Anal or Genital Warts (Human Papillomavirus)

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Anal or genital warts are small, hard lumps caused by certain types of the human papillomavirus (HPV). Warts can appear around the genitals, anus, inside the vagina, rectum, and urethra. HPV is transmitted via genital skin-to-skin contact with a person who has HPV. Over 90% of adults carry at least one strain of genital HPV in their bodies, but not all strains cause visible symptoms, such as warts. Transmission can happen even when warts are not visible. 

Because genital HPV is very common among all sexually active people, it may be challenging for sex workers who provide skin-to-skin genital contact to prevent exposure to HPV in a sex work setting. Staying up to date with cervical screening tests and getting vaccinated against HPV can significantly reduce your risk of getting genital warts and HPV-related cancers, such as cervical cancer.  

Understanding HPV

There are over 200 strains of HPV, and many cause no health issues at all. Some kinds of HPV can cause genital warts, and others can cause cancer of the cervix, vagina, vulva, or anus. Most people who have genital HPV will not show any symptoms and will naturally control or clear the virus.

There is no cure for HPV itself, but there are treatments for the health problems that HPV can cause, such as genital warts, cervical changes, and cervical cancer. Vaccination can protect you against the HPV types that cause genital warts and most cervical and other HPV-related cancers.

Signs and Symptoms

Content warning: click to show images of symptoms

HPV often has no symptoms (asymptomatic), but anal and genital warts can develop 1 to 20 months after exposure. It can take up to 10 years for a high-risk HPV infection to develop into cancer.





HPV is mainly transmitted through sexual contact, and most people are infected with HPV shortly after the onset of sexual activity. More than 90% of them clear the infection naturally. 

  • Genital skin-to-skin contact with a person who has HPV (e.g. penis/balls to vulva, vulva to vulva, penis to penis, anus to balls). 
  • HPV is highly contagious if a wart is visible or if the skin on the wart has been broken. 
  • HPV can be transmitted when no warts are visible 
  • Transmission can happen even when warts are not visible. 
  • It is also possible to transmit HPV from the genital area to the mouth, but this is very uncommon. There is growing evidence that HPV infection in the mouth and throat, transmitted through oral sex, is a major cause of throat cancer. For further information on HPV related cancers see
  • Only the skin area covered by a condom, glove, dam or other barrier is protected from the virus. 
  • The appearance of warts does not indicate that you were exposed to HPV recently. You may have been exposed to HPV months or years before seeing the presence of warts.



Cervical Screening Test

Use of condoms and dams


Here’s some information about testing for HPV. You can view a list of sex worker-friendly sexual health clinics at our Where To Test page.

Testing Method

When to Test

Other Info


No treatment has been demonstrated to get rid of HPV from the body or stop transmission. However, you can treat some of the symptoms.

Here’s what you need to know about treating HPV.

Treatment Method/s

Costs and Other Information 

How might this impact my work? 

Practical Considerations

Implications for working 

  • The only real way to protect against an HPV infection is to abstain from sexual contact, which is unrealistic for most sex workers.
  • If you have a high-risk strain, your doctor will discuss the next steps with you. 
  • Avoid having sex when you have genital warts you can see or feel, as this is when they are most contagious. If a client has warts, you might refuse service or provide an alternative service. 
  • It is recommended that you avoid sex during the treatment period if possible.
  • Some treatments can weaken latex condoms and/or irritate the skin. Skin irritation or breakage can increase your risk of other STIs.
  • If you have warts removed, it is recommended that you wait until the skin heals to have sex. Open sores increase your risk of other STIs/BBVs
  • While it is still possible to spread HPV when the warts are gone, their lower viral levels make transmission less likely.

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