Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) that nursing students should understand. It can lead to genital warts and, in some cases, serious health complications such as cervical cancer. This review provides an overview of HPV, including transmission, symptoms, screening guidelines, treatment options, and patient education tips.
Don’t forget to take the free nursing quiz at the end to test your knowledge.
What Is HPV?
HPV, or human papillomavirus, is a virus that infects the skin and mucous membranes. There are many types of HPV, but only specific strains cause genital warts and cancer. The most common strains causing genital warts are HPV 6 and 11, while HPV 16 and 18 are linked to cervical cancer.
How Is HPV Transmitted?
HPV can be transmitted through:
- Sexual contact – genital, anal, oral, or throat exposure
- Pregnancy – during delivery, rare cases can lead to respiratory papillomatosis in newborns, where papillomas develop in the airway
Signs and Symptoms of HPV
Many patients with HPV are asymptomatic. When symptoms do appear, genital warts are the most common sign. Use the mnemonic “WART” to remember:
W – Warty growths on genital or anal areas; this STI can still be spread even is warts are not present
A – Asymptomatic; Appearance varies in size, shape, and color
R – Rough texture, often clustered like cauliflower
T – Tender or bleeding with irritation or sexual activity
Even in the absence of visible warts, patients can still transmit HPV to others.
Screening Guidelines
HPV can cause cervical cancer, so screening is crucial. The CDC recommendations for cervical cancer screening include:
- Ages 21–29: Pap smear every 3 years; HPV testing is not routine due to high likelihood of immune clearance
- Ages 30–65: Options include:
- Co-testing (Pap smear + HPV test) every 5 years
- Pap smear every 3 years and HPV testing every 5 years
Abnormal Pap results prompt further HPV testing to identify high-risk strains.
Nursing Lecture on HPV
Treatment and Prevention
Currently, there is no cure for HPV, but treatments can manage symptoms and reduce transmission:
- Prevention via Vaccination:
- Gardasil 9 protects against 9 strains of HPV, including 6, 11, 16, and 18
- Recommended age: 11–12 years (2 doses, 6–12 months apart)
- Ages 15–26: 3 doses over 6 months
- Vaccination after 26 may be less beneficial, but some adults up to 45 may still be candidates
- Not recommended during pregnancy
- Treatment of Genital Warts:
- Topical creams: Imiquimod (stimulates immune response), Podophyllotoxin, Trichloroacetic acid (destroy wart tissue); generally avoided during pregnancy
- Cryotherapy: Freezing wart tissue with liquid nitrogen; safe during pregnancy
Patient Education for Nurses
Nurses play a key role in patient education on HPV:
- Condom use reduces transmission risk but is not 100% effective
- Pregnancy considerations: Hormonal changes may enlarge warts; large warts may require a C-section
- Awareness: Patients may be unaware of warts due to asymptomatic infections
- Vaccination advocacy: Encourage age-appropriate vaccination to prevent infection and future complications
Key Takeaways for Nursing Students
- HPV is common, often asymptomatic, but can cause genital warts and cervical cancer
- HPV can still be spread even if warts are not present
- Transmission occurs primarily through sexual contact; perinatal transmission is rare
- Screening and vaccination are critical preventive measures
- Management includes topical treatments, cryotherapy, and patient education
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You may be interested in: HPV STI NCLEX-Style Questions
References:
American College of Obstetricians and Gynecologists. (2023). How to prevent STIs. https://www.acog.org/womens-health/faqs/how-to-prevent-stis
Centers for Disease Control and Prevention. (2021). Sexually transmitted infections treatment guidelines, 2021. U.S. Department of Health and Human Services. https://www.cdc.gov/std/treatment-guidelines/default.htm
U.S. Food and Drug Administration. (2025, March). Patient information about GARDASIL®9 (human papillomavirus 9‑valent vaccine, recombinant). https://www.fda.gov/media/90070/download?attachment
World Health Organization. (n.d.). Sexually transmitted infections (STIs). Retrieved November 22, 2024, from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)