Viral STIs are caused by viruses passed from person-to-person during sexual activity. In general viral infections involve many different parts of the body at the same time. There are four infections in this category: Genital Herpes, HIV, Hepatitis B and HPV.
What is genital herpes?
Genital Herpes is caused by the Herpes Simplex Virus (HSV) which is from the same family of viruses that cause cold sores. Cold sores are generally caused by a type of Herpes Simplex Virus called HSV-1, and genital herpes is usually caused by type HSV-2. However, both types can infect the genital areas, causing painful sores.
There is no cure for genital herpes and often people will have recurring outbreaks. During these outbreaks the infected person will have sores and symptoms for a while, then the virus will go into a dormant stage and the person will have no symptoms again until the next outbreak. The number of outbreaks and the amount of time between outbreaks varies from person to person. Some people may have them frequently and others may have only one or two. It is still possible to transmit the virus during the dormant stages when a person has no symptoms.
How do you get genital herpes?
Genital Herpes is spread through skin-to-skin contact with an infected area, typically during oral, anal or vaginal sex. In rare cases, a herpes infection can be spread from mother to child during birth. Active cold sore infections of HSV-1 can also be transmitted through kissing.
When transmitted through oral sex, a herpes infection can be passed both ways - from mouth to genitals, or from genitals to mouth. The herpes virus is not spread through shared toilet seats, swimming pools, hot tubs or bathtubs.
Preventing genital herpes
- Condoms can help prevent HSV. However, because HSV can be passed from skin-to-skin contact, condoms likely offer less protection against HSV than against most other sexually transmitted infections.
- Use condoms and dental dams for protection during oral sex.
- Avoid sex when a person is visibly infected.
- Avoid oral sex with a person who has had a cold sore recently.
- Remember, an infected person can pass the virus even when they have no visible infection, so using protection such as condoms is always important.
Many people with HSV may have no symptoms or only mild symptoms. For those with symptoms, an active genital herpes infection may be visible and very embarrassing.
Symptoms for both men and women include:
- Itchiness of genitals
- Small blisters in the vagina or on the vulva or cervix; on or around the penis or testicles; on or around the anus; or on the thighs or buttocks
- Tender lumps on the groin (especially at the time of the first episode)
- The first episode may be accompanied by fever or headaches.
- Blisters often burst leaving painful sores. These sores may dry up leaving scabbing which may fall off
- Painful urination
- A slight tingling or burning may be a sign that an active outbreak is coming
Symptoms typically appear within 2 to 20 days of infection. For those with symptoms, outbreaks may occur frequently during the first few years after infection. As time goes by, these outbreaks are likely to become less common.
Infection from oral sex can cause sores inside the mouth or on the lips of both men and women. Though infection is commonly on or around the mouth or genitals, HSV can sometimes cause outbreaks of sores on the skin elsewhere on the body.
Testing for Herpes is performed by taking a tissue scraping sample or by taking a culture of an active sore or blister. A blood test can also detect HSV-1 or HSV-2 infections.
There is no cure for Herpes, but effective treatments for outbreaks do exist. To be effective these treatments must be started immediately after symptoms appear. Outbreaks of sores may appear again and again throughout a person’s life. If you think you have herpes, see a doctor immediately. Medication is available to help treat infected areas and to reduce the pain of sores. This medication may be prescribed for outbreaks as they happen, or it may be taken regularly to suppress the virus and lower the chance of having an outbreak.
Managing the symptoms of genital herpes infection:
- Wear loose clothing during outbreaks
- Drinking large amounts of fluids will decrease pain during urination, and urinating in the bath may be less painful
- Wash your hands with soap and water if you touch an infected area, and in particular, do not rub your eyes or touch your mouth after touching infected skin
- Avoid further infection by keeping the infected area clean and dry. When drying actively infected areas, use a hair dryer or lightly pat the area dry
- Epson salts in bath water can help clean and dry out infected areas
- Wash bath towels before reusing and wash underclothing frequently
- A healthy lifestyle including proper diet, adequate rest and low stress levels can improve your immune system, and reduce the likelihood of outbreaks
- Medication can be taken to make these outbreaks less common, and to treat the sores themselves.
