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Anal and Genital Warts

This is the lead-in

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 (CST) 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 of HPV

HPV can often be asymptomatic, however 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.

What are symptoms of HPV on the vagina/vulva?

Although HPV can present no symptoms at all, if signs or symptoms are present, there may be:

  • a cluster that looks like a cauliflower
  • a scatter of bumps that are darker than unaffected skin
  • growths that may be raised, flat, smooth, or rough
  • abnormal bleeding during vaginal sexual activity or when passing urine or stool.

Warts are usually indicative of low-risk (non-cancer-causing) HPV. There is a type of vulvar cancer that may present as cauliflower-like growths, so you should speak to a doctor if you see any unusual growths around the vulva.

What are symptoms of HPV on the penis?

HPV can present no symptoms at all. If signs or symptoms are present, there may be:

  • a cluster that looks like a cauliflower
  • a scatter of bumps that are darker than unaffected skin
  • growths that may be raised, flat, smooth, or rough
  • warts that appear on your scrotum or in your pubic hair
  • abnormal bleeding when passing urine or stool.
What are symptoms of HPV on the anus/rectum?

HPV can present no symptoms at all. If signs or symptoms are present, there may be:

  • a cluster that looks like a cauliflower
  • a scatter of bumps that are darker than unaffected skin
  • growths that may be raised, flat, smooth, or rough
  • abnormal bleeding during anal sexual activity or when passing urine or stool.

What do anal and genital warts look like?

Insert image gallery of wart pics.

How is HPV transmitted?

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 still be transmitted when no warts are visible. 
  • It is also possible to transmit HPV from the genital area to the mouth, but this is  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 www.hpv.org.nz. 
  • When using personal protective equipment (PPE), only the  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. 

Getting tested for HPV

Below is some information about testing for HPV. You can view a list of sex worker-friendly sexual health clinics on our Where to Test page.

What happens during the test?

Cervical Screening Tests are the best way to detect HPV if you have a cervix. Everyone who does a CST now has the choice of two options when testing:

  • have a doctor or nurse collect the sample for you, by using a speculum and inserting a small brush into your vagina, or
  • self collect the sample by inserting the swab provided to you by your doctor or nurse inside your vagina (there is usually a guide on the swab to indicate how far to insert it). 

A speculum is a device that healthcare providers use to gently widen and hold open the vagina. This shouldn’t be painful, but may cause slight discomfort for the duration of the CST. To look at how a speculum is used, head to our bacterial vaginosis resource under the heading ‘What does BV look like’? 

Many people opt for a self-collected CST and have no issues. However, on the occasion that your result is inconclusive, you may be asked to return for a follow-up test collected by your practitioner. 

  • Physical or visual exam from your doctor or nurse.
  • Cervical Screening Tests are the best way to detect HPV if you have a cervix.

  • If you or a partner develops bumps or warts in the genital area.

  • If a sexual partner is diagnosed with genital warts or has any symptoms.

  • All people with cervixes aged between 25 and 74 should get a CST every five years (instead of a Pap test every two years, which has been replaced by the CST).

  • We provide additional information in our Cervical Screening Tests resource.

  1. Check the packaging

    Make sure the wrapper isn’t damaged and check the expiry date before use. A torn or old dam is more likely to break during play.

    Tip
    this is a tip. test

  2. Place it flat

    Lay the dam over the vulva or anus so it fully covers the area before any licking or rimming starts. Smooth it out gently so it stays in place.

  3. Water based lube

    A little lube between the skin and the dam can increase sensation and reduce friction. You can warm the lube up first so it’s more comfortable.

  4. Hold it in place

    Use your hands or gentle body pressure to help keep the dam in place. The more relaxed and confident you feel using it, the more natural it tends to become. If the dam falls or slips, get a new one. Don’t flip it over and use the other side.

  5. Throw it out afterwards

    Dams are single use only. Once you’re done, put it in the bin, and wash your hands.

What happens if I test positive for HPV?

One you test positive for HPV, it stays in your body until your immune system clears it. About 80% of infections resolve within 12-24 months via immune clearance, and, if they don’t, effective treatments are available (see below).  If you have a high-risk strain, your doctor will talk you through what that means and what happens next!

What treatment options are available for HPV?

There are many treatments to remove warts depending on the size, number and location of warts. Be mindful that someSome treatments can weaken latex condoms and/or irritate the skin. Skin irritation or breakage can increase your risk of other STI. 

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Sexually Transmitted Diseases (STI’s)

April 02, 2026

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