HPV types 6 and 11 are the dominant causes of genital warts. These types are very rarely associated with cancer of the vulva or penis. HPV 16 and 18 are independent infections associated with cervical cancer.
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HPV is transmitted through sexual contact. During intercourse the virus can enter cells of the skin or mucosal layers of the genital tract through small breaks and multiply there. It may remain dormant or multiply further, causing a wart. The wart is possibly most contagious, but the virus in invisible lesions (subclinical lesions) can also be transmitted. This makes it difficult to prevent the spread of genital warts.
Condoms provide a mechanical barrier if they are used correctly, but the virus can also be located on the scrotum or the vulva and infect the other partner during sex.
Although the virus can be transmitted during birth, this type of transmission is very low (about 0.05% of individuals with HPV infection will deliver an infant with vocal chord infection by the virus). There is evidence that children acquire papillomavirus infections of many varieties long before they become sexually active; the routes of infection in children are not understood at this time.
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