It's the most common sexually transmitted disease in America. More than five million people are infected with human papillomavirus or HPV. It is extremely prevalent yet it remains a silent epidemic.

Concern about HPV has increased in recent years after studies showed that some types of HPV infection cause cervical cancer.

"We know that most if not all cervical cancers, (and) we know that genital warts don't have any symptoms whatsoever," said Jane Kiley, Women's Health nurse practitioner.

And that lack of symptoms may be one reason for the fact that at any one time an estimated 20 million people in the United States have genital HPV infections that can be transmitted to others.

When asked if he worried about catching STD's, 20-year-old Larry said he was not.

"Not too big of a deal for me," Larry said.

"With guys my age pregnancy is more of a fear than disease, in health class or whatever," said 20-year-old Enrique.

HPV is spread by skin to skin contact so condoms provide only minimal protection. HPV can be avoided if you know the main risk factors.

Early onset of intercourse and the book says that's under 20 and multiple sexual partners and the book says that's three or more.

HPV is likely the most common sexually transmitted disease among young sexually active people and is of increasing public health importance. About 30 different HPV types are sexually transmitted and most people will not have any obvious symptoms.

Young adults and teens may know a lot about sex, but not about the consequences.

"I just get shocked that people my age have slept with as many people as they have," said 22-year-old Samantha.

Anyone who is sexually active can come across this common virus but there are ways to reduce your risk. Abstinence, and having sex with only one partner who has sex only with you reduce the risk. Condoms used the right way provide some protection but since they don't cover all genital skin they don't give 100 percent protection.

For more information about HPV and other STD's you can go to the American Social Health Association's Web site at www.ashastd.org. Or to access the center's hotline call 1-877 hpv-5868.

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Human Papilloma Virus

• Human Papilloma Virus (HPV) is a very common virus that causes abnormal cells or growth of tissue on the skin of the body.

• HPV can cause abnormal tissue changes on the feet, hands, vocal cords, mouth and genital organs.

• Over 60 types of HPV have been identified so far, and each type infects certain parts of the body.

• Treating HPV is important because the abnormal tissue caused by some types of the virus can lead to cancer of the female organs. Finding and treating HPV-related tissue changes is a way to prevent cancer.

How Is HPV Spread?

• HPV is mainly spread through skin to skin (or mucous membrane to mucous membrane) contact.

• HPV found in the genital area is the most common sexually transmitted disease encountered today.

• Both men and women can be infected with the virus and not know it.

• In women, warts occur on the vulva, the labia, the urethra, inside the vagina, on the cervix and around the anus.

• In men, they may be found on the glans (tip) of the penis, the shaft of the penis, scrotum and around the anus.

• In both men and women, they can develop in the mouth and throat of a person who has had oral /genital contact.

• About two-thirds of persons having sexual contact with a partner with genital HPV will contact the virus.

• Newer, growing lesions are probably the most infectious.

Prevention

• Condoms can provide some protection, but will obviously not protect the entire genital area. Abstinence (no skin to skin, mucus membrane contact) is the only 100 percent effective means of prevention.

Treatment

• There are a variety of methods for treatment of the HPV infection. The locations of the virus and type of virus are often the most important factors.

• Early external lesions can be treated by applying a solution of 50 to 80 percent trichloroacetic acid (TCA) or podophyllin in the office. The acid destroys the virus and prompts the body to prepare an immunologic response.

• Cryosurgery (freezing) of the lesions can also be performed.

• Sometimes laser treatments are useful for extensive lesions, as is electrosurgery.

Sources: http://obgyn.uihc.uiowa.edu/Patinfo/Adhealth/HPV.HTM (The University of Iowa Health Care Web site) and http://www.princeton.edu/puhs/SECH/hpv.html (Princeton University Health Services Web site) contributed to this report.