What is HPV? How is it spread?
There are over 100 strains of human papillomavirus (HPV), about 40% of which are transmitted sexually. It is the most common sexually transmitted infection, infecting an estimated 70% of sexually active Canadians. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus, even if that person has no signs or symptoms and no bodily fluids are exchanged. Since most infections do not cause symptoms, people can have this virus without knowing it and pass it on to others. Proper use of barrier protection like condoms and dental dams can reduce the risk for HPV infection (and other STIs), however it can still be transmitted via skin-to-skin contact.
What are the symptoms?
Most infections of HPV do not cause symptoms. Some strains of HPV can cause anus or genital warts. Other strains can lead to various types of cancer: cervical, genital, mouth or throat, etc.
Is there a vaccine? Is there a cure?
There are vaccines available: Cervarix, Gardasil, and Gardasil 9. Cervarix protects against two types of HPV, Gardasil against four, and Gardasil 9 against nine. Gardasil 9 offers the most protection against the most common high-risk types of HPV, including:
- HPV types 16 and 18 — the 2 types that cause 80% of cervical cancer cases.
- HPV types 6 and 11, which cause 90% of genital warts cases.
- Another 5 types of HPV (types 31, 33, 45, 52, and 58) that can lead to cancer of the cervix, anus, vulva/vagina, penis, or throat.
In most cases, HPV goes away on its own without any intervention as the immune system is able to fight it off alone. There is no cure for HPV, making prevention important, through vaccination, proper barrier protection usage, and regular cancer screening and pap tests if appropriate. There are treatment options for HPV symptoms: genital warts are treated with in-office liquid nitrogen treatments, cervical precancer can be treated, and other forms of cancer are more treatable when diagnosed early.
Who should get vaccinated?
The HPV vaccine works best when given to individuals before they start having sexual contact. HPV vaccination is approved for people with vaginas from ages 9 – 45 and people with penises from ages 9 – 26. However, doctors may choose to give it to anyone of any age, even if they are sexually active. In Nova Scotia, the vaccine is offered for free through the school health program to all students in grade 7. This was introduced in 2007. Prior to 2015, this vaccine was only offered to female students. If you’re not sure whether you received this vaccination, you can contact the Nova Scotia Public Health Authority in your area for an official copy of your immunization record.
When should I get vaccinated? How much does it cost?
The HPV vaccine is given over a series of shots. For those over the age of 15, there are three shots taken over the course of 6 months. The second shot is taken 2 months after the first, and the third shot 4 months after the second. For people ages 9-14, only two shots are needed, taken 6 months apart.
While in general the vaccine is more effective the earlier you get it, if you did not get the vaccine in school, you can get it at any age up until 45. The vaccine is only publically funded for school age children, adult men who have sex with men (MSM), and HIV+ people. Otherwise, it is not covered by MSI, but may be covered by some private insurance plans. The Canadian Cancer Society estimates the cost for a full regimen of 3 shots as $600.
Where do I get the vaccine?
Doctors, nurse practitioners, and some pharmacists can prescribe these vaccines (if you are not looking for public funding). Once prescribed, the vaccine can either by injected at the pharmacy by a trained pharmacist, or it can be picked up from the pharmacy and brought back to your provider for injection. A pharmacy may charge prescription and/or injection fees in addition to the cost of the vaccine.
Publicly funded vaccines must all be prescribed by a doctor or nurse and be requested through Public Health. Your provider must fill out a “Requisition for Publicly Funded Vaccine” form. These can be found on the Nova Scotia Health Authority website (www.nshealth.ca) under “Immunization Forms”. There is a different form depending on which area of the province you are living in. Once that has been ordered and has arrived at your clinic, you will need to return for your injections.
If you don’t have a provider, the Halifax Sexual Health Centre is able to prescribe and administer these vaccines.
How else can I protect myself from HPV?
General safer sex practices can help prevent the spread of HPV. This could include: using condoms (including for sex toys), dental dams, and/or latex gloves; washing your hands thoroughly with soap before and after touching your or your partner’s genitals, and abstaining from sexual contact when experiencing an outbreak of HPV symptoms.