There is no cure for Herpes, but frequency and severity of infections can be partially managed with medication. By themselves, HSV-1 and HSV-2 are generally not considered a serious health risk. However, in very rare cases, the Herpes Simplex Virus can cause serious illness. Infected pregnant women can pass the virus to infants during birth, causing lesions and possibly life-threatening infections of the central nervous system of the baby. In a very small number of cases HSV can cause meningitis or encephalitis (inflammation of the brain), and herpes infection of the eye can cause scarring of the cornea and even blindness.
Because Herpes can cause sores on the penis or inside the vagina, it also increases the risk of transmission of HIV, the virus that causes AIDS.
What to tell your partner
For a few reasons, Herpes may be more difficult to talk about than other STIs: it is incurable, it can be transmitted through oral sex, and condoms do not completely protect against transmission.
For an existing partner, there is a chance they may already have the virus but they may experience no symptoms or only mild symptoms.
If you are diagnosed with the herpes simplex virus, it is important that your partner be tested even if he or she does not have symptoms.
When can I have sex again?
Having Genital Herpes does not mean your sex life is over, but it is an incurable, contagious infection. It can be transmitted through oral sex, and can be transmitted when you have no symptoms. Condoms will help reduce this risk but may not cover all infected areas. So, when deciding to have sex, you and your partner will have to accept a certain amount of risk. It is your responsibility to inform your partner of this risk.
If you have herpes, safer sex should always be practiced. Avoid having sex when you have an active infection. Ask your health care provider for more information about having sex while infected with HSV. Some suppression medications for Herpes may also lower the risk of transmitting the virus.
Oral sex can transmit the virus both ways (from mouth to genitals or from genitals to mouth) so protection is very important for both partners. Male partners should always wear condoms when receiving oral sex. For women, a dental dam or a condom cut lengthwise should be placed over her genitals to form a barrier between mouth and skin.
Human Immunodeficiency Virus (HIV)
What is HIV?
HIV stands for Human Immunodeficiency Virus, and is the virus that causes AIDS.
HIV is an incurable sexually transmitted virus that attacks and weakens a person’s immune system. Your immune system is a complex system that fights off infection and generally keeps you healthy. A person infected with HIV is said to be HIV-positive.
What is AIDS?
AIDS stands for Acquired Immunodeficiency Syndrome. AIDS is a syndrome, which is the name given to a collection of symptoms and effects that occur together. AIDS is the collection of symptoms, signs, and characteristics that occur once a person’s immune system has been substantially weakened by HIV infection.
AIDS can be diagnosed in two ways: A person with HIV may be diagnosed with AIDS if he or she contracts a disease that is listed as an “AIDS-defining” disease. People with healthy immune systems are usually able to easily fight off these “AIDS-defining” diseases, but for a person with a weakened immune system because of HIV, they are very serious and can be life-threatening.
The other way AIDS is diagnosed is if testing shows that part of an HIV-positive person’s immune system is determined to have weakened to a very low level, making them vulnerable to a wide range of infections, diseases and cancers. Infections that cause disease in people with a weakened immune system are often called “opportunistic infections”.
How long does it take for HIV to cause AIDS?
It is very difficult to say with certainty how long HIV will take to cause AIDS. On average (median), it takes more than 10 years for HIV to progress to AIDS. The time it takes is different for everyone, and depends on many things, including the health and lifestyle of the person, the strength of his or her immune system, and other factors such as a person’s age and immunity levels to other diseases. Another factor affecting how long HIV takes to cause AIDS is the growing effectiveness of the antiretroviral drugs that slow the spread of HIV in the body. As these drugs improve, people who are treated for HIV are taking a longer time to develop AIDS.
Because of all of these factors, and the constantly changing effectiveness of medications, there are currently no reliable estimates on how long on average HIV takes to progress into AIDS.
