly collected from the cervix during a routine pelvic exam. The test detects whether high-risk strains of human papillomavirus are present, and results typically come back within one to three weeks. For most people, this is a straightforward screening that takes just a few minutes in a clinical setting.
What Happens During the Test
An HPV test starts the same way as a Pap smear. You’ll lie on an exam table while a clinician inserts a speculum to see the cervix. They then use a small spatula and a soft brush to collect cells from the surface and opening of the cervix. The spatula is rotated in a full circle while pressed against the cervix, and the brush is inserted just into the cervical canal and gently turned. Both instruments are rinsed into a liquid-filled vial, and the sample is sent to a lab for analysis.
The collection itself takes under a minute. You may feel brief pressure or mild cramping, but it’s not typically painful. If you’re also getting a Pap smear, the same sample can often be used for both tests.
Self-Collection: A Newer Option
The FDA has approved two HPV tests for self-collection: BD’s Onclarity HPV and Roche’s cobas HPV. With these, you use a swab or brush to collect a vaginal sample yourself instead of having a clinician do a cervical collection. The key limitation right now is that self-collection must still be done in a health care setting, such as a primary care office, pharmacy, or mobile clinic. You cannot yet order an FDA-approved HPV self-collection kit to use at home.
Self-collection may appeal to people who find pelvic exams uncomfortable or who have avoided screening for that reason. The process is simpler since it doesn’t require a speculum, and studies show invalid sample rates for self-collected specimens are low, around 0.18%, compared to 0.05% to 0.10% for clinician-collected samples.
How the Lab Analyzes Your Sample
There are two main types of HPV tests, and they look for different things.
DNA-based tests detect the genetic material of the virus itself. They target a conserved section of the viral genome and can identify 14 high-risk HPV types, often reporting HPV 16 and 18 separately because these two strains cause about 66% of all cervical cancers worldwide, with type 16 alone responsible for roughly half.
mRNA-based tests (like the APTIMA assay) detect signs that the virus is actively producing proteins linked to cancer development. This is a meaningful distinction: a DNA test can pick up infections that are transient and will clear on their own, while an mRNA test is more likely to flag infections that are actively progressing. That gives mRNA tests higher diagnostic specificity, meaning fewer false alarms, though both types perform well overall with sensitivity rates above 80% across studies.
Your provider chooses the test type. You won’t need to request a specific one, but understanding the difference can help you interpret your results.
Who Should Get Tested, and How Often
Screening recommendations from the CDC vary by age:
- Ages 21 to 29: Pap tests every three years. Standalone HPV testing is not recommended in this age group because HPV infections are extremely common in younger people and usually resolve without treatment.
- Ages 30 to 65: You have three options. A primary HPV test alone every five years, an HPV test combined with a Pap (called co-testing) every five years, or a Pap test alone every three years. Talk with your provider about which approach makes the most sense for you.
After age 65, most people can stop screening if they’ve had consistently normal results. If you’ve had a hysterectomy that removed the cervix and you have no history of cervical precancer, screening is generally no longer needed.
What Your Results Mean
A negative HPV test means none of the 14 high-risk HPV types were detected. If you’re 30 or older and your result is negative, you can typically wait five years before your next screening.
A positive result means one or more high-risk HPV strains were found. This does not mean you have cancer. Most HPV infections clear within a year or two without causing any problems. What matters is which type was detected and whether your cervical cells show any abnormal changes.
If HPV 16 or 18 is specifically identified, your provider will likely recommend a colposcopy, a closer examination of the cervix, relatively soon. These two types carry the highest cancer risk. If a different high-risk type is found, the next step usually depends on your Pap results. Normal cells with a positive HPV test often just mean retesting in one year to see if the infection persists.
What Can Cause a False Negative
False-negative results, where the test misses an HPV infection that’s actually present, are uncommon but possible. The most straightforward cause is insufficient sampling: not enough cells were collected from the cervix. Other factors include vaginal treatments or lubricants that interfere with the lab’s chemical reactions, and occasional technical errors during sample processing.
Clinician-collected samples have very low rates of invalid results, between 0.05% and 0.10%. Completely empty samples (no cells at all) occur roughly once in every 16,500 clinician-collected specimens. These numbers are reassuring, but they’re one reason screening intervals exist. Repeating the test on schedule catches the rare infection that slips through.
HPV Testing for Men
There is currently no FDA-approved HPV test for men, and the CDC does not recommend routine HPV screening in men. This isn’t because men don’t get HPV (they do, frequently) but because no validated screening method has been shown to reduce HPV-related disease outcomes in the general male population.
The exception involves anal cancer screening. Men who have sex with men and transgender women living with HIV are recommended to begin screening for anal precancer at age 35. All other people with HIV should start at age 45. This screening uses anal cytology (similar to a Pap smear but with a swab of the anal canal), sometimes combined with HPV co-testing. There are no FDA-cleared anal HPV tests, but testing is available through certified clinical laboratories. If abnormal cells are found, the next step is high-resolution anoscopy, a procedure that lets a specialist examine the anal lining closely and take biopsies if needed.
For men without HIV who aren’t in a high-risk group, there’s no standard way to screen for HPV. Genital warts are diagnosed visually, and HPV-related cancers of the throat, penis, or anus are typically identified only after symptoms appear.
Cost and Insurance Coverage
Under the Affordable Care Act, most private insurance plans cover cervical cancer screening, including HPV tests, with no copay when performed according to recommended guidelines. This applies to in-network preventive services. Without insurance, the out-of-pocket cost for an HPV test varies by lab and location but generally falls between $50 and $150. Community health centers and Title X clinics often offer reduced-cost or free screening for people who are uninsured or underinsured.
Updated federal guidelines that endorse self-collection are expected to affect insurance coverage for that option starting in 2027, meaning private insurers would need to cover self-collected HPV testing without copays once those rules take effect.