title: The impact of human immunodeficiency virus on human papillomavirus transmission in heterosexually active couples.
abstract: OBJECTIVE
  This study investigated HPV transmission and the factors influencing it in heterosexually active couples in South Africa.
  
  
  METHODS
  A total of 486 heterosexual couples were recruited at a health facility and returned at 6-monthly intervals. Cervical and penile HPV types were determined by Roche Linear Array HPV genotyping assay. HPV transmission was defined as the detection of a new HPV type in an individual whose partner was infected with the same type at the date of acquisition.
  
  
  RESULTS
  The female-to-male HPV transmission rate was 2.80/100 person-months (95% confidence interval (CI): 2.03-3.86) while the male-to-female HPV transmission rate was 1.17/100 person-months (95% CI: 0.82-1.67). HIV-positive women were found to be at higher risk of HPV infection transmitted from their male partners compared to HIV-negative women (RR (relative risk): 2.31, 95% CI: 1.08-4.92, P = 0.03). HIV-positive men with CD4 counts <350/mL had a higher risk of HPV infection transmitted from their female partners compared to HIV-positive men with CD4 counts ≥350/mL (RR: 3.17, 95% CI: 1.05-9.55, P = 0.04).
  
  
  CONCLUSIONS
  HIV infection and low CD4 counts increase the rate of HPV acquisition from sexual partner.
authors.affiliation: Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa. Zizipho.Mbulawa@uct.ac.za
authors.forename: Zizipho Z A
authors.initials: ZZ
authors.lastname: Mbulawa
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Johnson
authors.forename: Dianne J
authors.initials: DJ
authors.lastname: Marais
authors.forename: David
authors.initials: D
authors.lastname: Coetzee
authors.forename: Anna-Lise
authors.initials: AL
authors.lastname: Williamson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000821:virology; D005191:Family Characteristics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D020010:Heterosexuality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000635:transmission*; D010413:Penis / Q000821:virology; D012307:Risk Factors; D013019:South Africa; D055815:Young Adult