Transmission of the virus requires direct friction with skin or mucosa where HPV lesions are present. Simple transmission of the virus from person to person is not usually enough to cause inflammation. There must be friction, resulting in micro-abrasions, for the virus to penetrate the epithelium. This is why sexual contact (either vaginal or anal) is the easiest way for HPV to be transmitted. Other kinds of sexual contact (hand to genital contact, genital skin to genital skin contact without penetration, oral-genital contact, shared use of sexual devices) may also lead to inflammation, if there are abrasions on the epithelium and the immune system is not working properly – these however are considered less frequent modes of transmission.