HIV in Canada and around the world
Worldwide, the numbers are disturbing. In a 2004 report, the United Nations Programme on HIV/AIDS estimated that about 38 million people are currently living with HIV worldwide, and that since the first AIDS diagnosis in 1981, more than 20 million people have died from the virus.1 An estimated 3.1 million died in 2004 alone.
In Canada, the number of people living with HIV infection is rising. The face of HIV is also changing. At one time, many people believed that HIV was a disease that only affected homosexual men. This is a myth. Women and particularly women in their teens and twenties have seen a very drastic rise in incidence of the disease. In Canada prior to 1995, only 10% of new HIV cases were among women; in 2004, that percentage had risen to over 25%.2
For several reasons, including the fact that HIV infection usually takes many years for symptoms to appear, there are no reliable statistics on the number of people currently infected in Canada. However, from 2000 to 2004, the Public Health Agency of Canada noted a 20 percent rise in the annual number of reported cases, from 2,111 in 2000 to 2,529 in 2004.3
How do you get HIV?
HIV is transmitted through contact with infected body fluids such as vaginal secretions, semen, pre-semen, breast milk, and blood.
It can be transmitted through anal, vaginal or oral sex. However, oral sex is considered a very low-risk activity for spreading HIV, and the risk of spreading it through vaginal or anal sex is much higher.
HIV can also be transmitted through shared needles, transmitted from an infected mother to a baby during birth, or to a baby through infected breast milk.
You can also become HIV-positive if infected blood gets inside your body. In Canada, this generally only applies to sharing needles for illegal drug use. There is also a potential risk in using unsterilized needles for tattooing, acupuncture or body piercings, though this is likely a very low risk activity. In some countries there may also be risks of contracting HIV through untested blood transfusions or organ transplants. 5,6
HIV is more easily transmitted if the partner has another sexually transmitted disease, such as herpes, chlamydia or gonorrhea.
The best way for sexually active people to protect themselves against HIV transmission is by using condoms every single time you have sex. If you are at higher risk of HIV because of high-risk sexual behaviour or intravenous drug use, you may want to consider being tested for STIs. Remember, other STIs such as chlamydia and gonorrhea are curable and may have no symptoms, and having them can increase your risk of contracting HIV. For this reason, getting tested and/or treated for other STIs can also help reduce your risk of contracting HIV.
Though the risk of spreading HIV through oral sex is very low, condoms and dental dams can offer protection during oral sex, and will also protect against other STIs.
Protection is also important if you are having sex while in foreign countries. In other parts of the world (including the Caribbean) HIV infection is much more common than in Canada. Do your homework before you travel, and always use protection.
Visit the Public Health Agency of Canada’s Travel Medicine Program for more information on STIs and international travel.
It often takes many years before a person infected with HIV displays any symptoms of infection. During this time a person may spread the virus to many people. This is one of the reasons why HIV is a very difficult illness to control - many people may not know they are infected until it has already been spread.
Some of the more common symptoms of HIV infection - such as constant weight loss and fatigue, night sweats, loss of appetite, constant diarrhea and recurring yeast infections - are easily confused with other illnesses, so the only way to be sure you have an HIV infection is to receive proper testing from a health professional.
Because HIV symptoms are often non-specific, HIV infection may not be suspected unless:
- symptoms fail to go away with time
- other possible causes have been disqualified
- the person is at higher risk of HIV infection because of past sexual behaviour or injection drug use (often going back many years)
- the person is diagnosed with an “opportunistic” illness, which is an illness that points to a weakened immune system.
Symptoms cannot identify an HIV infection. Testing is the only way to confirm if a person has HIV.
Generally, there is a three month “window” period for HIV testing. This is the approximate time between when a person is infected with HIV and the time when an HIV test will detect the virus in his or her body. For many people, testing may be accurate after several weeks of infection, but in rare cases it takes up to six months.
