This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

Human papillomavirus, or HPV, is one of the most common infections passed through intimate skin-to-skin contact. The CDC says most sexually active people will have it at some point, and most never know. That is why the science matters more than the worry.

This guide looks at HPV the way a researcher would. It covers what the virus is made of, what studies observe about HPV in men and HPV in women, how the vaccine is built, who should talk to a clinician before getting it, and how to find screening in Boston.

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What HPV is, at the molecular level

HPV is a small virus with no outer envelope. Its genetic material is a ring of double-stranded DNA. That DNA is packed inside a protein shell called a capsid.

The capsid is built mostly from a protein named L1, with a smaller amount of a second protein, L2. The virus also carries early genes, including E6 and E7. Research suggests these two genes matter most for cancer risk. In high-risk types, E6 and E7 products interfere with proteins that normally help a cell stop dividing or repair itself.

The CDC says there are more than 200 HPV types. About 40 of them infect the genital area, mouth and throat. Most are low-risk and cause no health problem at all.

Warts versus high-risk types

Types are grouped by what they tend to do in the body.

Low-risk types such as 6 and 11. The CDC says these cause about 90 percent of genital warts. They are not linked to cancer.
High-risk types such as 16 and 18. The CDC says these cause most HPV-related cancers, including most cervical cancers. They can also be linked to cancers of the anus, penis, vagina, vulva and back of the throat.

A person can have a high-risk type with no visible change. A person with warts has a low-risk type, but can also have other types at the same time. Only a clinician and the right test can sort this out for an individual.

HPV symptoms: why many people notice nothing

The CDC says most HPV infections have no symptoms and clear on their own, usually within two years, as the immune system responds. This is a key finding in the research. Infection is common, and persistent infection is the smaller group that matters for cancer.

When HPV symptoms do appear, they can include:

Small bumps or growths in the genital or anal area, which may be flat, raised or cauliflower-shaped
Itching or mild discomfort around the bumps
Common warts on the hands or feet, which are caused by other HPV types

Cancers linked to HPV usually produce no early signs. Cervical changes in particular are found through screening, not through how the body feels. Anyone who sees a new growth, or has unusual bleeding or pain, can ask a clinician to look at it. Many other conditions cause similar changes, so only an exam can say what it is.

HPV in men: what research and the CDC say

HPV in men is common, and the CDC says most infections in men also clear without causing problems. When they do cause problems, the most frequent are genital warts and, less often, cancers of the penis, anus or throat.

Why there is no routine HPV test for men

The CDC states that there is no approved test to look for HPV in men as a general check, and no routine HPV screening for men. The CDC STI Treatment Guidelines (2021) explain part of the reason. A positive result does not predict who will develop a problem. It would also not change care for most people, since most infections clear on their own.

Some clinicians offer anal cell checks to groups with a higher chance of anal cancer, such as people with HIV. The CDC guidelines describe this as a clinical decision. Whether it applies to you is a question for a clinician who knows your history.

In practice, HPV in men is found by a clinician looking at visible warts, or after a cancer-related symptom is evaluated. This is different from testing for other infections. A person who wants a routine check for common infections can read about chlamydia symptoms, testing and treatment in Boston. Chlamydia has a test that HPV in men does not have.

HPV in women: cervical screening

HPV in women is also usually harmless and temporary. The reason it gets more attention is the cervix. The CDC says nearly all cervical cancers are caused by HPV, and that cervical cancer can usually be prevented by finding and treating abnormal cells early.

Two kinds of screening test

Cytology (a Pap test) looks at cervical cells under a microscope for changes.
High-risk HPV testing looks for the genetic material of the high-risk types in a cervical sample.

Both use a sample taken during a pelvic exam. They answer different questions. Cytology looks for cell changes. HPV testing looks for the virus linked to those changes.

USPSTF screening intervals

The U.S. Preventive Services Task Force (USPSTF) recommends cervical cancer screening for women at average risk. Its recommendation says:

Ages 21 to 29: cytology every 3 years.
Ages 30 to 65: cytology every 3 years, or high-risk HPV testing every 5 years, or both together every 5 years.
Under 21, or over 65 with adequate prior screening: the USPSTF recommends against routine screening, with exceptions a clinician can explain.
After a hysterectomy that removed the cervix for reasons other than cancer or precancer: the USPSTF recommends against screening.

These intervals apply to average risk. A past abnormal result, a weakened immune system or other history can change the plan. The USPSTF also updates its recommendations over time, so ask a clinician what applies now.

This applies to anyone with a cervix, including transgender men and nonbinary people. Screening depends on anatomy, not on gender identity or the gender of partners.

The HPV vaccine: composition and what research suggests

What is in it

The HPV vaccine used in the United States is built from virus-like particles. Manufacturers make the L1 protein, and the L1 proteins assemble themselves into empty shells that look like the real capsid. These shells contain no viral DNA, so they cannot cause infection or cancer. The immune system learns to recognize the shell and responds if the real virus appears later.

