In the spring of her sophomore year, a 21-year-old TCU senior found a bump on her genitals. She had abnormal cervical cells and genital warts, and the Brown-Lupton Health Center diagnosed her condition – Human Papillomavirus.

“They told me I had HPV,” she said. “At that point, there hadn’t been a lot of education on campus, so I didn’t really know what it was and I freaked out.”

HPV is the most common sexually transmitted disease in the U.S., which can infect both men and women, said Melchor Boone, co-director of the dysplasia clinic in the John Peter Smith Health Center for Women. Of the more than 100 types of HPV, some are low risk, which can result in genital warts, and some are high risk, which can lead to cervical cancer, he said.

Boone said he sees about 30 patients a day – all of whom have high-risk HPV.

“The biggest danger is the potential for it to lead to precancerous lesions of the cervix,” he said. “Over time, those could lead to cervical cancer if not treated. Worldwide, cervical cancer is the second most common cancer in women.”

The TCU senior, who asked to remain anonymous, said her HPV virus is not cancerous right now, but it has not cleared her body.

She fits the most common demographic for the virus.

About one in four women in the U.S. has HPV, and almost 45 percent of those infected are between the ages of 20 and 24, according to the American Social Health Association.

HPV has infected about 20 million Americans, according to the Centers for Disease Control and Prevention. Likewise, local university health professionals say HPV is the No. 1 STD on college campuses, including TCU and Southern Methodist University.

Boone, an assistant professor at the University of North Texas Health Science Center at Fort Worth, said by using those numbers, one can conclude that the majority of cases would be in the college-age group.

Because HPV testing is a new practice, those being tested now tend to be in the college-age population, Boone said.

“Some of it may be just due to the fact that we know it’s very prevalent in this college group just because we’ve started testing this college group,” he said.

Cindy McLean, a sexually transmitted disease specialist with the Tarrant County Public Health Department, said there is a greater risk of STDs in general on college campuses.

“There seems to be more drinking on college campuses,” she said. “A lot of times, if you’re drinking or under the influence of drugs, you’re more likely to have unprotected sex. You’re also more likely to have sex with someone you wouldn’t have sex with if you were sober.”

Spreading the virus

HPV infects about 6.2 million Americans each year, according to the CDC.

Viruses, such as HPV, may not have symptoms, Boone said. The STD is becoming widespread because a majority of the people who have it are unaware they have been infected and continue to spread it, he said.

HPV is transmitted through skin-to-skin contact – fondling, touching genitals, oral sex – not just intercourse, said Johnnie Ireland, the Health Center’s nurse practitioner of women’s health.

And no protection is guaranteed.

McLean said even if people wear condoms, that doesn’t necessarily protect them from the skin-to-skin contact.

“And with all the people who are shaving nowadays, every time you shave you make microscopic nicks in the skin with the razor, and that’s the perfect place for the viruses like herpes and warts to climb right in,” she said.

Mary Rae, TCU’s director of Health Services, said people with a healthy immune system can clear the virus.

“Your own bodily defenses will get rid of the virus just the way your bodily defenses get rid of a cold virus eventually,” she said.

On the other hand, McLean said, anytime someone’s immune system is knocked down because of stress, lack of sleep, poor diet or binge drinking, he or she will be at a greater risk of infection.

“That’s the time where viruses that your immune system would usually keep in check, like herpes and warts, would come out more prevalent,” she said.

Preventing HPV

University health care professionals agreed that abstinence is the best prevention against STDs.

Ireland said students can become infected after the first time they have sex.

“There are serious side effects that you could potentially deal with for the rest of your life just because of one evening of fun,” she said.

Boone said the next best method of prevention is the three-dose Gardasil vaccine and use of condoms.

Lisa Petersen, immunization coordinator for the Fort Worth Public Health Department, said the inactive vaccine protects against four major types of HPV – preventing 70 percent of cervical cancer and 90 percent of genital warts.

Boone said though the vaccine will significantly reduce one’s chances of getting HPV, it’s still not a 100-percent guarantee because there are more than 100 different strains of the virus.

“It’s going to take years before we see a marked reduction in overall HPV prevalence as the vaccine gains in popularity,” he said.

As of September 2007, the Health Center had given about 210 HPV vaccines, Ireland said. And Megan Knapp, health educator at SMU, said she sees a constant flow of people coming to get the vaccine.

Boone said he thinks the vaccine will become mandatory, ultimately decreasing HPV in the U.S.

The vaccine is available only for women. But Boone said he believes men will be approved for HPV vaccine in the future.

Ireland said she is seeing more cases of HPV because of student awareness, but that doesn’t mean it’s getting worse.

“Statistics say by about age 50 we’ll all be exposed to HPV,” she said. “With that said, I’m not saying that it’s getting bad, but potentially from the screening and people getting screened and being more aware, you’re going to see more cases.”

Ireland and Karen Bell, assistant dean of health promotion, said it is against the Health Center’s policy to release statistics concerning the number of students at TCU who are infected with HPV.

McLean said there’s no treatment for HPV, only for the symptoms.

“We can treat the warts and make the physical warts go away, but there’s no treating the virus,” she said.

Sometimes when women in their late teens or early 20s get the virus, their bodies clear the virus, McLean said.

But Rae said even treating the symptoms – removing genital warts – is purely cosmetic.

“The tricky thing is that you can still have the virus under the surface,” she said. “Just like any wart, when you treat it, it’s just like knocking it back.”

Ireland said the treatment doesn’t eradicate the virus and it can still be transmitted.

However, Petersen said, it’s still important to have genital warts removed.

“If it goes untreated … the genital warts can get in the upper respiratory tract,” she said. “But there’s no treatment for the HPV infection. When you have it, you have it.”

University health care professionals agreed women should have regular Pap tests to check for HPV.

McLean said there’s no way to test men for HPV, but they are carriers of the virus.

“I tell my male patients that if they’ve ever had a girlfriend who had an abnormal Pap smear, chances are they have it and they have to have all future partners get their Pap every year,” she said.

In addition to providing the HPV vaccine, the Health Center does Pap smears, Bell said.

Ireland and Burton Schwartz, a physician at the Health Center, educate students in fraternities and sororities, as well as other campus organizations and dorms, Bell said.

Tossing out the stigma

The TCU senior said she knows several women who have HPV, and their sexual histories are all very different.

“I really hope that the stigma of ‘You have an STD so you must be a slut’ will go by the wayside as people start to understand things more,” she said. “You could have sex for the first time with one person and get HPV because it’s so widespread. There’s just no way to know someone has it unless they have warts.”

The 21-year-old said living with HPV has changed her.

“I’m a lot less judgmental about the choices people make with their bodies and their lives,” she said. “It has also made me a more ethical person in the sense that now if I choose to sleep with someone, I have to have this conversation with them.

“It has just really put me in charge of my sexual health. If we’re responsible enough to be having sex, we’re responsible enough to talk about sex.”