If you are considering being tested for HIV, you should know that the test may not detect an infection from the past three months. Three months after infection, the test will confirm 97% of HIV cases2. After 6 months, the test will confirm 99% of all cases.
Though there is no cure for HIV, treatment has progressed dramatically. People who are infected with HIV are living longer without opportunistic infection or other serious diseases.
HIV is an incurable, fatal disease. However, HIV/AIDS treatment is rapidly improving, and people treated for HIV now live longer, healthier lives than before.
AIDS itself does not cause death, but it weakens the immune system so that a person’s body cannot defend itself against other illnesses. There are many causes of death for people with AIDS, including opportunistic infections, cancers, pneumonia, hepatitis, and lung, cardiovascular and kidney conditions.
What to tell your partner
There is no easy way to tell your partner you have HIV. If you are diagnosed with HIV while in an ongoing sexual relationship, you need to tell your partner and they need to be tested for HIV (don’t forget the three month testing window). Remember, early diagnosis can make a huge difference in managing an HIV-infection, and modern drug treatments can slow the progression to AIDS.
Speak to your health care provider about counseling or other support services that may be available to you, and may help prepare you to tell your partner.
HIV is a reportable illness and you will be required to inform your health care provider of your history of past sexual partners. Because a person can have HIV for a long time before experiencing symptoms, sexual partners dating back many years may need to be tested.
Hepatitis B Virus
What is Hepatitis B?
The word hepatitis means “inflammation of the liver”. Hepatitis B is a sexually transmitted virus that can cause scarring of the liver, liver failure, and liver diseases such as cirrhosis and liver cancer. Worldwide, hepatitis B is very common.
Hepatitis B is incurable, but a vaccine exists and most infections will clear up on their own. Most people will have no symptoms of an infection. For these reasons, many people who are infected with hepatitis B may never know it and still transmit it.
Hepatitis B infection can either be a short-term “acute” infection or a long-term “chronic” infection.
When a person is first infected with the hepatitis B virus, they are said to have an “acute” infection.
During this time, a person may or may not have symptoms. For those that do, they may have few or very mild “flu-like” symptoms, or in rare cases they may have very severe symptoms requiring medical attention such as jaundice (yellow skin and eyes), abdominal pain, cutaneous eruption, or joint pain.
During an acute infection, which can last up to six months, a person can transmit the virus to others. About 90 percent of adults will recover from the acute stage within a few months of infection, as their bodies develop immunity to the virus and fight off the infection.1 These people will not develop “chronic” hepatitis. Their symptoms disappear (if they have any), they will no longer be able to transmit the virus to others and they typically have no long-term effects of the infection.
For others, their bodies will not be able to fight off the virus, and will develop “chronic” hepatitis, which is a long-term infection of the liver. These persons are called “chronic carriers” and can transmit infection all their lives.
A person has “chronic” hepatitis B if the infection persists for more than 6 months. About 350 million people worldwide have long-term hepatitis B infection.2 Chronic hepatitis B may last for life; however an infected person may have no symptoms. Whether they experience symptoms or not, this person can actively transmit the disease to others.
Infants can contract the hepatitis B virus during birth, and will almost always develop chronic hepatitis.
Those with a chronic hepatitis infection may develop serious liver damage over time. Chronic hepatitis B infected are at higher risk of liver failure and liver diseases such as cirrhosis and liver cancer. In some cases, complications of liver damage causes death.
How do you get Hepatitis B?
Hepatitis B is a sexually transmitted infection and can be spread through anal, vaginal or oral sex with an infected partner.
It may be spread from an infected mother to her child during birth.
It can also be passed along through blood-to-blood contact such as sharing needles for drug use, or by sharing personal items like razors or toothbrushes that have come into contact with infected blood.
Preventing Hepatitis B infection
If you are at higher risk of contracting the virus, ask your health care professional about getting the hepatitis B Vaccine.
- Practice abstinence or safer sex using condoms.
- Never share personal items such as razors or toothbrushes with an infected person.
- Avoid activities that could cause you to be exposed to infected blood or semen.
