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Shapiro SB, Laurie C, El-Zein M, Franco EL. Association between male circumcision and human papillomavirus infection in males and females: a systematic review, meta-analysis, and meta-regression. Clin Microbiol Infect 2023:S1198-743X(23)00149-0. [PMID: 37011808 DOI: 10.1016/j.cmi.2023.03.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/05/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Previous studies have suggested a protective effect of male circumcision on human papillomavirus (HPV) infections in males, and that this protection may be conferred to their female sexual partners. OBJECTIVES To synthesize the available evidence on the association between male circumcision and HPV infections in males and females. DATA SOURCES We searched MEDLINE, Embase, Scopus, Cochrane, LILACS, and ProQuest Dissertations & Theses Global for records published up to 22 June 2022. STUDY ELIGIBILITY We considered observational and experimental studies that assessed male circumcision status and HPV prevalence, incidence, or clearance in males or females for inclusion. PARTICIPANTS Males and their female sexual partners who were tested for genital HPV infection. INTERVENTIONS Male circumcision compared to no circumcision. RISK OF BIAS ASSESSMENT The Newcastle-Ottawa scale was used for observational studies and the Cochrane risk-of-bias tool was used for randomized trials. DATA SYNTHESIS We estimated summary measures of effect and 95% confidence intervals (CI) for the prevalence, incidence, and clearance of HPV infections in males and females using random-effects meta-analysis. We assessed effect modification of circumcision on HPV prevalence by penile site in males using random-effects meta-regression. RESULTS Across 32 studies, male circumcision was associated with decreased odds of prevalent HPV infections (OR 0.45, CI 0.34-0.61), a reduced incidence rate of HPV infections (IRR 0.69, CI 0.57-0.83), and an increased risk of clearing HPV infections (RR 1.44, CI 1.28-1.61) at the glans penis among male subjects. Circumcision conferred greater protection against infection at the glans than shaft (OR 0.68, 95% CI 0.48-0.98). Females with circumcised partners were protected from all outcomes. CONCLUSIONS Male circumcision may protect against various HPV infection outcomes, suggesting its prophylactic potential. Understanding site-specific effects of circumcision on HPV infection prevalence has important implications for studies of HPV transmission.
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Gamboa-Hoil SI. Human papillomavirus in men. Rev Int Androl 2023; 21:100325. [PMID: 36257902 DOI: 10.1016/j.androl.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/11/2021] [Accepted: 09/19/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To describe the clinical behavior of human papillomavirus in men. MATERIALS AND METHODS Current international literature was reviewed to describe the clinical behavior of human papillomavirus in men. RESULTS Internationally, the overall prevalence of HPV DNA is 50.8%, HPV considered high risk are 14 types. Prevalence of HPV DNA in invasive penile cancer ranges from 33.1% to 47%. HPV-16 has been the most frequent (68.3%), followed by HPV-6 (8.1%) and HPV-18 (6.9%). Positive HPV is described as an independent prognostic factor for cancer-specific survival. CONCLUSION It is not clear why HPV infection has a predilection in specific areas of the genital tract. However, it is important to note that there are factors that increase the risk of HPV infection.
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Zou K, Huang Y, Li Z. Prevention and treatment of human papillomavirus in men benefits both men and women. Front Cell Infect Microbiol 2022; 12:1077651. [PMID: 36506029 PMCID: PMC9729793 DOI: 10.3389/fcimb.2022.1077651] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Men should not be overlooked in research on human papillomavirus (HPV) and its associated genital diseases. This is because men infected with HPV are not only at higher risk of genital cancers, but also increase their partners' risk of HPV infection and reinfection through sexual contact. Herein, we summarized the state of knowledge regarding the prevention and treatment of HPV infection in men as well as the possible effects of the prevention and treatment of HPV in men on their female partners. Condom use, smoking cessation, male circumcision, and HPV vaccination for men each play an important role in preventing HPV infection within heterosexual couples. Additionally, men could choose to test for certain types of HPV, such as the oncogenic HPV16 or HPV18 strains, as part of a routine screening program when their partner is positive for HPV. Although there is no recognized treatment for HPV infection as of yet, immunotherapy drugs, such as toll-like receptor agonists, therapeutic HPV vaccines, and immune checkpoint inhibitors, have shown promising results in clinical trials and in actual clinical practice. HPV infection in men also increases the risk of cervical cancer in their female partners. Because of the high partner concordance for HPV demonstrated in prior research, the prevention and treatment of HPV in men should be explored more comprehensively in future research.
