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How are genital warts transmitted?

The HPV infection that causes genital warts is a highly contagious STI

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What’s causing genital warts?

Genital warts result from a viral infection by the human papillomavirus (HPV). There are some 40 different strains of HPV capable of causing genital warts, but the vast majority of genital warts are caused by HPV 6 and HPV 11. It’s estimated that around 20% of sexually active people will at some point be infected with wart-causing HPV. Even though the virus then stays inside the body for a person’s lifetime, it’s usually kept in check by the immune system, preventing any wart outbreaks.

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However, for an initial period of several months or years (depending on each person’s individual immune response) infected people may still be contagious to others, even if they don’t have any symptoms themselves. While women on average are more likely to develop genital warts, the risk of them passing HPV to others is no larger than the risk from infected men. In the long term though, the virus usually loses its ability to be transmissible. How this precisely works and whether HPV really can remain in the body for the host’s lifetime is the subject of ongoing scientific research. 

Although 20% of people get HPV at some point, only about 1% of the U.S. population will develop visible genital warts. These warts are pink to greyish bumps that can grow in clusters resembling cauliflower. A genital wart outbreak will cease on its own in 80% of cases within 18 months at the latest. 

There are medications, such as Imiquimod cream, which can significantly speed up the recovery process and clear warts in 3 to 4 weeks of treatment, although they don’t eradicate the underlying virus. The earlier you start treatment, the better are the chances that the warts will disappear quickly. 

If you think you may have an HPV infection and/or genital warts, it’s important that you seek professional medical help, since several other STIs can cause skin bumps that look similar to genital warts. You will need a doctor’s diagnosis to be sure and rule out more serious infections. Usually, a doctor can tell right away just by the appearance, but there’s also a variety of tests that can be done if not. Talk to your doctor or gynecologist to learn more.

 

How are genital warts contracted?

HPV infection can happen fairly easily, which is yet another reason to always have protected sex with partners you don’t know very well. Studies have shown that unprotected sexual intercourse with an infected person carries a 65% chance of contracting HPV. This is among the highest infection risks of all STIs.  

All it takes for HPV transmission to happen is direct skin-to-skin contact or contact with virus-carrying sexual fluids. The risk is highest when the infected individual has an active wart outbreak, however, even without any visible symptoms, there is still a risk of trasmission. Theoretically, even sex toys (or anything else that came in touch with sexual fluids) can become a virus carrier, although there’s not a lot of empirical evidence on this. 

Likewise, anal sex can cause HPV infections and genital warts of the skin area around and on the anus. While rare, oral sex can lead to infections and warts in the mouth and on the tongue and lips.  

One thing that makes genital wart infections difficult to diagnose and trace back to where you may have caught them, is that the incubation time is very long. The first warts, if you get any at all, will only appear after 1 to 8 months of the infection. It’s not entirely clear how contagious one is during the incubation period, but there’s a risk that you can pass on the virus to a new partner before you yourself even know that you have it.   

 

References

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Reviewed by Dr Roy Kedem, MD

Information last reviewed 10/13/21

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