Transmission of Human Papillomavirus in Heterosexual Couples

Abstract

We examined the transmission of human papillomavirus (HPV) in 25 heterosexual, monogamous couples (25 men, 25 women), followed up over an average of 7.5 months. A total of 53 heterosexual transmission events were observed among 16 couples (14 male-to-female and 39 female-tomale). Sexual transmission involved 13 different oncogenic and nononcogenic HPV types; 8% were vaccine-covered types transmitted between partners. The overall rate of HPV transmission from the penis to the cervix was 4.9/100 person-months, which was substantially lower than that from the cervix to the penis (17.4/100 person-months). Transmission between the hands and genitals, as well as apparent self-inoculation events (primarily in men), were also observed. Couples who transmitted HPV were more sexually active and used condoms less frequently. These results have implications for HPV prevention and control strategies, including the targeting of prophylactic vaccines. C ervical cancer remains a major source of illness and death among women globally, and infection with oncogenic human papillomaviruses (HPVs) is its principal cause (1,2). Men are assumed to be the main reservoirs of genital HPV infection for women, although comparatively little is known about the natural history of HPV in men.A limited number of cross-sectional and case-control studies have evaluated genotype-specifi c HPV concordance in male-female couples (3-7). There are, however, no empirical data on the heterosexual transmission of HPV. Our investigation evaluates the transmission of HPV in a cohort of male-female sexual partners. Methods Study ParticipantsThe study was conducted at the University Health Services of the University of Hawaii at Manoa from CME ACTIVITYMedscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. Medscape, LLC designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at http://www.medscape.com/cme/eid; (4) view/print certifi cate. Learning ObjectivesUpon completion of this activity, participants will be able to:Identify the most common baseline human papillomavirus ( CME Author

Prevalence of oral and oropharyngeal human papillomavirus in a sample of South African men: A pilot study

“…[15][16][17][18] Sexual contact, either genital or oral, remains the primary mode of HPV transmission, and it is well documented that having multiple partners increases the prevalence of oral and genital HPV. [6,9,19,20] A study in KwaZulu-Natal, SA, reported male undergraduate students to have had a median of four sexual partners in the previous year. [11] In many African cultures it is acceptable for men to have multiple partners and engage in sex outside the primary relationship.…”

Cervical Cancer, a Sequela of a Sexually Transmitted Infection: The Human Papillomavirus Infection

“…Oncogenic strains or high-risk genotypes which include serotypes 16, 18, 31, 35 and 45 are responsible for most cases of cervical cancer, although multiple infections with a combination of genotypes have been isolated in 6% of cases. It is estimated that only 20% of women will escape HPV infection in their lifetime and this underscores the importance of this infection [2,3].…”

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“…The large majority of infections clear spontaneously within 24 months, although the time depends on the HPV type and the immune status. Clearing an infection does not always create immunity if there is a new or continuing source of infection [13]. The virus can either be completely cleared or remain in a latent form which can be later reactivated.…”