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Large studies of genital human papillomavirus (HPV) infection in men are few and mainly include high-risk groups. We interviewed 779 men who requested a vasectomy in 27 public clinics in 14 states of Mexico. Exfoliated cells were obtained from the scrotum, the shaft of the penis, the top of the penis including the coronal sulcus, the glans and the opening of the meatus. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot. Unconditional logistic regression was used to estimate odds ratios (ORs) of being HPV-positive and corresponding 95% confidence intervals (CIs). The prevalence of any type of HPV was 8.7%. HPV positivity was highest among men below age 25 (13.6%), and lowest among men aged 40 years or older (6.0%). The most commonly found HPV types were, in decreasing order, HPV59, 51, 6, 16 and 58. Lifetime number of sexual partners was associated with HPV positivity (OR for 4 vs. 1 partner 5 3.7, 95% CI: 2.0-6.8), mainly on account of the strong association with number of occasional and sex-worker partners. Condom use with both regular (OR 5 0.4, 95% CI: 0.1-1.0) and sex-worker (OR 5 0.1, 95% CI: 0.0-0.3) partners and circumcision (OR 5 0.2, 95% CI: 0.1-0.4) were inversely associated with HPV positivity. HPV prevalence in Mexican men was similar to the prevalence found in Mexican women of the same age groups. The association between HPV positivity and lifetime number of sexual partners in the present low-risk male population is one of the strongest ever reported in studies in men. Condom use and circumcision were associated with a strong reduction in HPV prevalence. ' 2006 Wiley-Liss, Inc.Key words: human papillomavirus; men; Mexico; sexual habits; condom use Human papillomavirus (HPV) infection, the necessary cause of invasive cervical cancer and its precursor lesions, 1 is a very common sexually transmitted disease in women in many populations. 2 HPV infection in men causes genital warts, 3 and is associated with HPV infection 4,5 and cervical cancer 6,7 in female partners.Previous studies on genital HPV infection in men showed an approximately equal prevalence of HPV infection in any population in the 2 genders, 8 and the existence of a direct, though moderate, association between HPV positivity among men and lifetime number of sexual partners. 9,10 However, contrary to the relatively large amount of information on genital HPV infection in women, 2,11 large studies on HPV prevalence in the general male population are few. Furthermore, the majority of studies in men have focused on young individuals 12 or high-risk populations [e.g., men attending sexually transmitted disease (STD) clinics 9,13,14 or enrolled in military service [15][16][17] ].Two previous reports from Mexico 12,17 showed that more than one-third of the young men studied were infected with genital HPV. To further elucidate the characteristics of HPV infection in the general male population, we assessed the prevalence and determinants of infection with 35 HPV types among 779 Mexican men who attended publi...

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...

Morelos es evaluar el uso de la prueba del virus de papiloma humano (VPH), en relación con la prueba de Papanicolaou, para el tamizaje de cáncer cervical. Material y métodos. El Estudio de VPH en Morelos actualmente se está llevando a cabo en México, para examinar la posibilidad de usar la prueba de VPH para la detección de cáncer cervical. Se evaluó el uso de la prueba de VPH en muestras auto-tomadas vaginales y en muestras cervicales tomadas por un clínico. Se comparó la aceptabilidad del uso de la prueba de VPH en muestras autotomadas al uso del Papanicolaou. También se realizó un análisis de costo-efectividad y de costo-beneficio. Resultados. Los resultados del Estudio de VPH en Morelos indican que la prueba de VPH tiene una mayor sensibilidad para detectar los casos de neoplasia intraepitelial cervical 2/3 y cáncer cervical que la prueba de Papanicolaou. Los resultados también indican una Material and Methods. The Morelos HPV Study is currently being conducted in Mexico, to examine the possibility of using HPV testing for CC screening. The HPV testing of self-collected vaginal and clinician-collected cervical specimens was evaluated as part of this study. The acceptability of the HPV testing of self-collected specimens was compared to that of the Pap test. A cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) was also performed. Results. The Morelos HPV Study results indicate that HPV testing has a greater sensitivity to detect cervical intraepithelial neoplasia (CIN) 2/3 and CC than the Pap test. Our results also indicate an over-all lower acceptability of the Pap test as compared to the self-collected

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