HPV in Men: Key Findings From The HIM Study

Human papillomavirus (HPV) causes cervical cancer in women, but its epidemiology in men has been less studied. The HPV Infection in Men (HIM) study aimed to address these knowledge gaps by investigating genital HPV infections among over 4,000 men from 2005-2009. Using PCR testing, HIM provided novel insights into HPV prevalence, clearance, and progression to penile lesions in asymptomatic men.

What was the prevalence of HPV infection in men?

The HIM study found a high prevalence of genital HPV infection in asymptomatic men compared to previous estimates in women, with an overall prevalence of 65%. The prevalence was higher in Brazil compared to the United States and Mexico. This highlights how common HPV infection is in men.

What HPV types were most frequently detected?

The most common high risk HPV types detected were 16, 51 and 59. The most prevalent low risk types were 84, 62 and 6. This gives insight into the predominant strains circulating and causing infection in men.

What risk factors were associated with HPV infection?

Several risk factors were associated with higher HPV prevalence and incidence rates, including lifetime number of sexual partners, race, smoking, and alcohol use. This is consistent with sexual behavior being the main risk factor for exposure.

How did infection duration compare between men and women?

HPV infections were found to clear faster in men than previous estimates in women. The median duration of any HPV infection was 7.5 months in men, compared to longer persistence reported in women. This suggests differences in natural history of infection between genders.

What proportion of infected men developed lesions?

Around 5% of HPV infected men developed external genital lesions, mostly genital warts with a few cases of penile precancer. HPV types 6 and 11 caused the majority of genital warts. This indicates that while HPV is common in men, progression to lesions is relatively uncommon.

We review these key HIM findings. Results reveal high HPV prevalence, though most infections rapidly cleared. Only a small proportion developed lesions, mainly genital warts. The data significantly advance understanding of HPV natural history and transmission in men. Characterizing HPV's role in male diseases is important for informing vaccination and prevention strategies.

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Reference

Laura Sichero, Anna R. Giuliano, Luisa Lina Villa; Human Papillomavirus and Genital Disease in Men: What We Have Learned from the HIM Study. Acta Cytologica 24 April 2019; 63 (2): 109–117.