When people utter the words “sexually transmitted diseases”, chlamydia, gonorrhea and syphilis are probably the three diseases that directly pop into a person’s head. This is not without a reason, because these diseases are the three most common STDs to occur in Singapore, according to the Department of STI Control (DSC). However, there is one STD we should probably pay more attention to, which is human papillomavirus (HPV), since 70% of cervical cancer stems from this disease. Human papillomavirus (HPV) is a sexual disease caused by a common group of viruses. To date, there are more than 100 varieties of HPV, and approximately 40 of them are spread through sexual contact (vaginal, anal and oral sex). According to the World Health Organization (WHO), at least 14 types of HPV are cancer-causing.
Rather than a bacterial infection such as chlamydia and gonorrhea, HPV is a viral one. In most cases (90% of the time), HPV infections clear up on their own within a specific period of time (normally 2 years). Any sexually active person is always at risk for contracting HPV, especially when they have a new sexual partner. Some HPV cases show no symptoms at all and require no treatment. Nevertheless, in other cases, low-risk HPV strains may result in genital warts or lesions. On the other hand, high-risk HPV strains may cause abnormal changes to the cells and lead to cancer.
Low-risk HPV strains
Low-risk HPV strains normally do not come with symptoms and will clear up when the body develops immunity to the virus. These strains or types are not associated with cancer (non-carcinogenic) but cause genital lesions or warts. These warts may appear on the vulva and penis, but can also show up on the cervix and vagina (in women), scrotum (in men) or around the anus (in both men and women). Not limited to the genitals, genital warts can affect the mouth and throat. The term “papilloma” actually refers to the type of warts that emerge from certain HPV types. These viruses inhabit the epithelial cells (a kind of cell that lines the body’s surfaces).
Several strains of low-risk HPV include types 6, 11, 42, 43, 44, 54, 61, 70, 72 and 81 with types 6 and 11 causing 90% of genital warts. These warts can be cleared by consuming topical medications such as imiquimod and podofilox since these drugs destroy and eliminate genital wart tissue. Aside from topical medications, treatment for these warts can come in the form of cryosurgery (freezing the warts with the help of nitrogen), laser therapy, electrocautery (destroying warts with electrical current), and prescription ointment.
Some low-risk HPV subtypes such as HPV 11 may also cause light cervical dysplasia (abnormal cell growth on the surface of the cervix). However, these changes are not precancerous. Due to the trickiness in diagnosing HPV especially in men, sometimes the only way to be sure that a person has HPV is when warts are visible and present. HPV diagnosis is sometimes done by visual examinations because unlike diagnosis for other STDs, no blood tests can determine whether or not a person has HPV.
High-risk HPV strains
High-risk HPV strains can lead to more serious and extensive cervical dysplasia as well as certain types of cancer. More than 12 types of high-risk HPV subtypes exist: types 16, 18, 31, 33, 34, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 and 70. Among these high-risk strains, types 16 and 18 are the two that are behind most HPV-related cancers, particularly the anogenital ones, affecting the cervix, vagina, penis, vulva and anus. Some strains can cause oropharyngeal cancer, which attacks the throat, tongue and tonsils. It is believed that infections around the mouth and throat are due to sexual contact (oral sex) with a person who has an active high-risk infection. It is important to note that not all types 16 and 18 infections will develop to cancer. HPV 16 is highly associated with anal cancer and throat cancer.
High-risk HPV strains usually present no symptoms. Around 70% cervical cancer is caused by HPV and owing to this condition, scientists have worked to come up with more accurate and varied forms of HPV tests in women such as PAP tests (cells are examined under the microscope to check for abnormal changes) and DNA tests (these tests detect genetic materials and high-risk HPV strains which are related to cervical cancer). Women aged 21 to 65 years are encouraged to get regular HPV screening. The risk factors for men and women are different as men are less likely to develop serious health problems from HPV. However, the risk factors for HPV largely depend on age groups, race, ethnicities and a person’s sex life. Every sexually active person is bound to get HPV at some point in life. Women who are between 20 to 29 years old should be more careful and get tested routinely.
HPV prevention
Despite the fact that most HPV cases clear up on their own within a specified period of time, it is best that every person get vaccinated for HPV. Vaccinations are even recommended as early as 11 or 12 years old in both males and females. People below 26 years old can also reap maximum benefits of vaccines. People aged 27 to 45 years who have not been vaccinated might consult healthcare providers and still take the vaccines after learning more about HPV and its implications, but vaccine’s effectiveness for this age group might decrease. HPV vaccines are safe and effective. People normally take two doses of the vaccine, and the second dose is given 6 to 24 months after the first dose. There are 3 types of HPV vaccines: Gardasil (protects against types 6, 11, 16 and 18), Cervarix (protects against types 16 and 18) and Gardasil 9 (protects against types 6, 11, 16, 18, 31, 33, 45, 52 and 58). Wearing latex condoms every time a person engages in sexual activities can minimise the risks of exposure to HPV, but because HPV can infect areas not covered by condoms, the chances of contracting HPV is never zero.
Your sexual health is paramount to ensuring your overall well being, and the only way to be certain that you are free from any STDs is to get tested. Shim Clinic always gets your back and is always at your service. We specialise in STD tests and STD treatment. Not limited to that, we provide HIV prevention methods such as HIV PrEP and HIV PEP.