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Affiliation(s)
- Kangni Zou
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yue Huang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Zhengyu Li
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China,*Correspondence: Zhengyu Li,
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Morris BJ, Moreton S, Krieger JN, Klausner JD. Infant Circumcision for Sexually Transmitted Infection Risk Reduction Globally. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00811. [PMID: 36041835 PMCID: PMC9426975 DOI: 10.9745/ghsp-d-21-00811] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/21/2022] [Indexed: 12/26/2022]
Abstract
Population-based studies in high-income countries have failed to find that male circumcision protects against sexually transmitted infections. Using evidence from several sources, we show that male circumcision does protect against HIV during insertive intercourse for men who have sex with men.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences, University of Sydney, Sydney, Australia.
| | | | - John N Krieger
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jeffrey D Klausner
- Department of Medicine, Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Rezaee Azhar I, Yaghoobi M, Mossalaeie MM, Kollaee Darabi A, Nejadeh AH, Jamshidi M, Ahani A, Karkhane Mahmoodi M, Ghalichi L, Shabanzadeh A, Ataei-Pirkooh A, Marjani A, Khamseh A, Shafiei M, Hosseini P, Soltani S, Zandi M, Ghafari P, Aboofazeli A, Ghaziasadi A, Jazayeri SM. Prevalence of human papilloma virus (HPV) genotypes between outpatients males and females referred to seven laboratories in Tehran, Iran. Infect Agent Cancer 2022; 17:7. [PMID: 35248145 PMCID: PMC8897875 DOI: 10.1186/s13027-022-00421-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Human papilloma virus (HPV) causes the most common sexually-transmitted infection especially among sexually-active individuals. The aim of study was to characterize the molecular characterization of HPV genotypes between 5176 female and male patients. Methods HPV DNA was extracted from genital swabs of the study participants and amplified by Real Time Polymerase Chain Reaction (PCR). Genotyping was performed for 2525 cases using REALQUALITY RQ-Multi HPV Detection Kit for the identification of 14 high risk (HR) and 2 low risk (LR) HPV genotypes. Demographic figures were analyzed in correlation with virological data statistically. Results Out of 5176 cases from 7 laboratories, 2727 (53%) were positive for HPV, of which. 2372(87%) women and 355 (13%) men were HPV positive. However, in an intra-gender analysis, positive rate was higher in men (355/637, 55.7%) than in women (2372/4539, 52%; P value 0.007). HPV positive patients were younger than negative individuals. Positive rate was higher among age categories 20–40. Genotyping was performed for 2525 cases. Out of 1219 (48%) patients who contained single genotypes, 566 (22%) and 653 (26%) harboured HR and LR genotypes, respectively. In females and males, 1189 (54%) and 117 (37%) contained multiple genotypes. No substantial associations were found between different age categories and HR/LR and multiple genotypes distribution. Conclusion The prevalence of HPV infection in both genders was high. However, men had a higher rate of infection. These observations highlighted the necessity for a plan for targeted education to younger population in the society as well as application of infection control measures against HPV infection, especially in terms of general population mass HPV vaccination.
