Most people who get HPV will never know they have it, and their immune system will clear the infection without any symptoms or long-term effects. HPV is the most common sexually transmitted infection, and the vast majority of cases resolve on their own within one to two years. But not all infections follow that path. What happens to you depends largely on which type of HPV you have, how long the infection lasts, and a few personal risk factors.
Most Infections Clear on Their Own
Your immune system treats HPV much like it handles a cold virus. It recognizes the infection, mounts a response, and eliminates it. For most people, this process takes about one to two years. During that time, you likely won’t feel sick, develop any visible symptoms, or have any reason to suspect you’re infected. You can, however, pass the virus to sexual partners during this window.
The challenge is that some infections don’t clear. When HPV lingers in your cells for years, it’s called a persistent infection, and that’s when the risk of health problems goes up significantly. Several factors make persistence more likely. Smoking increases the odds by roughly 40%. Having a weakened immune system, particularly from HIV, dramatically raises the risk. Younger people tend to clear the virus more efficiently than older adults.
Low-Risk vs. High-Risk Types
There are many strains of HPV, but they fall into two broad categories that determine what can happen to you.
Low-risk types (most commonly HPV 6 and 11) don’t cause cancer. What they can cause is genital warts: small bumps in the genital or anal area that may be flat, raised, or have a cauliflower-like texture. They can appear as a single bump or a cluster. The timeline is unpredictable. Warts can show up weeks after exposure or years later, which makes it nearly impossible to pinpoint when you were first infected. In rare cases, low-risk types cause warts in the throat or airway, a condition called respiratory papillomatosis that can interfere with breathing.
High-risk types are the ones linked to cancer. There are 12 of them, but two in particular, HPV 16 and HPV 18, are responsible for about two-thirds of all cervical cancers. These strains produce proteins that disable your cells’ built-in safety mechanisms. Normally, when a cell’s DNA is damaged, a protein called p53 triggers the cell to self-destruct before it can become dangerous. High-risk HPV shuts down that process, allowing damaged cells to keep dividing. Over years, sometimes decades, those cells can progress from normal to precancerous to cancerous.
Cancers Linked to HPV
HPV doesn’t just affect the cervix. It’s responsible for cancers across multiple body sites, and it affects both women and men. According to CDC data from 2018 to 2022, about 49,908 new HPV-associated cancers are diagnosed in the U.S. each year: 27,081 in women and 22,827 in men.
The numbers break down by cancer type:
- Cervical cancer: HPV causes roughly 91% of cases
- Anal cancer: about 91% of cases are HPV-related
- Oropharyngeal cancer (back of the throat, base of the tongue, tonsils): about 70% of cases
- Vaginal cancer: roughly 75% of cases
- Vulvar cancer: about 69% of cases
- Penile cancer: approximately 63% of cases
For men, the most common HPV-related cancer is oropharyngeal cancer, with roughly 18,800 cases per year found in sites where HPV is often present. About 13,600 of those are estimated to be directly caused by the virus. This is worth knowing because there’s no routine HPV screening test for men, and throat cancers often aren’t caught until they’re more advanced.
What Screening Looks Like
For women, cervical cancer screening is the primary tool for catching HPV-related problems early. Current guidelines recommend different approaches depending on your age. Women aged 21 to 29 should get a Pap test every three years, which looks for abnormal cervical cells. Starting at age 30 through 65, the preferred approach is a primary HPV test every five years, which checks directly for the presence of high-risk HPV strains. Co-testing (a Pap test plus an HPV test together) every five years is also an option.
Self-collected HPV testing is now recognized as an appropriate screening method for women aged 30 to 65 at average risk, which may make screening more accessible for people who face barriers to in-office exams.
If a screening test finds high-risk HPV or abnormal cells, the next step is typically a closer examination of the cervix called a colposcopy, where a provider looks for and may biopsy any suspicious areas. Precancerous changes caught at this stage are highly treatable, usually with outpatient procedures that remove the affected tissue. This is exactly why screening matters: the progression from persistent HPV infection to actual cancer takes years, giving you a wide window to intervene.
HPV During Pregnancy
Having HPV during pregnancy is common. One study found HPV in 45% of pregnant women tested. The virus doesn’t typically affect the pregnancy itself or harm the developing baby, but there is a small chance of passing the infection to the child during delivery. Research has detected HPV in about 11% of newborns at birth or within the first three months, though most of these infections appear to clear. In very rare cases, a baby exposed to HPV types 6 or 11 during birth can develop respiratory papillomatosis, where warts grow in the airway, sometimes requiring repeated treatment.
Genital warts may grow larger or more numerous during pregnancy due to hormonal changes and shifts in immune function. Treatment options during pregnancy are more limited, and providers often prefer to wait until after delivery to address warts unless they’re causing obstruction.
How Vaccination Changes the Outlook
The HPV vaccine (Gardasil 9) protects against nine HPV types: the seven high-risk types responsible for most HPV-related cancers (16, 18, 31, 33, 45, 52, and 58) and the two low-risk types that cause most genital warts (6 and 11). The vaccine is approved for people ages 9 through 45, though it’s most effective when given before any exposure to the virus.
The real-world results have been striking. Within 12 years of the vaccine’s introduction, infections with the four originally targeted HPV types dropped 88% among 14- to 19-year-old females and 81% among 20- to 24-year-old females in the U.S. Cervical precancer rates among screened 18- to 20-year-olds fell by 50% compared to pre-vaccine levels. These numbers reflect population-level changes, meaning the vaccine is preventing infections and precancers at scale, not just in clinical trials.
If you’ve already been diagnosed with HPV, vaccination can still be worthwhile. The vaccine won’t treat an existing infection, but it can protect you against the other strains covered by the vaccine that you haven’t yet encountered.
Living With an HPV Diagnosis
An HPV diagnosis can feel alarming, but the practical reality for most people is straightforward. If you have a low-risk type causing warts, those warts can be treated with topical medications, freezing, or minor procedures, though they may recur until your body fully clears the virus. If you have a high-risk type with no abnormal cell changes, the standard approach is monitoring with repeat screening at regular intervals. Your body will most likely clear the infection on its own.
If screening reveals precancerous changes, treatment is effective and usually minor. The key is staying current with screening so that any changes are caught early. Quitting smoking, if you smoke, is one of the most meaningful steps you can take, since smoking both increases the likelihood that HPV will persist and contributes independently to cervical cell changes. There’s no antiviral medication that eliminates HPV directly. Your immune system is the treatment, and supporting it through general health measures is the best strategy while you wait for clearance.