Background: Human papillomavirus (HPV) infection is sexually transmitted, but the nature of the infection in males is poorly understood. We sought to identify determinants of HPV infection, acquisition, and persistence in 1,030 healthy military men in Mexico. Methods: From July 2000 to July 2003, trained interviewers administered a questionnaire, conducted a genital examination, and collected samples. The presence of multiple HPV types in genital cells from the urethra, urethral meatus, scrotum, penile shaft, and coronal sulcus was evaluated. At baseline 1,030 participants and after 1-year follow-up 336 individuals were sampled using a highly sensitive DNA reverse blot strip assay. Results: HPV prevalence was 44.6%; infection with high-risk types was observed in 34.8% participants and 51.1% were multiply infected. After 1-year follow-up, 165 men remained free of HPV, 68 cleared their infection, 45

Objective: To elucidate which anatomical sites need to be sampled to detect human papillomavirus (HPV) infection in the lower male genital tract. Method: In an HPV survey of Mexican soldiers (median age 24 years; range 16-50 years), a cell sample from 2 cm deep into the distal urethra (group 1; n = 168 men), or 0.5 cm deep into the meatus urethralis (group 2; n = 414 men) was collected, along with a sample from the external genitalia. The different samples were tested for 27 HPV types using a polymerase chain reaction based strip assay. Results: HPV DNA was detected more frequently in external genitalia samples (46.4%) than in the urethra (20.8%) or meatus samples (12.1%). Lack of samples from the urethra or meatus would have led to 5.1% and 1.5% false HPV negative results, respectively. The most frequently detected high risk HPV types (HPV 59, 52, 51, and 16) were similar in different sites, whereas low risk types were found rarely in urethra samples.Conclusions: The addition of cell samples from the meatus to those from external genitalia contributed negligibly to the evaluation of the prevalence of HPV in men. HPV detection was slightly improved by the addition of urethra samples, but the gain may not justify the discomfort of the procedure in large epidemiological studies.T he prevalence of human papillomavirus (HPV) in the genital tract of men tends to be similar to that in women (that is, between 3% and 40%, depending upon the population and age group considered). [1][2][3][4][5][6][7][8] It is unclear, however, which genital sites need to be sampled to detect HPV in men. Exfoliated cells were collected from the meatus urethralis and from the distal urethra in certain studies, 7 but urethral sampling is painful and can potentially decrease participation, especially in follow up studies.We therefore compared the relative contribution of cell samples from the external genitalia and the distal urethra or meatus urethralis to the evaluation of HPV prevalence. METHODSThe present report deals with the first 820 men recruited between February 2001 and October 2002 in a larger study on HPV prevalence in 1612 Mexican soldiers. An age stratified random sample was drawn from a list of soldiers who were attending a 1 year minimum period of service in central Mexico. Overall, 7.5% of the men contacted refused to participate in the study and 1.4% could not attend because of concurrent illnesses. All study participants were fully informed of study aims and procedures and signed an informed consent form. The study was cleared by the ethics committee of the National Institute of Public Health of Mexico, and the International Agency for Research on Cancer.Participants were instructed not to wash their genitalia 12 hours before the urological examination. Samples were collected using a cytobrush (Cytobrush Plus Sterile, Medscand Medical Inc, Hollywood, FL, USA), moistened in phosphate buffered saline (PBS), to brush the penis in a continuously rotational movement, from bottom to top, starting at the middle third of the scrot...