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Yousefi Z, Aria H, Ghaedrahmati F, Bakhtiari T, Azizi M, Bastan R, Hosseini R, Eskandari N. An Update on Human Papilloma Virus Vaccines: History, Types, Protection, and Efficacy. Front Immunol 2022; 12:805695. [PMID: 35154080 PMCID: PMC8828558 DOI: 10.3389/fimmu.2021.805695] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/31/2021] [Indexed: 12/18/2022] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted agent worldwide. Early prevention with HPV vaccination is a safe and effective method against this disease. HPV vaccines provided more protection against several oncogenic HPV strains. Three prophylactic HPV vaccines have been approved to target high-risk HPV types and protect against HPV-related disorders. These existing vaccines are based on the recombinant DNA technology and purified L1 protein that is assembled to form HPV empty shells. The prophylactic vaccines are highly immunogenic and can induce production of specific neutralizing antibodies. However, therapeutic vaccines are different from these prophylactic vaccines. They induced cell-mediated immunity against transformed cells, instead of neutralizing antibodies. The second generation of prophylactic HPV vaccines, made from alternative viral components using cost-effective production strategies, is undergoing clinical evaluation. The purpose of this review is to provide a complete and up-to-date review of the types of HPV vaccines and the efficiency of each of them for readers.
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Affiliation(s)
- Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamid Aria
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farhoodeh Ghaedrahmati
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Bakhtiari
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdieh Azizi
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Bastan
- Department of Immunopharmacology, Faculty of Medicine, Karaj University of Medical Sciences, Alborz, Iran
| | - Reza Hosseini
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Eskandari
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Bégin M, Ensink K, Bellavance K, Clarkin JF, Normandin L. Risky Sexual Behavior Profiles in Youth: Associations With Borderline Personality Features. Front Psychol 2022; 12:777046. [PMID: 35095660 PMCID: PMC8789890 DOI: 10.3389/fpsyg.2021.777046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14-21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships.
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Affiliation(s)
- Michaël Bégin
- École de Psychologie, Université Laval, Quebec, QC, Canada
| | - Karin Ensink
- École de Psychologie, Université Laval, Quebec, QC, Canada
| | | | - John F. Clarkin
- Weill Cornell Medical College, Cornell University, New York, NY, United States
| | - Lina Normandin
- École de Psychologie, Université Laval, Quebec, QC, Canada
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Abstract
Viral venereal diseases remain difficult to treat. Human papilloma virus (HPV) and herpes simplex virus (HSV) are two common viral venereal diseases. HPV infections are characterized by anogenital warts and less commonly by premalignant or malignant lesions. HSV infections classically present as grouped vesicles on an erythematous base with associated burning or pain; however, immunosuppressed patients may have atypical presentations with nodular or ulcerative lesions. This review discusses the epidemiology, diagnosis, and management of anogenital HPV and HSV infections with an emphasis on treatment modalities for the practicing dermatologist. Diagnosis of these diseases typically relies on clinical assessment, although multiple diagnostic techniques can be utilized and are recommended when diagnosis is uncertain or evaluating an individual with increased risk of malignancy. Management of HPV and HSV infections involves appropriate counseling, screening, and multiple treatment techniques. Particularly for HPV infections, a practitioner may need to use a combination of techniques to achieve the desired outcome.
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Sindiani AM, Alshdaifat EH, Alkhatib AJ. Investigating Cervical Risk Factors that Lead to Cytological and Biopsy Examination. Med Arch 2020; 74:294-297. [PMID: 33041448 PMCID: PMC7520059 DOI: 10.5455/medarh.2020.74.294-297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Cervical cancer ranks the fourth prevalent cancer in women at the global level, and the second in poor countries. The main objectives of the present study were to investigate the risk factors associated with cervical cancer and to study their possible association with the decision to take a cervical biopsy. Aim: The main objectives of this study were to investigate the risk factors associated with cervical cancer and to study their possible association with the decision to take a cervical biopsy. Methods: It was cross-sectional study and we analyzed an online data posted on Kaggle. This Dataset is obtained from UCI Repository. A list of risk factors for cervical cancer leading to biopsy examination was included, such as age, number of sexual partners, first sexual intercourse, number of pregnancies, smoking variables, hormonal contraceptives, IUD, and sexually transmitted disease variables, Hinselmann, Schiller, Cytology, and Biopsy. The dataset was prepared for appropriateness through filtering invalid cases with missing data. Results: The results of the study showed that the following variables were significantly associated with cytological examination: STD-Condylomotosis (p=0.035), STD-Pericondylomotosis (p=0.029), STD_HIV (p=0.006), Hinselmann (p<0.001), Schiller (p<0.001), and biopsy (p<0.001). the results also showed that the following variables were significantly associated with cytological examination. Conclusion: Taken together, cytological variables or biopsy examination variables if carried out at an early stage, lead to better diagnostic and therapeutic options.
