Prevalence, Concordance And Determinants Of Human Papillomavirus Infection Among Heterosexual Partners In A Rural Region In Central Mexico

Parada et al. BMC Infectious Diseases 2010, 10:223 http://www.biomedcentral.com/1471-2334/10/223

RESEARCH ARTICLE

Open Access

Prevalence, concordance and determinants of human papillomavirus infection among heterosexual partners in a rural region in central Mexico
Rocio Parada1, Rosalba Morales2, Anna R Giuliano3, Aurelio Cruz1, Xavier Castellsagué4, Eduardo Lazcano-Ponce1*
AbstractBackground: Although human papillomavirus (HPV) infection in heterosexual couples has been sparsely studied, it is relevant to understand disease burden and transmission mechanisms. The present study determined the prevalence and concordance of type-specific HPV infection as well as the determinants of infection in heterosexual couples in a rural area of Mexico. Methods: A cross-sectional study wasconducted in 504 clinically healthy heterosexual couples from four municipalities in the State of Mexico, Mexico. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot in cervical samples from women and in genital samples from men. Thirty-seven HPV types were detected, including high-risk oncogenic types and low-risk types. Multivariate logistic regression modelswere utilized to evaluate factors associated with HPV. Results: The prevalence of HPV infection was 20.5% in external male genitals and 13.7% in cervical samples. In 504 sexual couples participating in the study, concordance of HPV status was 79%; 34 partners (6.7%) were concurrently infected, and 21 out of 34 partners where both were HPV positive (61.8%) showed concordance for one or more HPVtypes. The principal risk factor associated with HPV DNA detection in men as well as women was the presence of HPV DNA in the respective regular sexual partner (OR = 5.15, 95%CI 3.01-8.82). In men, having a history of 10 or more sexual partners over their lifetime (OR 2.5, 95%CI 1.3 - 4.8) and having had sexual relations with prostitutes (OR 1.7, 95%CI 1.01 - 2.8) increased the likelihood ofdetecting HPV DNA. Conclusions: In heterosexual couples in rural regions in Mexico, the prevalence of HPV infection and type-specific concordance is high. High-risk sexual behaviors are strong determinants of HPV infection in men.

Background Although there is clear evidence for the influence of the male factor in the development of cervical neoplasia [1,2], HPV transmission in heterosexual couples hasrarely been studied. The few studies conducted have included the male sexual partners of women with clinical HPV lesions [3-8] In addition, heterosexual couples have been studied through controlled clinical trials to evaluate the effect of the use of condoms on the rate of
* Correspondence: elazcano@insp.mx 1 Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública,Cuernavaca, Morelos, México Full list of author information is available at the end of the article

persistence of flat penile lesions [9]. Previous reports from prospective studies of women initiating sexual life have estimated an accumulated HPV risk of 50% over a period of three years. The risk of HPV infection in these women increases if the male sexual partner had initiated sexual life at anearly age [10]. In light of the scarce studies exploring HPV transmission among heterosexual couples, mathematical models have emerged to simulate HPV transmission dynamics. A greater transmissibility of HPV has been estimated as compared to other sexually transmitted infections, such as HIV and type 2 herpes simplex [11]. Information about HPV transmission probabilities in couples is of paramountimportance

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