HPV is an extremely common viral infection, affecting nearly all sexually active people at some point. The virus is easily spread through intimate contact, and lesbians can definitively get HPV. HPV transmission primarily relies on skin-to-skin contact for its spread, not requiring penile-vaginal intercourse. This common transmission method means the risk of infection is present in any sexual relationship, regardless of the partners’ genders or sexual orientation.
Understanding Skin-to-Skin Transmission
The mechanism for Human Papillomavirus spread is direct contact between infected skin or mucous membranes and uninfected areas. This means traditional barrier methods, like condoms, offer less than complete protection because HPV can inhabit areas the barrier does not cover. In sexual relationships between women, this skin-to-skin route is the primary way the virus is transmitted, often involving the vulva, anus, or oral cavity.
Vulva-to-vulva contact, or “scissoring,” is a direct path for the virus to move between partners’ genital skin and mucous membranes. Manual contact, such as fingering, can also facilitate the spread of HPV from one partner’s genitals to the other’s genital or anal regions. The virus can even be transferred from a partner’s infected genital area to the mouth through oral-genital contact.
Sharing sex toys is another common route for transmission, especially if the devices are not thoroughly cleaned or covered between uses. Proper disinfection protocols are necessary to eliminate the virus, which can sometimes linger on surfaces. Sexual activity that involves friction can also increase the likelihood of micro-abrasions, which provide tiny entry points for the virus to enter the body’s tissues.
Specific Health Risks and Affected Areas
HPV infection can lead to a range of health issues, categorized by the type of virus involved. Low-risk HPV types, such as types 6 and 11, typically cause genital warts, which are benign growths appearing as small bumps or cauliflower-like clusters on the vulva, near the anus, or in the vagina. These types are generally not associated with cancer but are highly contagious and can be uncomfortable.
High-risk HPV types, most notably types 16 and 18, are responsible for causing cellular changes that can progress to cancer. Individuals with a cervix remain at risk for cervical cancer, which is caused by HPV in almost all cases. The virus can also affect the vulva, vagina, and anus, potentially leading to vulvar, vaginal, and anal cancers.
Anal cancer risk is a particular concern for anyone who engages in anal sex. The virus can also infect the back of the throat, leading to oropharyngeal cancer, which is increasingly linked to HPV infection. Since HPV often causes no symptoms, these cellular changes can go unnoticed until they have progressed significantly, making awareness and regular screening particularly important.
Screening and Diagnosis
For all individuals with a cervix, regular cervical cancer screening is necessary to detect precancerous cell changes caused by HPV. This screening is typically done using a Pap test, which examines cells collected from the cervix, or through primary HPV testing, which looks for the presence of high-risk virus types. The American Cancer Society recommends that screening begin at age 25, with primary HPV testing preferred every five years, or co-testing (Pap and HPV) every five years.
For those who engage in anal sex, or who have a history of genital HPV-related disease, screening for anal cancer may be recommended due to a heightened risk. This involves an anal Pap test, or anal cytology, which collects cells from the anal canal to check for abnormal growth. If abnormal cells are found, a high-resolution anoscopy (HRA) may be performed to visually examine the area and take biopsies.
Managing abnormal results generally involves monitoring or treatment, depending on the severity of the cellular change. Low-grade abnormalities may be monitored, as the body often clears the infection on its own. Higher-grade lesions may require procedures like colposcopy for cervical changes or a Loop Electrosurgical Excision Procedure (LEEP) to remove the affected tissue before it can develop into cancer.
Prevention Through Vaccination and Communication
The most effective tool for preventing HPV infection is vaccination, which is recommended for all young people, typically around age 11 or 12. The HPV vaccine is highly effective at protecting against the types of HPV that cause most cancers and genital warts. The vaccine is a preventative measure, protecting against new infections, even for those who have already been exposed to one strain of the virus.
Vaccination is also recommended for those not adequately vaccinated when younger, up to age 26. Some adults aged 27 through 45 may also benefit from vaccination after a discussion with a healthcare provider, as it can still protect against strains to which they have not yet been exposed. For adults over 15, the vaccine is given as a three-dose series over six months.
Open communication with partners about sexual health history is another layer of prevention. While less effective than for other STIs, using barrier methods like dental dams for oral-genital contact or gloves for manual contact can reduce the risk of skin-to-skin transmission. These measures, when combined with vaccination and regular screening, form a comprehensive strategy for managing the risk of HPV infection and its consequences.