- Never share needles for injection drugs
In many acute and chronic infections, the infected person will have no symptoms. These cases may go completely unnoticed, or unnoticed for a long period of time after infection.
Symptoms of acute hepatitis are often mild and may be mistaken for the flu. These include: tiredness, aching joints, pain in the stomach area, loss of appetite, nausea and a general feeling of sickness. In some cases, hepatitis B may also cause Jaundice, which is a sign of liver problems.
At first, many people with chronic hepatitis B infections will have no symptoms; however, a chronic infection can cause serious liver scarring, and sometimes-fatal liver diseases including cirrhosis and liver cancer. People who are infected with the virus but do not show symptoms can still transmit the infection to others. Drinking alcohol can speed the destruction of the liver in people with hepatitis.
For those who do show symptoms of the infection, these symptoms will usually appear within 45 to 180 days of infection.
Hepatitis B infection can be tested for with a blood test.
There are some treatments available for chronic hepatitis B infections that help control the virus from spreading. However, these medications are not recommended for everyone.
Impact if not treated
Hepatitis B can cause permanent damage to the liver, including cirrhosis of the liver, liver cancer or liver failure.
Pregnant women who carry the virus can pass it to their infants during birth; however, treatment exists that can help prevent transmission from an infected mother. In Canada, pregnant women are routinely tested for hepatitis B infection before giving birth.
People with weakened immune systems because of HIV infection are at a much higher risk of developing a chronic hepatitis infection.
About the vaccine
The hepatitis B vaccine works by “tricking” your body into thinking it has hepatitis B. The vaccine is not a virus and it will not hurt you, but to your body, the vaccine “looks” exactly like the hepatitis B virus. Because your body thinks a virus is invading it, it will build up defences to try to fight it off. To do this, your body produces special cells, built for the specific purpose of fighting off hepatitis B. Your body will continue to produce these defences long after the vaccine is gone. This way, if you ever get the real hepatitis B virus, your body will have defences ready, and will be able to fight off the virus before it establishes itself in your body.
In Canada, all provinces and territories in Canada currently have a universal childhood hepatitis B immunization program in place.
The vaccine may also be recommended for:
- people who are at high risk, such as people who have many sexual partners or men who have sex with men
- people who share needles
- people who work in environments where they may come into contact with contaminated blood or body fluids, and people who require certain transfusions or blood procedures
- a person whose partner has hepatitis B
- people who have certain liver diseases.
What to tell your partner
For an existing partner: If you have an existing partner or partners and are diagnosed with an acute or chronic hepatitis infection, be honest and ask them to go for testing. Remember, the vast majority of adults who are infected with HBV will not develop a chronic infection. Your partner(s) may have already cleared an HBV infection with mild or no symptoms. Or, they may never have been infected.
However, there is also a chance that they will develop a severe acute infection or a chronic infection. So, be honest, tell your partner, explain the risks and consider offering to accompany them for testing.
If testing determines that your partner has never been infected with hepatitis B, he or she will not have immunity to the hepatitis B virus. In this case, you may want to ask your partner to be vaccinated by the health care professional.
For new partners: Chronic hepatitis B virus can be spread, is incurable and can be very serious. For this reason, if you have an infection and are starting a relationship with a new partner, you have a responsibility to inform them. Explain the risks and that a vaccine exists, and that he or she may want to be vaccinated. Talk to your health care provider about the vaccine, safer sex methods including condoms, and ways to reduce the risk of transmission.
When can I have sex again?
You can have sex after an acute case clears up and you are no longer infectious. Remember, you may still be infectious even if you have no symptoms. You will need to see a health care professional for testing to be sure the infection is gone. As always, you should practice safer sex to reduce the risk of transmission of hepatitis B or other STIs.
If you have chronic hepatitis B infection, consult a health care professional before having sex again. If you are already in a sexual relationship, your partner should be tested. They may have the virus, or they may already be immune to the virus from a previous case that has cleared up. If they have not contracted the virus, consult a health care professional about safer sex and possibly having your partner vaccinated against hepatitis B. You should use condoms to try to prevent the risk of transmission.
