title: External genital human papillomavirus prevalence and associated factors among heterosexual men on 5 continents.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Medical Virology, University of Stellenbosch, South Africa and Lancet Laboratories, Johannesburg, South Africa. eftyxia.vardas@lancet.co.za
authors.forename: Eftyhia
authors.initials: E
authors.lastname: Vardas
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.forename: Stephen
authors.initials: S
authors.lastname: Goldstone
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
authors.forename: Edson D
authors.initials: ED
authors.lastname: Moreira
authors.forename: Mary E
authors.initials: ME
authors.lastname: Penny
authors.forename: Carlos
authors.initials: C
authors.lastname: Aranda
authors.forename: Heiko
authors.initials: H
authors.lastname: Jessen
authors.forename: Harald
authors.initials: H
authors.lastname: Moi
authors.forename: Daron G
authors.initials: DG
authors.lastname: Ferris
authors.forename: Kai-Li
authors.initials: KL
authors.lastname: Liaw
authors.forename: J Brooke
authors.initials: JB
authors.lastname: Marshall
authors.forename: Scott
authors.initials: S
authors.lastname: Vuocolo
authors.forename: Eliav
authors.initials: E
authors.lastname: Barr
authors.forename: Richard M
authors.initials: RM
authors.lastname: Haupt
authors.forename: Elizabeth I O
authors.initials: EI
authors.lastname: Garner
authors.forename: Dalya
authors.initials: D
authors.lastname: Guris
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000821:virology; D000914:Antibodies, Viral / Q000097:blood; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000821:virology; D020010:Heterosexuality; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D010413:Penis / Q000821:virology; D010502:Perineum / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D012611:Scrotum / Q000821:virology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral