HPV Related Cancers
HPV is a common STI with over 200 different types, or strains. Nearly everyone gets some form of HPV within the first few years of starting to have sex.
A small number of high-risk HPV strains can cause cancer. Regular HPV testing is an important part of finding these cancers early. HPV testing is not usually part of a regular STI check up.
People with HIV are at higher risk of HPV-related cancers, especially anal cancer and cervical cancer.
HPV vaccination protects people from getting the high-risk HPV strains that cause cancer as well as the HPV strains that cause warts. Vaccination is especially important for PLHIV.
This page contains information about screening for HPV-related cancers, including anal cancer and cervical cancer.
For information on other cancers that can affect people with HIV as they age please visit this page.
HPV and cancer?
Most HPV strains don’t do anything, but some can cause warts and a few high-risk strains can cause cancer.
Sometimes the body can naturally clear the high-risk HPV infection, but if the high-risk HPV stays in the body it can lead to cell changes that if untreated can go on to cause cancer.
Almost all cervical cancer, and 90% of anal cancer is caused by high-risk HPV. HPV also causes 70% of mouth and throat cancers, as well as some other (rare) genital cancers.
Why are people with HIV at higher risk of HPV-related cancers?
People with HIV are less likely to naturally clear HPV infection. Also, the impact of HIV on the immune system can make it harder for the body to prevent cell changes and keep HPV under control. Effective HIV treatment significantly lowers the risk of HPV-related cancer but unfortunately the risk is still there.
Cell changes are not cancer, and most abnormal cells do not become cancer. Some higher risk cell changes will need to be treated to prevent cancer.
Anal cancer
All people with HIV have an increased chance of developing anal cancer, compared to the general population.
Australia’s first ever anal cancer screening guidelines for people with HIV were released in 2025, and you can read them here. These guidelines will give us the best chance of finding cancer early, monitoring cell changes and making decisions about treatment.
The guidelines for HIV positive people recommend,
- Regular screening for all men who have sex with men over 35, trans women over 35, and all other positive people over 45
- The screening is a HPV test every three years, and a digital anal rectal exam (DARE) every year
Remember, HPV tests are not included in your regular STI screening.
Symptoms of anal cancer can include: blood or mucus in faeces or on toilet paper; itching, discomfort or pain around the anus, or a feeling of fullness, discomfort or pain in the rectum; a lump near the edge, or inside, of the anus; ulcers around the anus; difficulty controlling bowel movements; feeling that the bowel hasn’t been emptied completely.
Sometimes, anal cancer doesn’t cause any symptoms at all. And sometimes symptoms can be similar to other common, less serious health problems, like piles (haemorrhoids) and anal fissures.
Cervical cancer
People with HIV who have a cervix are six times more likely to develop cervical cancer than the general population. Women and people with a cervix who also have HIV are more likely develop cell changes and these changes have greater chance of developing into cancer more quickly.
For people with HIV, cervical cancer screening is recommended every three years. The screening test is an HPV test.
Australia has a national cervical cancer screening program which recommends HPV testing every 5 years for all women and people with a cervix aged between 25 and 75. Eligible people will get a reminder letter reminding them to have a test. People with HIV will not be reminded to test more frequently, so talk with your doctor about when your next HPV test is due.
Symptoms of cervical cancer can include: vaginal bleeding between periods; menstrual bleeding that is longer or heavier than usual; pain during sex; bleeding after sex; pelvic pain; a change in your vaginal discharge such as more discharge or it may have a strong or unusual colour or smell; vaginal bleeding after menopause.
Remember, HPV tests are not included in your regular STI screening.
HPV vaccination
The younger you are the more likely you are to benefit from the HPV vaccine.
The vaccine may be less effective for older people because they are more likely to have been exposed to several strains of HPV.
The Australian immunisation program provides free HPV vaccination to men up to age 26 and women up to age 40. There is good evidence that MSM men up to age 40 could benefit.
If you aren’t eligible for a free vaccine because of your age or because you don’t have Medicare, the cost of a HPV vaccine is up to $300 depending on which service you use.