RESUMEN
BACKGROUND: The epidemiology of high-risk (hr) human papillomavirus (HPV) infections in mid-adult women with new sex partners is undefined. METHODS: We analyzed baseline data from 518 25- to 65-year-old women online daters. Women were mailed questionnaires and kits for self-collecting vaginal specimens for polymerase chain reaction-based hrHPV testing. Risk factors for infection were identified using Poisson regression models to obtain prevalence ratios (PRs). RESULTS: The prevalence of hrHPV infection was 35.9%. In multivariate analysis restricted to sexually active women, the likelihood of hrHPV infection was associated with abnormal Papanicolaou test history (PR = 1.42, 95% confidence interval [CI]: 1.10-1.84), lifetime number of sex partners >14 (compared with 1-4; PR = 2.13, 95% CI: 1.13-4.02 for 15-24 partners; and PR = 1.91, 95% CI: 1.00-3.64 for ≥25 partners), male partners with ≥1 concurrent partnership (PR = 1.34, 95% CI: 1.05-1.71), and male partners whom the subject met online (PR = 1.39, 95% CI: 1.08-1.79). Age was inversely associated with infection only in women who were sexually inactive (PR = 0.67 per 5-year age difference, adjusted for Papanicolaou history and lifetime number of partners). Compared with sexually inactive women, the likelihood of infection increased with increasing risk level (from low-risk to hr partners; P < 0.0001 by trend test). In multivariate analysis, infection with multiple versus single hrHPV types was inversely associated with ever having been pregnant (PR = 0.64, 95% CI: 0.46-0.90) and recent consistent condom use (PR = 0.56, 95% CI: 0.32-0.97), and positively associated with genital wart history (PR = 1.43, 95% CI: 1.03-1.99). CONCLUSIONS: Measures of both cumulative and recent sexual history were associated with prevalent hrHPV infection in this hr cohort of mid-adult women.
Asunto(s)
Condiloma Acuminado/epidemiología , Prueba de Papanicolaou , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Conducta Sexual/estadística & datos numéricos , Neoplasias del Cuello Uterino/epidemiología , Frotis Vaginal/estadística & datos numéricos , Adulto , Distribución por Edad , Anciano , Condiloma Acuminado/prevención & control , Condiloma Acuminado/virología , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Papillomaviridae/genética , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Reacción en Cadena de la Polimerasa , Prevalencia , Factores de Riesgo , Parejas Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/virologíaRESUMEN
BACKGROUND: The role of circumcision in male HPV acquisition is not clear. METHODS: Male university students (aged 18-20 years) were recruited from 2003 to 2009 and followed up triannually. Shaft/scrotum, glans, and urine samples were tested for 37 α human papillomavirus (HPV) genotypes. Cox proportional hazards methods were used to evaluate the association between circumcision and HPV acquisition. Logistic regression was used to assess whether the number of genital sites infected at incident HPV detection or site of incident detection varied by circumcision status. RESULTS: In 477 men, rates of acquiring clinically relevant HPV types (high-risk types plus types 6 and 11) did not differ significantly by circumcision status (hazard ratio for uncircumcised relative to circumcised subjects: 0.9 [95% confidence interval{CI}: 0.7-1.2]). However, compared with circumcised men, uncircumcised men were 10.1 (95% CI: 2.9-35.6) times more likely to have the same HPV type detected in all 3 genital specimens than in a single genital specimen and were 2.7 (95% CI: 1.6-4.5) times more likely to have an HPV-positive urine or glans specimen at first detection. CONCLUSIONS: Although the likelihood of HPV acquisition did not differ by circumcision status, uncircumcised men were more likely than circumcised men to have infections detected at multiple genital sites, which may have implications for HPV transmission.
Asunto(s)
Circuncisión Masculina , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/transmisión , Adolescente , Alphapapillomavirus/clasificación , Alphapapillomavirus/genética , Alphapapillomavirus/aislamiento & purificación , Circuncisión Masculina/estadística & datos numéricos , ADN Viral/análisis , ADN Viral/aislamiento & purificación , Genitales Masculinos/virología , Humanos , Modelos Logísticos , Masculino , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/orina , Infecciones por Papillomavirus/virología , Modelos de Riesgos Proporcionales , Estudiantes , Universidades , Washingtón/epidemiología , Adulto JovenRESUMEN
Determining the rate at which men develop genital warts after infection with alpha genus human papillomavirus (HPV) types will provide important information for the design of prevention strategies. We conducted a cohort study of 18-21-year-old men who underwent triannual genital examinations. The 24-month cumulative genital wart incidence was 57.9% (95% confidence interval [CI], 38.1%-79.1%) among 46 men with incident detection of HPV-6 or HPV-11 infection, 2.0% (95% CI, 0.5%-7.9%) among 161 men with incident detection of infection with other HPV types, and 0.7% (95% CI, 0.2%-2.8%) among 331 men who tested negative for HPV. Our results suggest that genital warts are common after HPV-6 or HPV-11 infection in young men.
Asunto(s)
Condiloma Acuminado/epidemiología , Condiloma Acuminado/etiología , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/epidemiología , Adolescente , Adulto , Alphapapillomavirus , Estudios de Cohortes , Condiloma Acuminado/virología , Papillomavirus Humano 11 , Papillomavirus Humano 6/fisiología , Humanos , Incidencia , Masculino , Factores de Riesgo , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: In contrast to the wealth of data on human papillomavirus (HPV) infections in women, much less is known about HPV in men. METHODS: Between June 2003 and March 2006, a total of 240 heterosexually active male university students 18-20 years of age were recruited for participation in a cohort study of HPV infection. Genital cell samples were collected, at 4-month intervals, for HPV-DNA analysis by polymerase chain reaction. The subjects maintained a Web-based journal of sexual activity. RESULTS: At 24 months, the cumulative incidence of new infection of any genital HPV type was 62.4% (95% confidence interval [CI], 52.6%-72.2%). Acquisition rates did not differ by genital site (i.e., glans, penile shaft, or scrotum) of initial detection (P=.86). The most commonly detected types were HPV-84 and HPV-16. In multivariate analysis, a report of a new sex partner during the prior 0-4 (hazards ratio [HR], 2.0 [95% CI, 1.3-3.0]) and 5-8 (HR, 1.8 [95% CI, 1.2-2.7]) months and a history of smoking (HR, 1.6 [95% CI, 1.1-2.4]) were associated with an elevated risk of HPV acquisition. CONCLUSION: Genital HPV infection is common and multifocal in young men, and its incidence is higher than that reported for similar cohorts of young women. The high rates of HPV infection in men should be considered when strategies for the prevention of HPV infection in female adolescents and young women are being developed.