The current vaccine covers nine types. The CDC lists them as the low-risk types 6 and 11 and the high-risk types 16, 18, 31, 33, 45, 52 and 58. Like other vaccines, it also contains small amounts of added ingredients that help the immune response. The full list of ingredients is in the CDC's vaccine information materials and the package insert, and a clinician can go through it with you.

What the research observes

Research suggests the vaccine works best before a person is first exposed to HPV. The CDC reports that, since the vaccine came into use in the United States, infections with the types it covers have dropped sharply among teens and young adults. Studies also observe fewer cervical precancers in vaccinated groups. The CDC notes that the vaccine does not treat an infection a person already has.

Who gets it

The CDC recommends routine vaccination at ages 11 to 12, and the series can start as early as age 9. It also recommends catch-up vaccination for everyone through age 26 who was not vaccinated earlier. For some adults aged 27 through 45, the CDC says the decision can be made together with a clinician, because the benefit is smaller for people who have likely already met some of the types. The number of visits depends on the age at the first one, and a clinic will explain it.

Safety profile and contraindications

The CDC and other safety monitoring systems have followed the vaccine in large numbers of people. Common effects are short-lived, such as soreness, redness or swelling where the shot was given, a mild fever, headache or fainting after any injection. Serious allergic reactions are rare.

The CDC lists these cautions:

A severe allergic reaction to a previous dose, or to any ingredient in the vaccine, is a reason not to be given it.
The vaccine is not recommended during pregnancy. The CDC says it can be started or finished after pregnancy, and that getting it by accident during pregnancy has not been linked to problems in studies so far.
Moderate or severe illness at the time of the visit is a reason to wait.

Vaccination does not replace cervical screening. Because the vaccine does not cover every high-risk type, the CDC says vaccinated women still follow the same screening schedule.

Treatment: what a clinician prescribes or does

HPV itself is not curable. It is manageable, and most infections clear on their own. The CDC STI Treatment Guidelines (2021) describe treatment as aimed at the problems HPV causes, not the virus.

Genital warts can be treated by a clinician, using a prescribed medicine or an in-office procedure. They may also go away without treatment. Warts can come back, which does not mean a new exposure.
Abnormal cervical cells are followed or treated by a clinician, depending on the result and the person's history.
HPV-related cancers are treated by specialists. Early detection through screening gives treatment the most options.

Sourcing and quality: how to judge the information and the care

For a topic where many sites repeat rumors, a few habits help you judge what is reliable.

Look for the named source. The CDC, the USPSTF and the Boston Public Health Commission publish the guidance this page relies on. A claim with a number should say who produced the number.
Be wary of kits and supplements. This site does not recommend any product, brand or mail-in kit. Cervical HPV testing is done on a sample a clinician takes, and the result is read in the context of your history.
Look for plain limits. Good sources say what a test cannot tell you, such as that an HPV result does not show how long someone has had the virus or who passed it on.
Check currency. Screening and vaccine guidance changes. Check the date on a page.

Getting screened and vaccinated in Boston

The City of Boston's Getting Tested for STIs page is a good starting point. The Boston Public Health Commission's Mayor's Health Line, 617-534-5050, is described by the city as a free, confidential, multilingual line for health information and referral.

The CDC's GetTested directory lists two Boston-area health centers that offer the HPV vaccine:

Planned Parenthood League of Massachusetts, Greater Boston Health Center, 1055 Commonwealth Ave, Boston, 617-295-7235. The directory says an appointment is required, and lists insurance, Medicaid, Medicare and a sliding scale.
DotHouse Health, 1353 Dorchester Avenue, Dorchester, 617-288-3230. The directory lists sliding scale fees, Medicaid and Medicare. Its listing says an appointment is required, while another community resource list mentions walk-in testing through urgent care, so call to confirm.

The directory pages do not list hours or prices for these services. They also do not say whether each site does cervical screening. Ask the clinic when you call, along with the cost and what to bring.

You can compare more places on our list of local testing sites. For costs, coverage and what a visit includes, read STD testing in Boston: where to get tested and what it costs. The CDC's GetTested directory also lets you look up testing sites by ZIP code.

For teens and young adults

The City of Boston says people 13 or older can get a confidential STI test without parental permission. Massachusetts law, M.G.L. c. 112, s. 12F, lets a minor who reasonably believes they are at risk of exposure through sexual activity consent to care to diagnose or treat the disease. That law does not spell out vaccines, so ask the clinic how consent works for vaccination at the age you are.

Questions to bring to a visit

Am I due for cervical screening, and which test fits my age and history?
Is the HPV vaccine right for me, and what would the visits look like?
I have a bump or a change I noticed. Can you look at it?
What happens next if a result is abnormal?
What will this cost with my coverage, or without it?

HPV is common, and the tools for prevention and early detection are well studied. A conversation with a clinician is the step that turns general research into a plan for you.

HPV in Men and Women: Testing, Vaccines and Cervical Screening in Boston