AIDS, Hepatitis and Sexual Health

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Genital Warts

Genital Warts are caused by human papilloma virus (sometimes referred to as HPV), and can show up as small painless lumps on the penis, vagina, anus or groin area. Many people with wart virus may have no symptoms, or symptoms may only appear some considerable time after infection. If the warts are in the vagina or anus they may not be noticed. A pap smear in women may show the presence of wart virus. This virus can cause warts in the genital area. These are small, painless cauliflower-shaped or flat lumps on the skin that may be so small you can't see or feel them. Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or anal area. In women, the warts occur on the outside and inside of the vagina, on the opening (cervix) to the womb (uterus), or around the anus. In men, genital warts are less common. If present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus.

Transmission

Genital warts are very contagious and are spread during genital or anal sex with an infected partner. About two-thirds of people who have sexual contact with a partner with genital warts will develop warts, usually within three months of contact. The wart virus is spread by direct contact with skin or mucous membrane. Remember it can be transmitted even if the infected partner is not showing any symptoms. As the virus can have serious consequences for women if left undetected (such as risk of cervical cancer), sexually active men should have regular medical checks, and women regular pap smears. In very rare cases, genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person. It should be noted that this situation is extremely uncommon. Like many STIs, genital HPV infections often do not have visible signs and symptoms. People who are infected but who have no symptoms may not know they can transmit HPV to others or that they can develop complications from the virus.

Prevention

Condoms will lower the risk of spreading genital warts but they can't totally prevent infection during intimate sexual contact because the condom does not cover some areas of skin.

Sexually active women should have regular Pap tests every two years to detect any wart virus on the cervix, as there is a link between the wart virus and some cervical cell changes.

Cervical cancer vaccine: On 28 August 2006, a vaccine against the human papilloma virus (HPV), became available in Australia.. The vaccine is being marketed under the name GARDISAL´Ż«. The vaccine prevents infection of four types of HPV, which are responsible for 90% of genital warts. The vaccine works by mimicking the disease and creating resistance. It is referred to as a recombinant vaccine and does not contain the HPV virus. It requires three doses (injections), which are given over a 6 month period. At present the length of immunity provided by the vaccine is not fully known and, therefore, it is possible that an additional dose of the vaccine may be required (a booster). In Australia , the Therapeutic Goods Administration (TGA) has approved the use of the vaccine in girls aged nine to 26 years of age. The vaccine has also been approved in boys aged nine to 15 years. The age brackets have been determined by the research data currently available on the vaccine. The vaccine is most effective when administered at an early age and before the start of sexual activity (and, therefore, exposure to genital HPV). The vaccine is currently not listed on the Pharmaceutical Benefits Schedule (PBS). It is important that women know that the vaccine is not a substitute for regular Pap smears. As the vaccine only provides protection from 70% of the HPV types, which cause cervical cancer, women who have ever had sex still need to have two yearly Pap smears.

Treatments

Unfortunately there is no cure for wart virus, but there are treatments for warts and areas of infected skin. Freezing them off, painting them with a chemical, or laser burning can be offered. Although these methods may successfully remove warts, they can recur on the same site or there may be new outbreaks. Prevention of infection will be aided by the use of condoms during penetrative sex, but they may not be totally successful as the virus may be present in anal or genital areas not protected by the condom.

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