Gynecological conditions and HIV / AIDS

October 2005     View PDF     En español

Human papillomavirus

Human papillomavirus (HPV) is a sexually transmitted infection that causes abnormal growth of tissue on the feet, hands, vocal chords, mouth, anus or genitals. Many women do not experience symptoms of HPV. If symptoms are present, they can include itching, burning, slight bleeding, or a slight discharge. HPV is diagnosed by a Pap smear, colposcopy or biopsy (see Screening). Two kinds of abnormal growth can occur: genital warts or dysplasia.

Genital warts are soft, moist, red or pink swellings. They can develop on the vulva, in or around the vagina or anus, on the cervix or thigh. Dysplasia refers to abnormal changes in the size, shape or appearance of the cells that line the cervix or anus. There are several types of HPV that have been linked to cervical cancer. Although dysplasia is not cancer, if left untreated it can turn into cancer.

There are many ways to treat HPV, including surgery, electric current (electro-cautery), chemicals, lasers and the topical cream imiquimod (Aldara). Treatment can be painful and may need to be repeated.

Recent studies caution against using cryotherapy, which involves freezing off the warts or abnormal cells. It can cause normal tissue to heal over deeper areas of dysplasia. In this case, future screenings may appear normal while abnormal tissue grows undetected. Also, many women report that the time after cryotherapy can be very painful.

For women living with HIV, there are additional challenges to consider when diagnosed with HPV. Many women may respond poorly to standard therapies, especially those who have low CD4+ cell counts or HGSIL (see Reading Pap Smear Results). Multiple treatments using different methods may be needed.