title: Prevalence, concordance and determinants of human papillomavirus infection among heterosexual partners in a rural region in central Mexico.
abstract: BACKGROUND
  Although human papillomavirus (HPV) infection in heterosexual couples has been sparsely studied, it is relevant to understand disease burden and transmission mechanisms. The present study determined the prevalence and concordance of type-specific HPV infection as well as the determinants of infection in heterosexual couples in a rural area of Mexico.
  
  
  METHODS
  A cross-sectional study was conducted in 504 clinically healthy heterosexual couples from four municipalities in the State of Mexico, Mexico. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot in cervical samples from women and in genital samples from men. Thirty-seven HPV types were detected, including hi223gh-risk oncogenic types and low-risk types. Multivariate logistic regression models were utilized to evaluate factors associated with HPV.
  
  
  RESULTS
  The prevalence of HPV infection was 20.5% in external male genitals and 13.7% in cervical samples. In 504 sexual couples participating in the study, concordance of HPV status was 79%; 34 partners (6.7%) were concurrently infected, and 21 out of 34 partners where both were HPV positive (61.8%) showed concordance for one or more HPV types. The principal risk factor associated with HPV DNA detection in men as well as women was the presence of HPV DNA in the respective regular sexual partner (OR = 5.15, 95%CI 3.01-8.82). In men, having a history of 10 or more sexual partners over their lifetime (OR 2.5, 95%CI 1.3 - 4.8) and having had sexual relations with prostitutes (OR 1.7, 95%CI 1.01 - 2.8) increased the likelihood of detecting HPV DNA.
  
  
  CONCLUSIONS
  In heterosexual couples in rural regions in Mexico, the prevalence of HPV infection and type-specific concordance is high. High-risk sexual behaviors are strong determinants of HPV infection in men.
authors.affiliation: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Rocio
authors.initials: R
authors.lastname: Parada
authors.forename: Rosalba
authors.initials: R
authors.lastname: Morales
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.forename: Aurelio
authors.initials: A
authors.lastname: Cruz
authors.forename: Xavier
authors.initials: X
authors.lastname: Castellsagué
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State / Q000453:epidemiology / Q000635:transmission; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005837:Genitalia, Male / Q000821:virology; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000635:transmission*; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population; D012725:Sexual Behavior; D012747:Sexual Partners; D014773:Virology / Q000379:methods; D055815:Young Adult
chemical_list: D004279:DNA, Viral