This is what HPV might look like if you were shrunk down to the size of a virus. Image: University of Arizona

When I was a high school student in the 1990s, human papillomavirus (HPV) didn’t get a lot of screen time in our sex education classes. They slapped a few scary pictures of genital warts on the overhead projector and called it a day, neither mentioning that other strains of HPV could cause cancer, nor elucidating the connection between the virus and Pap testing.

Since the introduction of the HPV vaccine, awareness of the virus has skyrocketed — but with that increased awareness has come a flurry of myths and misinformation.

1 Myth: Condoms are useless in protecting against HPV.
Fact: The consistent use of condoms decreases the risk for HPV transmission.

Many people claim that condoms are worthless protection against HPV, reasoning that because the virus lurks in skin cells and condoms don’t cover the entire genital region, HPV transmission can still result from skin-to-skin contact. There is a kernel of truth here, but it is an exaggeration that condoms are useless. Although latex condoms don’t necessarily cover the entire affected area, using them consistently and correctly lowers the risk of contracting HPV. While latex condoms are even more effective in protecting against fluid-borne sexually transmitted diseases (STDs) such as HIV and chlamydia, they can still reduce the spread of HPV.

One study found that over an eight-month period, females whose male partners used condoms each and every time were 70 percent less likely to acquire HPV than were females whose partners used condoms only 5 percent of the time. This is hardly a case against condoms!

Other studies have shown that condom use can promote the regression of both cervical-cell abnormalities and penile lesions, as well as increase the speed at which HPV is cleared by the immune system. Put in plainer English, even if you’re already infected with a cancer-causing strain of HPV, using condoms can decrease your chances of developing cervical or penile cancer.

2 Myth: If you abstain from sex until marriage, you don’t have to worry about STDs, including HPV.
Fact: Even if you only have had one sexual partner, you can still acquire an STD.

Imagine you’re a female in a long-term monogamous relationship with a male, the only person with whom you’ve ever engaged in any kind of sexual activity. You might think your risk of acquiring HPV is low — but one study found that nearly 50 percent of females in these types of relationships contracted HPV within three years. Risk was correlated with the male partners’ previous sexual experience.

You can avoid STDs by abstaining completely from all sexual activity. For most people, this is not desirable. In the case of sexual assault, it might not be possible. While having fewer sexual partners reduces your risk of acquiring an STD, your partner’s behavior also plays a major role in your risk. If your partner has engaged in sexual activity with anyone other than you, it’s possible to acquire an STD from him or her.

In the absence of symptoms, there is no sure-fire way to know your HPV status. Pap testing can detect HPV in cervixes, but a normal Pap doesn’t definitively rule out an HPV infection. And there is no FDA-approved test for detecting HPV on penises. Unless you are certain your partner has never had any other sexual partners, you cannot be assured that your partner is HPV-free.

As a strategy to avoid HPV, abstinence until monogamous marriage works best when both partners have practiced it — and these are not the types of marriages most people find themselves in.

3 Myth: Genital warts increase risk for cancer.
Fact: The strains of HPV that cause warts are different from the strains of HPV that can cause cancer.

Many people with genital warts worry about “giving” cancer to their partners. While it’s possible to be infected simultaneously with a cancer-causing HPV strain without knowing it, genital warts are caused by completely different strains of HPV than those that cause cancer.

There are many strains of HPV, and they were numbered in the order of their discovery. HPV-16 and HPV-18 are jointly responsible for 70 percent of cervical cancers and 90 percent of anal cancers. However, genital warts are caused by HPV strains such as HPV-6 and HPV-11, which together cause 90 percent of genital warts.

4 Myth: HPV only affects women.
Fact: Anyone can develop genital warts or HPV-related cancers as a result of infection.

It is true that HPV is mostly thought of as a “women’s” disease, but this is an oversimplification. If you have a penis, HPV can affect you in several ways:

1. you can spread the virus to your partner(s), putting them at increased risk for warts or certain cancers
2. you can develop genital warts
3. you can develop cancers of the penis, anus, mouth, or throat
4. because there’s no FDA-approved test for asymptomatic males, you usually can’t know your HPV status

For these reasons, the FDA has approved the HPV vaccine, Gardasil, for everyone, regardless of gender, from the ages of 9 to 26.

5 Myth: The HPV vaccine only works on people who haven’t had any sexual encounters.
Fact: The vaccine can be beneficial to people who have already had sex.

Gardasil protects against four strains of HPV, and it’s not a foregone conclusion that anyone who has had sex has already been exposed to all four viral strains. There is also emerging evidence that natural HPV infections might not confer effective immunity against re-infection — meaning that even if you have been infected with one of the vaccine-targeted strains, the vaccine might still boost your immunity.

Furthermore, recent research has shown that even among females who have already had abnormal Pap results, Gardasil might reduce the recurrence of cervical-cell abnormalities. Research on the vaccine is being conducted at a furious pace, and as studies are published we learn more and more about its efficacy.

6 Myth: Anyone above the age of 26 cannot receive the HPV vaccine.
Fact: In the United States, people in their late 20s, 30s, 40s and beyond can receive Gardasil — but because it is only approved for 9- to 26-year-olds, it probably won’t be covered by insurance.

You can talk to a health care provider at Planned Parenthood to evaluate if Gardasil is right for you. We administer the vaccine to anyone who wants it, even if they’re older than 26. However, even if you have insurance, it probably won’t be covered by your plan — you’ll have to pay full price.

You can read about additional HPV vaccine myths on our blog.

Planned Parenthood health centers, as well as other clinics and health-care providers, offer both Pap tests and the HPV vaccine. More information about the vaccine is available from Planned Parenthood and the National Cancer Institute. Planned Parenthood’s website also debunks a few more HPV myths.