External Genital Human Papillomavirus

External Genital Human Papillomavirus Prevalence and Associated Factors Among Heterosexual Men on 5 Continents

1. Eftyhia Vardas1,
2. Anna R. Giuliano2,
3. Stephen Goldstone3,
4. Joel M. Palefsky4,
5. Edson D. Moreira Jr.5,
6. Mary E. Penny6,
7. Carlos Aranda7,
8. Heiko Jessen8,
9. Harald Moi9,
10. Daron G. Ferris10,
11. Kai-Li Liaw11,
12. J. Brooke Marshall11,
13. Scott Vuocolo11,
14. Eliav Barr11,
15. Richard M. Haupt11,
16. Elizabeth I.O. Garner11 and
17. Dalya Guris11

+ Author Affiliations

1. ¹Division of Medical Virology, University of Stellenbosch, South Africa and Lancet Laboratories, Johannesburg, South Africa
2. ²Risk Assessment, Detection, and Intervention Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
3. ³Mount Sinai School of Medicine, New York, New York
4. ⁴Department of Medicine, University of California, San Francisco, San Francisco, California
5. ⁵Associação Obras Sociais Irmã Dulce and Oswaldo Cruz Foundation, Brazilian Ministry of Health, Bahia, Brazil
6. ⁶Instituto de Investigación Nutricional, Lima, Peru
7. ⁷University Medical Center, National Public Health Institute, Morelos, Mexico
8. ⁸J2: Private Clinic for Infectious Diseases, Berlin, Germany
9. ⁹Olafia STI Clinic, Oslo University Hospital, University of Oslo, Oslo, Norway
10. ¹⁰Gynecologic Cancer Prevention Center, Medical College of Georgia, Augusta, Georgia
11. ¹¹Merck, North Wales, Pennsylvania

1. Reprints or correspondence: Prof Eftyhia Vardas, Division of Medical Virology, University of Stellenbosch, PO Box 19063, 7505 Tygerberg, South Africa and Consultant Clinical Virologist, Lancet Laboratories, PO Box 8475, Johannesburg, 2000, South Africa. (eftyxia.vardas@lancet.co.za).

 

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Abstract

Background. We examined the baseline prevalence of penile, scrotal, and perineal/perianal human papillomavirus (HPV) in heterosexual men (HM). We also evaluated baseline characteristics of HM to assess factors associated with prevalent HPV detection.

Methods. We tested serum samples from 3463 HM aged 16–24 years with 1–5 lifetime female sexual partners for antibodies to HPV 6, 11, 16, and 18. We collected baseline swab specimens for the detection of DNA of HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59 from 3 areas: penile, scrotal, and perineal/perianal. Risk factors for prevalent HPV DNA detection were evaluated.

Results. The prevalence of any tested HPV type was 18.7% at the penis, 13.1% at the scrotum, 7.9% at the perineal/perianal region, and 21.0% at any site. Having >3 lifetime female sexual partners had the greatest impact on HPV prevalence: odds ratio (OR) 3.2 (95% confidence interval (CI) 2.1–4.9) for HPV 6, 11, 16, and 18; and OR 4.5 (95% CI 3.3–6.1) for all HPV types tested. HPV DNA detection was highest in Africa. Neither condom usage nor circumcision was associated with HPV DNA prevalence.

Conclusion. Genital-HPV DNA detection is common in young, sexually active HM. We found HPV to be most prevalent in African men and least prevalent in men from the Asia-Pacific region. Increased numbers of sexual partners was an important risk factor for HPV DNA prevalence.