How is HPV screened and treated in men?

Dear Reader, 

Globally, Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) and yet, there are vast disparities in knowledge about how HPV affects people assigned female at birth versus those assigned male at birth—not to mention how much more difficult it is to recognize, test, and diagnose the latter. On average, two out of five people aged 15 to 59 will be infected with HPV at some point in their life and those assigned male at birth will often be asymptomatic—never show symptoms—causing them to never properly be tested and diagnosed. Currently, there is no approved test to check for HPV in people assigned male at birth. There is currently no cure or treatment for HPV itself; however, genital warts can be treated with prescription medication and HPV-related cancers can be treated when found early enough. 

HPV can be spread through vaginal, anal, and oral sex as well as skin-to-skin contact, even if the infected partner is asymptomatic. The most common symptoms include warts, unusual growths, lumps, and sores, and can appear years after initial contact with an infected person. In rare cases, if the infection doesn’t go away on its own, certain strains can cause various cancers. For people assigned male at birth, these cancers include penile cancer, anal cancer, and oropharyngeal cancer (cancer in the back of the throat). Those most vulnerable to developing cancers from HPV are often people with a weakened immune system or those who receive anal sex. While this information might seem scary at first, it’s important to note that most strains of HPV clear up on their own and don't cause health problems. 

Historically, tests for those assigned male at birth have shown inconsistent results and proven less reliable than those tests for people assigned female at birth. This is often due to the difficulty of collecting a viable cell sample from the thick skin of the penis. Oftentimes, screening for HPV involves a visual inspection to check for warts. However, because those assigned male at birth tend to show fewer symptoms, visual screenings are nearly impossible. If someone is showing symptoms of HPV or has been exposed and suspects they may have been infected, it's best to reach out to a health care provider to discuss next steps. Though anal cancer is rare, anyone with a history of receptive anal sex may find it beneficial to ask for an anal Pap test as a precaution. 

The HPV vaccine is often the best method of prevention to help reduce transmission. The vaccine protects against certain strains that have been associated with cancer and is most effective when received prior to HPV exposure. It’s recommended for folks as early as age 9 up to age 26, though the ideal age to get immunized is between 11 and 12 years old, with two doses 6 to 12 months apart. Unvaccinated adults ages 27 to 45 may also get the vaccine after speaking to a health care provider about their personal risk of contracting HPV and any other possible benefits of vaccination. That being said, the vaccine may not be as effective in this age group as they are more likely to have already been exposed to HPV at some point in their lives. Using condoms correctly and consistently is another great way to reduce the risk of contracting HPV. However, HPV can be spread by skin that isn’t covered by the condom. Having open and honest conversations about sexual history with those you have sexual contact with can also help to reduce your risk for contracting HPV.