title: Determinants of prevalence, acquisition, and persistence of human papillomavirus in healthy Mexican military men.
abstract: BACKGROUND
  Human papillomavirus (HPV) infection is sexually transmitted, but the nature of the infection in males is poorly understood. We sought to identify determinants of HPV infection, acquisition, and persistence in 1,030 healthy military men in Mexico.
  
  
  METHODS
  From July 2000 to July 2003, trained interviewers administered a questionnaire, conducted a genital examination, and collected samples. The presence of multiple HPV types in genital cells from the urethra, urethral meatus, scrotum, penile shaft, and coronal sulcus was evaluated. At baseline 1,030 participants and after 1-year follow-up 336 individuals were sampled using a highly sensitive DNA reverse blot strip assay.
  
  
  RESULTS
  HPV prevalence was 44.6%; infection with high-risk types was observed in 34.8% participants and 51.1% were multiply infected. After 1-year follow-up, 165 men remained free of HPV, 68 cleared their infection, 45 acquired one, and 37 remained infected with the same HPV type. The period prevalence was 50.9%, the incidence rate was 17.9/1,000 men-months [95% confidence interval (95% CI), 13.0-23.9], clearance was 54%, and persistence was 29.4%. At baseline, the number of partners before age 20 years, a history of a sexually transmitted disease, and the presence of condilomas significantly increased the association with HPV infection. Having anal intercourse with males was associated with the risk of acquiring a HPV infection (odds ratio, 5.2; 95% CI, 1.2-23). The odds ratio for persistent infection was 0.10 (95% CI, 0-0.87) in men who reported being circumcised compared with those who did not.
  
  
  CONCLUSIONS
  High-risk sexual behavior increases the risk of HPV infection in males, whereas circumcision may lower the risk of persistence.
authors: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors: Martín
authors: M
authors: Lajous
authors: Nancy
authors: N
authors: Mueller
authors: Aurelio
authors: A
authors: Cruz-Valdéz
authors: Luis Victor
authors: LV
authors: Aguilar
authors: Silvia
authors: S
authors: Franceschi
authors: Mauricio
authors: M
authors: Hernández-Avila
authors: Eduardo
authors: E
authors: Lazcano-Ponce
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008889:Military Personnel; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000635:transmission; D015995:Prevalence; D012725:Sexual Behavior; D011795:Surveys and Questionnaires