HPV (human papillomavirus) is primarily transmitted through direct skin-to- skin contact, especially during sexual activity. The main routes of transmission include:

• Vaginal, anal, or oral sex with someone who has HPV. This includes genital-to-genital, oral-genital, and anal-genital contact

• Close skin-to-skin touching of the genital area during sex, even without penetration

• Hand-to-genital contact (such as fingering or handjobs), though this is less common than genital-to-genital contact

• Sharing sex toys can also spread HPV

• Vertical transmission from an infected pregnant person to their baby during childbirth, though this is less common

HPV can be transmitted even when the infected person shows no signs or symptoms, making it highly contagious

. It is not spread through casual contact like hugging, shaking hands, sneezing, or coughing, nor through blood or body fluids like semen

. In summary, HPV spreads mainly through intimate skin-to-skin contact during sexual activities, including penetrative and non-penetrative contact, and can be passed on even if no symptoms are present.