title: Circumcision and acquisition of human papillomavirus infection in young men.
abstract: 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.
authors: Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors: Kelley
authors: K
authors: Vanbuskirk
authors: Rachel L
authors: RL
authors: Winer
authors: James P
authors: JP
authors: Hughes
authors: Qinghua
authors: Q
authors: Feng
authors: Yuzo
authors: Y
authors: Arima
authors: Shu-Kuang
authors: SK
authors: Lee
authors: Michael E
authors: ME
authors: Stern
authors: Sandra F
authors: SF
authors: O'Reilly
authors: Laura A
authors: LA
authors: Koutsky
mesh_terms: D000293:Adolescent; D052685:Alphapapillomavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D002944:Circumcision, Male / Q000706:statistics & numerical data; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D005837:Genitalia, Male / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008297:Male; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000635:transmission* / Q000652:urine / Q000821:virology; D016016:Proportional Hazards Models; D013334:Students; D014495:Universities; D014861:Washington / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral