ConditionInfections
Human Papillomavirus (HPV): What a Positive High-Risk HPV Test Means
A positive human papillomavirus (HPV) test means a high-risk type of the virus was found in cells from your cervix. It is very common and does not mean you have cancer. Most high-risk infections clear on their own within 2 years. What happens next depends on which type was found (HPV 16 and 18 carry the most risk), your Pap result and your past results: usually a repeat test in a year, or a colposcopy to look at the cervix more closely.
Also called: High-risk HPV, HPV-positive result, HR-HPV, papillomavirus
At a glance
- What it means
- A high-risk HPV type was found in cervical cells. It is not a cancer diagnosis.
- How common
- Very. Most sexually active people get HPV at some point, and most clear it.
- Highest-risk types
- HPV 16 and 18, which cause about 70% of cervical cancers.
- Usual next steps
- A repeat test in 1 year, or colposcopy, depending on type, Pap result and history.
- Treatment
- None for the virus itself; precancerous cells are found and removed before cancer develops.
When to get help
See a doctor within a day or two
- Bleeding after sex, between periods or after menopause
- Pelvic pain, unusual discharge or a sore on the genitals that does not heal
- A colposcopy or biopsy appointment you have missed or been unable to book after a positive result
Book a routine appointment
- A positive high-risk HPV test: follow the plan your clinician gives you, even if you feel well
- HPV 16 or 18 positive: a colposcopy is usually advised within weeks, not months
- An abnormal Pap result together with a positive HPV test
- Questions about HPV vaccination for yourself or your child
What a positive HPV test means
Cervical screening tests look for about 14 high-risk HPV types. A positive result means one or more of these types is present in the cervix. It says nothing about when you caught it, and it does not mean there are abnormal cells.
High-risk HPV is extremely common, especially in your 20s and early 30s. About 9 in 10 infections are cleared by the immune system within 2 years. The concern is the minority that persist for many years, because persistent infection is what can slowly turn cervical cells precancerous and, if never treated, cancerous. That process usually takes 10 years or more, which is why screening and follow-up work so well.
About HPV in general
HPV is a group of more than 200 viruses spread by skin-to-skin sexual contact. Low-risk types cause genital warts; high-risk types can cause cancers of the cervix, throat, anus, penis, vagina and vulva. Our main HPV guide covering symptoms, risks and the vaccine explains how it spreads and who should be vaccinated.
Understanding your results
High-risk vs low-risk types
| Low-risk types (such as 6 and 11) | High-risk types (such as 16, 18, 31, 33, 45, 52, 58) | |
|---|---|---|
| Main effect | Genital warts | Precancerous cell changes and cancer |
| Tested in screening | No | Yes |
| Cancer risk | Very low | Low for any one infection, higher if it persists |
HPV 16 and 18
Many labs report whether HPV 16 or 18 is present (genotyping). These two types cause about 70% of cervical cancers, so a positive 16 or 18 result usually leads straight to colposcopy, even if the Pap test is normal. "Other high-risk HPV positive" carries less risk.
Combined HPV and Pap results
Under the risk-based ASCCP guidelines used in the US, your clinician combines your current HPV and Pap results with your history. Typical next steps for someone with no recent abnormal results:
| HPV result | Pap (cytology) result | Usual next step |
|---|---|---|
| Positive, HPV 16 or 18 | Normal | Colposcopy |
| Positive, other high-risk type | Normal | Repeat HPV test (or co-test) in 1 year |
| Positive | ASC-US or LSIL (mild changes) | Colposcopy in most cases |
| Positive | HSIL or worse | Colposcopy, or treatment straight away |
| Negative | Normal | Routine screening in 5 years |
Your own plan may differ if you have had abnormal results before, are pregnant, are under 25 or have a weakened immune system.
What happens at a colposcopy
A colposcopy is a short outpatient exam, similar to a Pap test. The clinician uses a magnifying instrument to look at the cervix, applies a mild vinegar solution that makes abnormal areas show up, and takes small biopsies if needed. It takes 10 to 20 minutes. Biopsies feel like a brief pinch or cramp.
Results are graded as CIN 1 (mild changes that usually go away), or CIN 2 and CIN 3 (moderate to severe changes). Mild changes are usually watched. Moderate to severe cervical dysplasia is treated, most often with LEEP, a loop excision that removes the abnormal area and is highly effective at preventing cervical cancer.
Common questions about a positive result
Does it mean my partner cheated?
No. HPV can stay inactive in the body for years and then become detectable again, so a positive result in a long-term relationship does not mean anyone has been unfaithful. Partners who have been together for a while usually share the same HPV types.
Should my partner be tested?
There is no approved routine HPV test for men, and testing partners does not change your care. Male partners can get genital warts and, rarely, HPV-related cancers of the penis, anus or throat, so any persistent lump, sore or neck mass should be checked.
Can I do anything to help clear it?
There is no medicine that clears HPV. The things that help your immune system control it are:
- not smoking, since smokers clear HPV more slowly and have a higher risk of cervical cancer
- keeping follow-up appointments, so any change is caught early
- getting the HPV vaccine if you are eligible, which protects against types you have not yet caught
- managing conditions that weaken immunity, such as HIV
Frequently asked questions
What does a positive HPV test mean?
It means a high-risk HPV type was found in cells from your cervix. It does not mean you have cancer or precancer. Most infections clear within 2 years. Your clinician will recommend a repeat test in 1 year or a colposcopy, based on the HPV type, your Pap result and your history.
Is a positive HPV test with a normal Pap smear serious?
Usually not. It means the virus is present but no abnormal cells were seen. If the type is HPV 16 or 18, colposcopy is advised because these carry more risk. For other high-risk types, a repeat test in 1 year is typical, and most infections will have cleared by then.
Can HPV be dormant for years?
Yes. HPV can become undetectable and then reappear years later, without a new exposure. This is why a positive test after years in one relationship does not point to a new partner. Persistence or reactivation is more common with smoking or a weakened immune system.
How long does it take for HPV to turn into cancer?
For cervical cancer, usually 10 to 20 years of persistent high-risk infection, and only in a small minority of people. Regular screening finds precancerous changes long before cancer develops, and treating them prevents cancer in nearly all cases.
Can I get the HPV vaccine after a positive HPV test?
Yes, if you are in the recommended age range. Routine vaccination is advised through age 26, and adults 27 to 45 can decide with their clinician. The vaccine does not clear an existing infection, but it protects against the other high-risk types you have not caught.
Sources
This guide was written from current patient and clinical guidance, including:
- American Society for Colposcopy and Cervical Pathology (ASCCP): 2019 Risk-Based Management Consensus Guidelines
- US Preventive Services Task Force: Cervical cancer screening recommendation
- CDC: About HPV; Cervical cancer screening
- American Cancer Society: Understanding your HPV test results
- National Cancer Institute: HPV and Pap test results