The Human Papillomavirus (HPV) is an extremely common group of over 100 viruses, many of which are sexually transmitted. For males, while most infections are temporary and harmless, some types can persist and lead to serious health conditions, often without initial symptoms. The virus can remain silent for years, meaning an infected person may not know they carry it, but it still poses a risk for developing warts or, less commonly, cancer. Understanding transmission and potential health outcomes is important for sexually active men to manage their risk.
Prevalence and Transmission Among Males
Human Papillomavirus is the most common sexually transmitted infection globally, and the majority of sexually active men will contract at least one type of HPV in their lifetime. A recent global analysis indicated that nearly one in three men over the age of 15 are infected with at least one genital HPV type. Transmission occurs through skin-to-skin contact, typically during vaginal, anal, or oral sex, and does not require penetrative intercourse. The virus can be spread even when the infected person shows no visible signs or symptoms. Most HPV infections are transient, with the body’s immune system clearing the virus naturally within one to two years. However, a persistent infection with certain types creates a long-term health risk.
Specific Health Risks Associated with HPV
HPV-related health issues in males fall into two categories: non-cancerous conditions and various cancers. The most common manifestation of HPV is the development of genital warts, typically caused by low-risk types, specifically HPV 6 and HPV 11. These warts can appear as small, flat bumps or larger growths, and they can be found on the penis, scrotum, groin, or around the anus. While genital warts are rarely painful, they can cause itching, discomfort, and emotional distress, and they are highly contagious.
The more serious health risks are associated with high-risk HPV types, particularly HPV 16 and HPV 18, which can lead to cancer. The most common HPV-related cancer in American men is oropharyngeal cancer, which affects the back of the throat, including the base of the tongue and the tonsils. High-risk HPV is responsible for the majority of these throat cancers, and their incidence has been steadily rising. Anal cancer is another significant risk, with over 90% of cases linked to HPV infection, primarily types 16 and 18. This cancer is rare in the general male population but carries a substantially higher risk for men who have sex with men and those with compromised immune systems. Penile cancer is the third HPV-associated cancer in men, with HPV infection contributing to approximately half of all cases. These cancers generally take many years to develop after the initial persistent infection.
Detection and Ongoing Management
There is currently no routine, Food and Drug Administration (FDA)-approved screening test for HPV infection in asymptomatic males, unlike the Pap test for females. Consequently, HPV detection in men usually occurs only when a health condition develops, such as the appearance of genital warts or symptoms related to a developing cancer. A healthcare provider can diagnose genital warts through a visual examination.
Management of HPV-related conditions focuses on treating the resulting symptoms, as there is no specific medication to eliminate the virus itself. Visible genital warts can be treated using prescription topical medications applied at home, or by in-office procedures such as cryotherapy, laser therapy, or surgical removal. While these treatments remove the warts, they do not clear the underlying virus, which may remain dormant and cause future outbreaks. Individuals at higher risk for anal cancer, such as men who have sex with men, may be candidates for an anal Pap test to check for abnormal cells. If an HPV-related cancer is diagnosed, treatment typically involves a combination of surgery, radiation, or chemotherapy, depending on the cancer type and stage.
Primary Prevention Through Vaccination
The most effective strategy for preventing HPV infection and its associated diseases is vaccination. The HPV vaccine is designed to protect against the types of the virus that cause the majority of cancers and genital warts. Routine vaccination is recommended for boys at ages 11 or 12, as the vaccine provides the highest level of protection when administered before any exposure to the virus.
A two-dose schedule is typically used for adolescents who start the series before their 15th birthday. For those who start later, between the ages of 15 and 26, a three-dose series is necessary to establish immunity. Adults aged 27 through 45 who were not previously vaccinated may also choose to receive the vaccine after a discussion with a healthcare provider about their personal risk. Other preventive measures, like the consistent use of condoms, can offer some protection by reducing the risk of transmission. However, because HPV can infect areas of the skin not covered by a condom, vaccination remains the most comprehensive method of prevention.