What are genital warts and how do I get them?
Warts are abnormal skin growths caused by the human papilloma virus (HPV). They are transmitted by touch during sex. Related forms of the virus produce genital warts or warts on the hands. Although rare, it is possible to transfer warts from the hands to the cock or arse. Certain strains (types) of HPV have also been linked to an increased risk of mouth and anal cancer. These strains of HPV are different to the ones that cause warts. HIV-positive people may be more at risk of these cancers if they are infected with these strains of HPV.

How do I prevent them?
HPV spreads easily so skin contact with warts should be avoided. However, the warts may go unnoticed and so avoiding HPV can be difficult, especially since condoms do not always cover the area where warts may be present. This is perhaps why warts are one of the most common viral STI diagnosed in the UK. In 2014, there were just over 3,456 new diagnoses among gay men at sexual health clinics in England [1].

In 2015 the Joint Committee on Vaccination and Immunisation recommended to each of the UK health departments that men who have sex with men up to the age of 45 should be offered the HPV vaccine Gardasil from sexual health clinics.

What is the vaccine and how do I get it?
The Gardasil vaccine is a course of 3 injections spread over 4-12 months. It provides protection against four HPV strains: HPV-16 and HPV-18, the two high risk HPV types that can lead to cancer; and HPV-6 and HPV-11, the two HPV types that cause approximately 90 per cent of all anogenital warts in males.

In England a pilot is currently being run across a number of sexual health clinics to deliver the vaccinations. The vaccine will be available in Wales from April 1st 2017, and a national programme is already underway in Northern Ireland. Scotland have not yet announced how they will implement the vaccine.

Ongoing lobbying efforts are underway to make it available for all school age children, and you can still pay to have it at some private health clinics.

How do I know I've got them?
Genital warts can be found on the inside or outside of the cock and arse. Usually white or pink, they come in a variety of shapes and sizes: smooth and flat, rough and bumpy, small and isolated, and cauliflower-like clusters. They are periodically itchy or painful, particularly if you get them inside the opening of your cock or inside your arse. If this happens, they can cause severe discomfort or bleeding when you fuck, piss, shit, or cum.

It usually takes about three months from the time of infection for genital warts to become visible. However they can appear as soon as two weeks, or up to a year after the virus is contracted. Without treatment the warts multiply and spread.

A sexual health clinic will look for signs of warts as part of a routine sexual health check-up. However, you can have HPV without having warts. Some tests are available to detect signs of HPV in the arse by taking samples from inside the arse (known as a Pap smear test) but these are not routinely available and only offered in certain circumstances (e.g. if early signs of anal cancer are suspected).

How do I get them treated?
It can take a long time to get rid of them, and treatments may have to be repeated several times. Treatments include applying creams, freezing them with liquid nitrogen, burning them with acid or lasers, or removal by surgery as a last resort. Untreated warts can spread extensively throughout the genital and anal areas. Warts don't cause any serious health problems themselves, but they can cause irritation and make you more vulnerable to other infections like HIV.

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1 Public Health England (PHE). Health Protection Report; Infection Report. Vol.9 No.22: 23 June 2015