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STI guide

HPV: what the test tells you, and which one to take

Almost everyone gets HPV at some point and almost everyone clears it. The question worth answering is which type you have, and in South Africa that question has a local answer.

From R890High-risk HPV, yes or no
R1,925Names which of 27 strains
Self-collectedSwab, at a branch or at home

Basically

  • Most people get HPV and most people clear it, usually within about 2 years and usually without knowing.
  • The Basic Screen at R890 answers yes or no. The Comprehensive panel at R1,925 names which of 27 strains you carry.
  • HPV is included in the Medium panel at R1,580 and every panel above it, reported as detected or not detected rather than typed.
  • In South Africa, HPV 35 is detected more often than HPV 18, and no licensed vaccine covers it. Most screens fold it into “other high risk”.
  • The swab is self-collected. No examination, no speculum, and it works the same from a home kit.
  • An HPV test is not a pap smear. Epicentre does not do pap smears, colposcopy or any physical examination.
  • A positive result is not a diagnosis. It tells your doctor how closely to follow you up.

What HPV is

Human papillomavirus is the most common sexually transmitted infection in the world. Most people who have ever been sexually active will get it at some point, and in most cases the immune system clears it within about 2 years without anyone ever knowing it was there.

So the useful question is not whether you have HPV. It is which type, and is it one of the ones that matters.

Of the roughly 200 known HPV types, about 14 are classed as high risk, meaning they are the ones associated with cervical, anal, penile, vulval and throat cancers. The rest either cause genital warts or cause nothing at all.

How it spreads

Through skin-to-skin genital contact, which includes vaginal, anal and oral sex. Penetration is not required. Condoms reduce transmission but do not prevent it entirely, because they do not cover all the skin involved.

Symptoms

Usually none, which is the entire point of screening for it. The low-risk types can cause genital warts. The high-risk types cause nothing you can feel, for years, while cell changes develop quietly. By the time there are symptoms, the thing being treated is no longer an infection.

We do not do pap smears

An HPV test and a pap smear are not the same thing. A pap smear looks at cervical cells under a microscope to see whether they have already changed. An HPV test looks for the virus that causes those changes, often years earlier. Epicentre is a laboratory and does not perform pap smears, colposcopy or any physical examination. If you need one, your doctor or clinic does that.

Why the South African picture is different

Most HPV screening worldwide is built around types 16 and 18, because between them they cause roughly 70% of cervical cancer globally. A screen that reports “16, 18, or other high risk” is the international standard.

South African data complicates that. In Khayelitsha screening studies, the most commonly found high-risk types were HPV 16, 35 and 58. Nationally, HPV 35 is detected more often than HPV 18. It contributes only around 2% of cervical cancers globally, which is exactly why it is rarely named individually, and why a partial genotyping screen folds it into “other high risk” and moves on.

HPV 35 is also covered by no licensed vaccine.

That is an argument for screening rather than an argument against vaccination. Vaccination remains the most effective thing available against the types it does cover. But if you are being screened in this country, knowing which type you carry is worth more here than the global averages suggest. We have written about this in HPV 35 in South Africa: the type most tests don't name.

How HPV is tested at Epicentre

By PCR on a swab, which you collect yourself in a private room at a branch or at home from a couriered kit. No examination, no speculum, no blood.

There are two dedicated HPV tests, and HPV is also included inside the broader sexual health panels.

TestWhat it coversPrice
HPV Basic Screen High-risk HPV detected, or not detected. A yes or no answer, and the cheapest way to get one. R890
Comprehensive HPV PackageNames the strain Names which of 27 strains you carry, including 16, 18, 35, 45, 52 and 58. R1,925

And inside the broader panels, where HPV is reported as detected or not detected rather than typed:

TestWhat it coversPrice
Medium Sexual Health Package 9 targets including HPV, plus chlamydia, gonorrhoea, trichomoniasis, both herpes types, ureaplasma, Mycoplasma genitalium and E. coli O18. R1,580
Large Sexual Health, vaginal swab 17 targets for anyone with a cervix, including HPV, plus the vaginal flora and candida. R1,925
Large Sexual Health, penile swab 17 targets for anyone with a penis, including HPV, plus syphilis, chancroid and candida. R1,925
Extra Large Sexual Health 34 targets including HPV. Our most thorough screen, and not sex specific. R3,305
Essential Oral Sexual Health 9 targets from a throat swab, including HPV. Relevant to throat cancer risk after oral exposure. R1,580

If you are testing for more than HPV, you may not need a separate HPV test at all: it is in the Medium panel and everything above it. If a previous screen came back positive and you want to know which strain, the Comprehensive panel is the one that names it.

There is more detail on all of this, including what to do with a positive result, on our HPV testing page.

HPV in men

There is no routine HPV screening programme for men anywhere, which leaves a genuine gap: HPV causes penile, anal and throat cancers, and men transmit it. Epicentre tests HPV on a penile swab through the 17-target penile panel and the Extra Large, and on a throat swab through both oral panels.

What a result means for a man is less well defined than it is for cervical screening, and that is worth saying plainly rather than implying a clean answer exists. It is information; what to do with it is a conversation with a doctor.

When to test

HPV is not a test you take days after an exposure. It is a screening test, and the sensible time to take one is when you want to know your current status: before or between partners, after an abnormal pap result, when a previous HPV screen was positive and you want the strain named, or on a periodic basis alongside cervical screening as your doctor recommends.

