title: Prevalence and Correlates of Penile HPV Infection in a Clinic-Based Sample of Hispanic Males.
abstract: OBJECTIVE
  The aim of this manuscript is to describe the prevalence, genotypic distribution of penile HPV infection and the behavioral risk factors associated with penile HPV infection (any HPV type, high-oncogenic-risk [HR] types, low-oncogenic-risk [LR] types, and of multiple HPV types) in a group of sexually active males who went to an STI clinic in San Juan, Puerto Rico.
  
  
  METHODS
  After providing informed consent, the participants, underwent a detailed behavioral interview and a clinical examination. Frequency distributions and descriptive statistics were used to characterize the study samples. Prevalence estimates and 95% confidence intervals (CI) were calculated for any type of HPV, HR types, LR types, or multiple types. Logistic regression analyses was performed to determine factors associated with each of the HPV types.
  
  
  RESULTS
  Two hundred and six participants were enrolled in this study. The mean age of the participants was 37.8±13.1 years. Close to 80% of the sample were infected with at least one HPV type; 73.5% were infected with one or more LR-HPV types; 32.4%, with one or more HR-HPV types; and 46.0%, with multiple HPV types. The most prevalent HR types were HPV-35, -31, and -16; the most prevalent LR types were HPV 6/11, and -84. After adjusting for age, having a high number of lifetime female sexual partners was highly associated with having multiple types of HPV infection (estimated OR=2.86; 95% CI=1.41, 5.80).
  
  
  CONCLUSIONS
  HPV infection is common among sexually active males frequenting this STI clinic. HPV types not covered by the current quadrivalent HPV vaccine were identified. Multiple HPV types in the penis are significantly related to the lifetime number of female sexual partners. The high prevalence of HPV at this particular STI clinic evidences that males need to be targeted in primary care settings if the available vaccine is to be effectively promoted. In addition, opportunities for secondary prevention of HPV in STI settings are recommended, because of the burden of anal and penile cancer documented in the island.
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Vivian
authors.initials: V
authors.lastname: Colón-López
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Ortiz
authors.affiliation: UPR/MDACC: Partnership for Excellence in Cancer Research Program, San Juan, PR.
authors.forename: Lizbeth
authors.initials: L
authors.lastname: Del Toro-Mejías
authors.affiliation: Center for Research on Global Health, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Michael
authors.initials: M
authors.lastname: Clatts
authors.affiliation: Puerto Rico Department of Health, San Juan, PR.
authors.forename: Greduvel
authors.initials: G
authors.lastname: Durán-Guzmán
authors.affiliation: Puerto Rico Central Cancer Registry, Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR.
authors.forename: Naydi
authors.initials: N
authors.lastname: Pérez
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA.
authors.forename: Maria
authors.initials: M
authors.lastname: DaCosta
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA.
authors.forename: Joel
authors.initials: J
authors.lastname: Palefsky
mesh_terms: D000328:Adult; D005260:Female; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D010409:Penile Diseases / Q000453:epidemiology / Q000821:virology*; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D055815:Young Adult
keywords: Hispanics; Human Papillomavirus (HPV); Men; Puerto Rico; STD Clinics