Human Papillomavirus (HPV)
What is HPV?
HPV infects the body inside and outside:
The human papillomavirus or HPV is one of the most common family of viruses in the world today. HPV is also the world’s most common sexually transmitted infection and is transmitted by skin-to-skin (including sexual) contact. HPV infects cells inside and outside of the body. These include surfaces of the skin, lining of the mouth, tongue, throat, tonsils, vagina, penis, cervix, and anus.
Most people who get HPV don’t have any signs or symptoms and may unknowingly spread the disease. HPV is not related to HIV (the human immunodeficiency virus, which can cause AIDS). However, people with HIV have weakened immune systems and are therefore likely to be infected with various germs, including one or more types of HPV.
Different health risks caused by different types
There are many different types of HPV viruses. Over 80 types of HPV have been reliably identified, but researchers believe there are likely over 200. Some types of HPV can cause common skin warts and plantar warts (warts on the soles of the feet), while over 30 other types of HPV affect the anogenital tract (on or between the anus and genitals).
Of those HPV types that can cause genital infections:
Some types (such as 16 and 18) can cause pre-cancerous lesions, cervical cancer and other genital cancers and are referred to as carcinogenic or ‘high-risk HPV types’.
Other types (such as 6 and 11) can lead to genital warts and are referred to as ‘low-risk HPV types’ because they rarely cause cancer.
The most visible types of HPV are skin warts (common, plantar or flat) that develop on areas of the skin such as the hands, arms, legs and bottom of the feet. HPV infections of this type are very common, harmless, non-cancerous, and easily treated.
Not to be confused with skin warts, genital warts (also known as condylomata acuminatum) are mostly caused by HPV types 6 and 11. In women, genital warts can appear on the vulva, urethra, cervix, anus or thighs. In men, they can appear on the penis, scrotum, anus or thighs.
In women, HPV can infect cells on the vagina and cervix where they can’t be seen. These lesions (medically known as dysplasia, or abnormal cells of the cervix) are considered to be a pre-cancerous condition. HPV is one of the most frequent causes of cervical dysplasia. There are three types of cervical dysplasia: mild, moderate and severe. Left untreated, dysplasia can progress to cervical cancer.
Carcinogenic types of HPV cause most cervical cancers and 70% are caused by HPV types 16 and 18. These types may also be linked to oral and penile cancers. Research has shown a strong link between anal cancer and HPV 16.
Transmission and natural history of HPV
HPV is not transmitted by blood. The most common means of transmission is by skin-to-skin contact with the penis, scrotum, vagina, vulva, or anus of an infected person. Kissing or touching a partner’s genitals with the mouth can also transmit HPV. Using a condom does not guarantee protection since the virus can be on an area of skin not covered by the condom.
HPV is usually acquired at a young age at the time of sexual debut, typically measured as the age of ‘first intercourse’. Research shows that sexual debut for young Canadians (male and female) can be as young as 15 years of age and it has been reported that oral sex is practised by girls as young as 12 and 13 years old, regardless of their social or economic background.
Genital warts are very contagious and are spread during oral, vaginal or anal sex with an infected partner:
Most people (66%) who have sexual contact with a partner infected by genital warts will develop warts themselves, usually within three months of contact.
Genital warts can cause problems during pregnancy:
- Sometimes they get larger, making it difficult to urinate.
- They can make the vagina less elastic and cause obstruction during delivery.
- In rare cases infants born to women with genital warts develop warts in their throats - a potentially life-threatening condition for the child.
Genital warts may last for years and eventually go away. Even if this happens the HPV virus can remain dormant in the body and the manifestation can return at a later date. The natural course taken by an HPV infection varies over time and from one person to another:
Genital warts can develop quickly inside or outside the vagina, usually within three months of contact with an infected person.