Your result, and what happens next

You get one report, emailed to you and to nobody else. It is the YourGenes patient report: colour coded, in plain language, with a line for every organism on your panel saying whether it was detected. There is no second document, and no separate practitioner version. This report is what your doctor reads too.

If high-risk HPV is detected, Epicentre does not treat it. We are a diagnostic laboratory. We collect samples, run tests and report results. We do not diagnose, prescribe medication or provide treatment, anywhere, including on WhatsApp. You have two equally good routes from here:

  • Your own doctor, clinic or pharmacy clinic. Take the report. It names the organism, which is exactly what they need.
  • An independent doctor we work with, who consults online or in person on sexual health results. She prescribes on her own responsibility, not as an Epicentre service.
Your partner should be tested

This is the part people skip. If one of you is treated and the other is not, the infection comes straight back at the next exposure. Your partner should be tested, whatever your result says about you.

For HPV specifically, a positive result is not a diagnosis of anything and it is not an emergency. Most infections clear on their own. What it does is tell your doctor how closely to follow you up, and that follow-up, including a pap smear or colposcopy if needed, is done by them and not by us.

Where to test

Cape Town

24 Lower Main Road, Observatory, 7925

Monday to Friday, 08:30 to 16:00

021 201 1658  ·  Branch page

Durban

2 Knelsby Avenue, Hillcrest, 3650

Monday to Friday, 08:30 to 16:00

031 880 2150  ·  Branch page

Johannesburg

02 7th Avenue, Parktown North

Monday to Friday, 08:30 to 16:00

010 825 6318  ·  Branch page

Walk in during those hours, no appointment and no doctor's referral. All three branches are closed on South African public holidays. If you would rather not come in, a home kit is couriered to you in discreet packaging and a free courier collects the sample.

You do not need a reason to get tested

No doctor's referral, no appointment, no awkward conversation first. Results are emailed to you and to nobody else.

Book a test The full STI guide

Common questions

How much does an HPV test cost in South Africa?

The HPV Basic Screen is R890 and tells you whether high-risk HPV is present. The Comprehensive HPV Package is R1,925 and names which of 27 strains you carry. HPV is also included in the Medium sexual health panel at R1,580 and every panel above it, where it is reported as detected or not detected rather than typed.

Is HPV included in the Medium package?

Yes. HPV is one of the 9 targets in the Medium Sexual Health Package at R1,580, and it is in both 17-target panels, the 34-target Extra Large and both oral panels. It is not in the 4-target Small package.

Is an HPV test the same as a pap smear?

No. A pap smear looks at cervical cells to see whether they have already changed. An HPV test looks for the virus that causes those changes, often years earlier. They answer different questions and are frequently used together. Epicentre does not perform pap smears, colposcopy or any physical examination.

Do I need a doctor's referral for an HPV test?

No. Walk into any Epicentre branch or order a home kit. The swab is self-collected. You only need a doctor if something is found and needs following up, because Epicentre does not diagnose or treat.

Can men get an HPV test?

Yes. HPV is tested on a penile swab through the 17-target penile panel and the Extra Large, and on a throat swab through both oral panels. There is no routine HPV screening programme for men anywhere, and what a result means for a man is less well defined than for cervical screening, so it is worth discussing with a doctor.

How long do HPV results take?

5 to 7 working days, emailed to you.

Can I do an HPV test at home?

Yes. The HPV swab is self-collected, so a home kit works exactly as well as a branch visit. The kit is couriered to you in discreet packaging and a free courier collects the sample.

Which HPV strains does the Comprehensive panel test for?

Twenty-seven, named individually: 6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 61, 66, 68, 69, 70 and 73. That includes HPV 35, which is more commonly detected than HPV 18 in South Africa and is folded into “other high risk” by most partial genotyping screens.

I tested positive for HPV. What now?

It is not a diagnosis and it is not an emergency. Most HPV infections clear on their own within about 2 years. What the result does is tell your doctor how closely to follow you up. Take the report to your doctor or clinic; follow-up such as a pap smear or colposcopy is done by them. Epicentre does not diagnose or treat.

Does the vaccine cover every high-risk type?

No. No licensed vaccine covers HPV 35, which is one of the most commonly detected high-risk types in South Africa. Vaccination is still the most effective protection available against the types it does cover, which is why screening and vaccination work together rather than replacing each other.

Why people trust us with this

Since 2001Running diagnostic and epidemiological research in South Africa.
Published with CAPRISA and the NICDIncluding work in The Lancet HIV. The same laboratories run our walk-in testing.
HPCSA practice 1117394A registered practice, not an online reseller.
Results go to you onlyNot to a partner, an employer, or a medical aid unless you submit the claim yourself.

Ready to test

No appointment and no doctor's referral. Walk into any of our three branches, or have a kit couriered to you in discreet packaging.

Book a test

Not ready yet

That is normal, and there is no rush. Take the prices away with you, or ask us something without booking anything.

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Important. Epicentre Walk-In Labs is a diagnostic laboratory operated by Epicentre Aids Risk Management (Pty) Ltd. We collect samples, run tests and report results. We do not diagnose conditions, prescribe medication or provide treatment, and nothing on this page is medical advice. Results are released to the person tested. If you have symptoms that worry you, or think you may need urgent care after an exposure, see a doctor or clinic without waiting for a test result.