title: The role of monogamy and duration of heterosexual relationships in human papillomavirus transmission.
abstract: BACKGROUND
  Published data are equivocal about the relative rates of male-to-female and female-to-male human papillomavirus (HPV) transmission. Our objective was to estimate genital HPV incidence among heterosexual partners from a broad age range and to investigate the effects of monogamy and relationship duration on incidence.
  
  
  METHODS
  HPV genotyping was conducted for heterosexual partners, aged 18-70 years, from Tampa, Florida, who provided genital exfoliated cell specimens at semiannual visits during a 2-year study. The rate of incident HPV detection was assessed for 99 couples, and transmission incidence was estimated among a subset of 65 discordant couples. We also evaluated the effect of monogamy and relationship duration on transmission incidence.
  
  
  RESULTS
  Couples were followed up for a median of 25 months and had a mean age of 33 years for both sexes. The HPV type-specific transmission incidence rate was 12.3 (95% confidence interval, 7.1-19.6) per 1000 person-months for female-to-male transmission and 7.3 (95% confidence interval, 3.5-13.5) per 1000 person-months for male-to-female transmission. Regardless of monogamy status or relationship duration, there was a similar pattern of increased incident HPV detection among men compared with women.
  
  
  CONCLUSIONS
  HPV may be transmitted more often from women to men than from men to women, suggesting a need for prevention interventions, such as vaccination, for men.
authors.affiliation: Center for Infectious Diseases, The University of Texas School of Public Health at Houston.
authors.forename: Alan G
authors.initials: AG
authors.lastname: Nyitray
authors.forename: Hui-Yi
authors.initials: HY
authors.lastname: Lin
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.forename: Mihyun
authors.initials: M
authors.lastname: Chang
authors.forename: Lynette
authors.initials: L
authors.lastname: Menezes
authors.forename: Beibei
authors.initials: B
authors.lastname: Lu
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.forename: Mary
authors.initials: M
authors.lastname: Papenfuss
authors.forename: Christine
authors.initials: C
authors.lastname: Gage
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Galindo
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005431:Florida / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000635:transmission*; D011446:Prospective Studies; D012725:Sexual Behavior; D055815:Young Adult
keywords: couples; epidemiology; genitals; human papillomavirus; incidence; transmission