Human Papillomavirus (HPV) is the most common sexually transmitted infection globally. Nearly every sexually active person will contract some form of HPV at some point. The infection is often temporary, as the human immune system typically clears the virus spontaneously within one to two years without causing symptoms. This high clearance rate means many people never know they were infected.
How HPV is Transmitted Between Partners
A woman who has HPV can transmit the virus to a male partner. Transmission occurs primarily through intimate skin-to-skin contact, not just through the exchange of bodily fluids. This direct contact can happen during vaginal, anal, or oral sex, or even through hand-to-genital contact.
Penetrative intercourse is not required for transmission; simple genital-to-genital touching is sufficient. Transmission can occur even if the infected partner has no visible warts or symptoms, because the virus resides in the skin itself. An infection can also be passed on years after the initial exposure, as the virus may remain present in the body without manifesting signs.
Manifestations of HPV in Men
Once a man contracts HPV, the infection is frequently silent, causing no noticeable symptoms. The majority of HPV infections in men clear on their own, often within a year. If the infection persists, it can lead to two distinct health outcomes based on the type of HPV involved.
Low-risk HPV types, specifically types 6 and 11, cause genital warts. These non-cancerous growths may appear on the penis, scrotum, or around the anus, sometimes resembling small, cauliflower-shaped bumps. Warts can appear weeks, months, or years after the initial infection.
High-risk HPV types, particularly type 16, are the primary cause of HPV-related cancers in men. These strains often produce no outward signs until cancer has developed. The most common HPV-associated cancer in men is oropharyngeal cancer, affecting the throat and back of the mouth. HPV is also linked to most cases of anal cancer and about half of all penile cancers.
Testing and Monitoring for Men
Unlike screening programs for women, there is currently no routine, FDA-approved test to screen for HPV infection in men. The Centers for Disease Control and Prevention (CDC) does not recommend routine HPV testing for the general male population. This is because most infections clear spontaneously, and a positive test result for a transient infection offers no clear clinical benefit.
Monitoring for HPV-related disease in men relies mainly on visual inspection for symptoms. A healthcare provider can usually diagnose genital warts simply by looking at them. For certain high-risk groups, such as men who have sex with men or men with HIV, specialized monitoring may be recommended. This targeted screening may involve an anal cytology test (anal Pap test) to look for abnormal cell changes that could indicate a precursor to anal cancer.
Reducing Transmission Risk
The most effective tool for preventing HPV infection and its associated diseases in both men and women is the HPV vaccine. The 9-valent vaccine (Gardasil 9) protects against nine HPV types responsible for the majority of HPV-related cancers and genital warts. Routine vaccination is recommended for adolescents starting at age 11 or 12, though it can begin as early as age 9.
Vaccination is also recommended for all individuals up to age 26 who were not adequately vaccinated when younger. For adults aged 27 through 45, vaccination is possible following a discussion with a clinician, as the benefit depends on individual risk factors. Consistent use of barrier methods, like condoms, can lower the risk of HPV transmission, but they do not offer complete protection. Since HPV spreads through skin-to-skin contact, the virus can infect areas of the genital region not covered by the condom.