What does it mean when you test positive for HPV?

There are 14 million new human papillomavirus (HPV) infections every year, but many women are still shocked when a routine Pap smear comes back positive for HPV.

“When patients get that positive result back, they often don’t know what to do with it,” says Sara Sarraf, MD. an OB/GYN who practices at the Virginia Women’s Center West End office. “The reality is that approximately 80% of sexually active people will come in contact with HPV at some point in their lives. And, even though it’s very common, HPV can have serious consequences.” 

Here’s what you need to know about an HPV diagnosis:

HPV  is one of the most common sexually transmitted infections (STI). The American College of Obstetricians and Gynecologists (ACOG) estimates that about 79 million Americans have been infected with HPV.

What are the symptoms of HPV? 

In men, HPV is often undetected because men seldom have symptoms and men are not screened regularly for HPV.  Women and men with HPV sometimes develop genital warts. In Women, HPV can also cause abnormal cell growth on the cervix and cervical cancer.  And, though less common, HPV can cause cancer of the vagina, vulva, penis, anus, mouth and throat.

Keep in mind that HPV is a viral infection that you can spread to others—even if you don’t have symptoms.  

How did I get HPV?

“Often, we cannot detect when you were exposed to HPV,” explains Dr. Sarraf. And there’s no approved HPV screening test for men. Some women are HPV positive for years without knowing it because they don’t have any symptoms and doctors only began regularly testing women over 30 for HPV about five years ago. 

It’s important to remember that you can get HPV even if you’ve only had one sexual partner and that you can transmit HPV through oral sex, direct genital skin contact and other sexual encounters (not just intercourse). 

Now what?

A positive test result for HPV does require careful follow-up. Sometimes, abnormal cervical cells and/or a certain HPV strain warrant a procedure called a colposcopy“It sounds worse than it is,” says Dr. Sarraf. “It’s really an opportunity for us to take a more detailed look at the cervix with a microscope.” If your doctor sees abnormal cells, they will take a small biopsy for a pathologist to evaluate. 

If your doctor detects severely abnormal cells, they may recommend removing them using a loop electrosurgical excision procedure (LEEP). “LEEP is an outpatient procedure with a quick recovery,” Dr. Sarraf explains. “We do it in the office and you can go back to work the next day.” Your doctor would follow up on either of these procedures with additional Pap smears. 

Just because you tested positive for HPV does not mean that you have or will develop cervical cancer. “You may not even need to treat your HPV,” explains Dr. Sarraf.  “Often, the body’s immune system is able to resolve the HPV infection and mildly abnormal cells on its own,” 

I don’t have HPV. How can I prevent getting it in the future?

  • If you’re 26 or younger, get the HPV vaccine if you haven’t already. We recommend that young women and men get the HPV vaccine, which is effective against nine strains of the virus (that’s why it’s called Gardasil 9). There is some evidence that 11-12 is the best age to receive the vaccine because the body generates more of the protective antibody at this age. That said, insurance typically covers the HPV vaccine cost for people ages nine to 26. After that, you’ve probably already been exposed to the virus so the vaccination isn’t likely to be as effective. That said, the vaccine was just approved for ages 27-45. However, insurance may or may not cover this age group, so it is important to check with your insurance company.
  • Practice safe sex. Using condoms can prevent HPV and other sexually transmitted infections (STIs).
  • Limit sexual partners. The more sexual partners you have, the more likely you are to be exposed to HPV.
  • Stop smoking or don’t start. We know that smoking can make it harder to fight off HPV if exposed, and may make changes to dysplastic cells more likely.

The good news is that the majority of HPV resolves on its own over the course of a year. Still, close follow-up is extremely important. If you have questions about HPV, or if you’d like to get the HPV vaccine, call 804.288.4084 to schedule an appointment with Dr. Sarraf or another VWC provider.

Dr. Sara I. Sarraf - Richmond, Virginia Obstetrician-GynecologistDr. Sara Sarraf practices at our West End location. She is board certified in obstetrics and gynecology and certified in pediatric and adolescent gynecology.  She is passionate about HPV prevention and caring for women of all ages—especially teens and young women. When she’s not caring for women in the office, she enjoys spending time with her husband and their three young children.