If you think oral or anal sex is a way to sidestep sexually transmitted infections, it is worth knowing the facts. HPV – human papillomavirus – is the most common STI in the United States, and it spreads through more than just vaginal sex. Here is a clear, current look at oral and anal HPV: how they work, what the real risks are, and how to protect yourself.
HPV Basics
HPV is extremely common – most sexually active people will get some form of it at some point in their lives, and there are hundreds of types. Here is the genuinely good news: the large majority of HPV infections cause no symptoms and clear on their own within a year or two as your immune system handles them.
The concern is a small group of “high-risk” types – especially HPV 16 and 18 – that can occasionally persist and, over many years, lead to certain cancers. That is why awareness, screening, and the HPV vaccine matter, even though most infections never become a problem.
Oral HPV
Oral HPV is an infection in the mouth and throat, usually picked up through oral sex (and possibly through deep kissing – researchers are still clarifying exactly how it spreads). About 7% of U.S. adults have some form of oral HPV, though only a small fraction carry the cancer-associated types.
The main concern is oropharyngeal cancer – cancer at the back of the throat, the base of the tongue, and the tonsils. HPV 16 is the major driver, linked to roughly 70% of these cancers. Oral HPV is usually symptomless, and there is no routine screening test for it – which is exactly why prevention matters so much.
To lower your risk during oral sex, use a condom for a partner with a penis, or a dental dam for a partner with a vulva or for oral-anal contact. Barriers reduce risk – they do not eliminate it, since HPV spreads through skin-to-skin contact.
Anal HPV
The anus is more vulnerable to infection than the vagina – its lining is thinner and tears more easily – so unprotected anal sex carries real STI risk, HPV included. HPV is behind the large majority of anal cancers, with studies attributing roughly 90% or more to the virus; HPV 16 and 18 are the most common culprits.
Because early anal cancer can resemble something benign, it is sometimes mistaken for hemorrhoids. If you have been treated for hemorrhoids that will not resolve, it is reasonable to ask your provider to take another look. For people at higher risk, a provider may use a digital anorectal exam (DARE) or an anal Pap test.
For protection during anal play: use condoms (over a penis, or over any porous toy that is shared), use plenty of lube so a condom is less likely to break, and keep every toy clean. Condom Depot, our sister site, has a thorough guide to anal sex and a rundown of the best condoms for anal sex.
The HPV Vaccine (Gardasil 9)
The HPV vaccine used in the U.S. today is Gardasil 9, which protects against nine HPV types – including the high-risk 16 and 18 behind most HPV-related cancers. It works best before any exposure, which is why it is given young. But the age window is wider than many people realize:
- Ages 11-12: routine vaccination is recommended (it can start as early as 9).
- Through age 26: catch-up vaccination is recommended for anyone not already vaccinated.
- Ages 27-45: it becomes a shared decision with your provider. The FDA approved the vaccine for this age group in 2018, and some adults benefit – so if you are in this range and think you may be at risk, it is a conversation worth having.
- Over 45: the vaccine is not currently licensed.
One important point: the vaccine is preventive, not a treatment. It will not clear an infection you already have, but it can protect you against types you have not yet encountered.
How to Protect Yourself
- Consider the vaccine. Talk to your provider about whether Gardasil 9 is right for you, whatever your age.
- Use barriers. Condoms and dental dams lower your risk – though not to zero, since HPV spreads skin-to-skin.
- Keep up with screening. Cervical Pap/HPV tests, and anal screening if you are higher-risk, catch problems early.
- Keep toys clean and non-porous. Non-porous materials can be fully sanitized; porous ones can harbor bacteria and viruses. Clean every toy after every use with a toy cleaner, and see our guide to anal plugs for material tips.
- Listen to your body. A lump, a sore, or a “hemorrhoid” that will not heal is worth a visit to your provider.
The Bottom Line
HPV is common, usually harmless, and increasingly preventable. Most infections clear on their own – and for the ones that do not, vaccination, regular screening, and an open conversation with your provider are the best tools you have. When in doubt, the CDC’s HPV resources are the most current and authoritative place to read more.