934. Factors Associated with Human Papillomavirus Infection in Men in the United States, Mexico, and Brazil
Session: Poster Abstract Session: Biomarkers and Risk Factors for Viral Infections
Saturday, October 22, 2011
Room: Poster Hall B1

Human papillomavirus infection (HPV) is the most common sexually transmitted infection, but little is known about the epidemiology of HPV in men.  The objective of this study was to determine characteristics associated with HPV infection in men across multiple countries.


This is a cross-sectional analysis of men without signs of HPV aged 18-70 living in the U.S., Mexico, or Brazil, who enrolled in the HPV in Men (HIM) study from 2005–2006. 3,546 men reported ever having sex with a male or female partner and were included in the analysis.  Participants were surveyed about sexual behaviors; tested for HPV with genital swab PCR and genotyping; and tested for chlamydia, syphilis, herpes simplex virus (HSV), and gonorrhea.  Multivariable regression was used to estimate HPV prevalence ratios (PR) and identify factors independently associated with HPV within the entire cohort and individual countries.  For factors associated with HPV in any country, interaction terms by country were tested.


Overall HPV prevalence was 67% (64% in the U.S., 62% in Mexico, 73% in Brazil).  Within the entire cohort, increasing lifetime number of sexual partners (PR 1.003, p=0.003), increasing recent number of sexual partners (PR 1.1, p<0.001), inconsistent condom use (PR 1.1, p<0.03), co-infection with HSV (PR 1.1, p=0.004), and having a partner with condylomata (PR 1.1, p=0.008) or an abnormal Pap smear (PR 1.1, p=0.013) were independently associated with higher HPV prevalence.  Whereas, increasing age at sexual debut (PR 0.9, p=0.027) was associated with lower HPV prevalence.  No interactions by country were statistically significant (all p > 0.8).  In Brazil, median lifetime number of sexual partners (10) was significantly higher than in Mexico (5) or the U.S. (6), as was proportion positive for HSV (38% compared to 9% and 20%, respectively) (both p <0.001), which may explain its higher HPV prevalence.  No unique associations were found in the U.S. or Mexico.


In this large international cohort, factors associated with HPV were largely similar between the countries and mainly related to increased sexual activity.  Differences in prevalence, rather than differences in independent associations, may explain the variation in HPV prevalence by country.

Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Alexandra Swartzman, BA1, Carrie Nielson, PhD, MPH2, Rochelle Fu, PhD2, P. Todd Korthuis, MD, MPH2,3, Priya Srikanth, MPH2, Louisa Villa, PhD4, Eduardo Lazcano, PhD5 and Anna Giuliano, PhD6, (1)Oregon Health & Science University, Portland, OR, (2)Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR, (3)Department of Medicine, Oregon Health & Science University, Portland, OR, (4)Ludwig Institute for Research on Cancer, Sao Paulo, Brazil, (5)Instituto Nacional de Salud Publica, Cuernavaca, Mexico, (6)H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL


A. Swartzman, None

C. Nielson, None

R. Fu, None

P. T. Korthuis, None

P. Srikanth, None

L. Villa, None

E. Lazcano, None

A. Giuliano, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.