Millions of American men don’t know they have a sexually transmitted infection that could give them cancer, and gendered misconceptions are still keeping young boys from receiving the vaccines that could help them.

The human papilloma virus, aka HPV, is the most widespread sexually transmitted infection in the United States. “It’s often referred to as the common cold of sex,” Fred Wyand, Director of Communications at the American Sexual Health Association told ATTN:. “The vast majority of sexually active people have it.”

According to the Center for Disease Control, there are over 40 types of the HPV virus that can be spread through sexual contact, most of which don’t have any noticeable symptoms for men other than an increased likelihood of developing genital warts. There is no cure for the virus. However, there are several vaccines that can help prevent infection in the first place, such as Gardasil and Cervarix. 

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Most doctors recommend both boys and girls get vaccinated as a preteen or teenager, before they become sexually active. Young women are generally aware of HPV vaccines, which gynecologists often recommend because the virus can cause cervical cancer. But a new study published by JAMA Oncology reveals that most men still aren’t getting vaccinated. Aside from transferring symptoms and risk to female partners, infected men can face life-threatening consequences of their own.

When the urology study analyzed penile swabs from 1,868 men, researchers found 45 percent of them tested positive for at least one type of genital HPV infection, including 25 percent who had a strain of high-risk HPV. The high-risk strains can develop into cancer of the penis, anus, and oropharynx, which includes the back of the tongue and throat. The CDC estimates at least 400 men get HPV-related penile cancer and around 1,500 get HPV-related cancer of the anus every year, making it the most common cause for both cancers. 

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“I think there’s definitely a stigma,” Wyand said. “And an education issue...a lot of guys see HPV as something that only effects women.”

Less than 11 percent of men in the urology study had been vaccinated against HPV. It's usually recommended that people get multiple vaccines to protect against different strains of the virus. Women usually find out if they have the virus, and check which strains they've already been vaccinated against, when they go to the gynecologist for a routine papsmear. However, there is no such test for men. It's hard to get a good cell sample from men because their genital skin is thicker and tougher than the surface of a cervix. So, at least for now, early vaccination or abstinence are their only options. 

“HPV vaccination is absolutely a good idea for men,” Wyand added. “We still have a lot of work to do spreading the word, even with women, but men are especially lacking.”