Within one year of initial HPV infection, low-grade cervical dysplasia (CIN 1) may develop (CIN stands for cervical intraepithelial neoplasia and is a system of classifying cervical lesions: CIN 1 = mild, CIN 2 = moderate, CIN 3 = severe).
In some women the HPV infection persists and can lead to the beginning stages of cancer (CIN 2-3) - this transformation is generally slow and can take anywhere from five years to a lifetime.
Symptoms - physical and psychological
Though usually painless, symptoms for genital warts include:
Itching or burning sensation and occasional minor bleeding as a result of anal sex or bowel movement.
The cauliflower-like growths are unsightly and embarrassing and associated with a high incidence of depression, sexual dysfunction and disruptions to long-term relationships.
Research conducted among people with visible genital warts and who were diagnosed with HPV reported feelings of:
- Depression, shame, guilt;
- Fear of rejection by their partner, loss of sexuality and enjoyment of sex.
- Pre-cancerous lesions
Cervical dysplasia seldom causes any noticeable symptoms. It is usually detected through a Pap test (smear) or colposcopy. HPV infection has social and psychological consequences. Studies of women who have received abnormal Pap test results indicate that they often experience psychological consequences including:
- Anxiety, fears about cancer;
- Sexual difficulties;
- Changes in body image;
- Concerns about loss of reproductive functions.
Treatments and strategies for prevention
Vaccination against HPV
Vaccination to prevent the most common types of HPV infection and cancer of the cervix is now available in Canada. The Government of Canada has approved vaccination for females between the ages of 9 and 26, and studies show that the vaccination is 100% effective in stopping four types of HPV infection. These four types of HPV can cause:
pre-cancerous changes and cancers of the cervix, vulva and vagina (types 16 and 18), as well as
genital and anal warts (types 6 and 11).
These four types of HPV cause 70% of all cancers of the cervix and 90% of genital warts, and associated diseases such as cancers of the vagina and vulva. The HPV vaccination does not stop you from getting other sexually transmitted infections. Even when you have been vaccinated, you should always use a condom during sex to protect yourself.
Regarding treatment, unlike bacteria, viruses cannot be destroyed with antibiotics, and there is currently no medical cure to eliminate an HPV infection. Treatment depends on the type of HPV infection and in the case of cervical cancer the stage of development.
Trying to remove the visible warts does not always eliminate HPV and genital warts can reappear. Chemical treatment methods can be painful, embarrassing and may cause scarring. Two powerful chemicals (podophyllin and trichloroacetic acid) are capable of destroying external genital warts with direct application, but this must be repeated several times. A new product, Imiquimod cream, is now available and has had some success at stimulating the immune system to fight the virus.
Depending on the size, number of warts and where they are located, other methods for removal of external warts include:
- Cryotherapy (damaged cells are killed by freezing them with liquid nitrogen);
- Electrosurgery (passing an electric current through abnormal cells);
- Laser therapy (super heats and vaporizes abnormal cells).
Early-stage cervical cancer can usually be treated successfully. Options at this stage can include LEEP (loop electrosurgical excision procedure - the removal of tissue using a hot wire loop), laser therapy or cryotherapy. If the cancer has invaded deeper layers of the cervix and has spread to the uterus, more extensive treatment may be involved such as a radical hysterectomy with lymph node removal. Side-effects associated with this procedure include: inability to control urination, sexual problems, psychological stress, and swelling in the legs.
Later-stage disease kills by invading nearby tissues. There are some benefits from chemotherapy and radiation therapy. Disease that has spread beyond the pelvis is generally regarded as incurable since the survival rates are about one in five. Cervical cancer can be prevented through detection and treatment, but the ideal solution is to prevent the infection that causes it - HPV.
At present, it is almost impossible to break the chain of communicability by stopping unprotected sexual activity. Even when condoms are used, they cover only the penis (or the outer edge of the vagina in the case of the female condom) and other anogenital skin contact can occur. Also, some people are allergic to latex; they use condoms made of sheep intestine instead, but these condoms have pores large enough to let small bacteria and viruses such as HPV through.