Human Papillomavirus (HPV) Infection in Heterosexual South African Men Attending Sexual Health Services: Associations Between HPV and HIV Serostatus

The study authors assessed distribution of human papillomavirus genotypes and determined the associations between HPV and HIV co-infection in sexually active heterosexual men with anogenital warts (GW), male urethral discharge and asymptomatic men.

From the three patient groups, valid specimens for HPV genotyping were obtained from 108 men with GW, 56 men with urethral discharge syndrome, and 50 asymptomatic men attending voluntary HIV counseling and testing. The Linear Array HPV Genotyping Test was used to determine the HPV genotype distribution among the men, while sera were tested for HIV antibodies using two commercial rapid tests.

Anogenital HPV prevalence among study participants was 78 percent (166): HPV DNA was detected in 100 percent (108) of men with GW, 48 percent (27) of men with urethral discharge syndrome and 62 percent (31) of voluntary counseling and testing participants. HPV types 6, 11, 16, and 18 were prevalent as either single or combined infections in 81 percent (134) of all HPV-positive men. HPV types 6 and/or 11 were significantly higher among GW patients (p<0.001). Adjusting for patient groups showed HIV seropositivity was significantly associated with multiple HPV infections (odds ratio [OR]=3.98, 95 percent confidence interval [CI] 1.58 to 10.03) but not with the presence of a foreskin (OR=0.67, 95 percent CI 0.32 to 1.40).

"Infections with HPV were prevalent among sexually active heterosexual men attending the men's sexual health clinic," the authors concluded. "Associations were observed between HIV co-infection and multiple HPV infections. Further population-based studies on the prevalence of HPV genotypes are required to determine if men should be included in any future national HPV vaccination program in South Africa."