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Affiliation(s)
- Amer Mahmoud Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Jordan
| | | | - Ahed J Alkhatib
- Department of Legal Medicine, Toxicology and Forensic Medicine, Jordan University of Science & Technology, Jordan
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10
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Abstract
Cervical cancer is the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases and 266,000 deaths in 2012 [1]. Almost nine out of ten (87%) cervical cancer deaths occur in the less-developed regions of the world. The cervical cancer incidence significantly increases after 20 years of age and peaks at 50 years of age. Because cervical cancer mainly affects African women at a relatively young age, the socio-economic consequences are enormous. The human papillomavirus (HPV) is central to the development of cervical neoplasia and can be detected in 99.7% of cervical cancers. Hence primary prevention aims at reducing human papillomavirus (HPV) infection by HPV vaccine administration. Secondary prevention involves cervical cancer screening and management of precancerous lesions via either Pap smear, visual inspection with acetic acid (VIA) or with lugols iodine (VILI) or HPV testing for high-risk HPV types.
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Affiliation(s)
- Mamsau Ngoma
- Ocean Road Cancer Institute, PO Box 5408, Dar Es Salaam, Tanzania
| | - Philippe Autier
- International Prevention Research Institute, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130 Ecully ouest Lyon, France
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Chandler E, Ding L, Gorbach P, Franco EL, Brown DA, Widdice LE, Bernstein DI, Kahn JA. Epidemiology of Any and Vaccine-Type Anogenital Human Papillomavirus Among 13-26-Year-Old Young Men After HPV Vaccine Introduction. J Adolesc Health 2018; 63:43-49. [PMID: 30060856 PMCID: PMC6086131 DOI: 10.1016/j.jadohealth.2018.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE The aims of this study were to determine prevalence of and factors associated with any human papillomavirus (HPV) and vaccine-type HPV among young men after vaccine introduction, stratified by vaccination status. METHODS Young men were recruited from clinical sites from 2013 to 2015, completed a survey, and were tested for 36 anogenital HPV types. We determined factors associated with ≥1 HPV type among all participants, and vaccine-type HPV (HPV6, 11, 16, and/or 18) among all, vaccinated and unvaccinated participants, using multivariable regression. RESULTS Mean age was 21.5 years and 26% had received at least one HPV vaccine dose. HPV prevalence was lower in vaccinated versus unvaccinated young men (50.5% vs. 62.6%, p = .03). HPV positivity was discordant by anogenital site. At both sites, 59.4% were positive for ≥1 HPV type and 26.0% for ≥1 4-valent vaccine type. In multivariable logistic regression, factors associated with ≥1 HPV type among all participants were frequency of oral sex (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.00-3.24), recent smoking (OR = 1.84, CI = 1.17-2.90), and sexually transmitted infection history (OR = 1.56, CI = 1.02-2.38). Factors associated with vaccine-type HPV among all participants were white versus black race (OR = 1.91, CI = 1.10-3.34) and gonorrhea history (OR = 2.52, CI = 1.45-4.38); among vaccinated participants were private versus Medicaid insurance (OR = 5.6, CI = 1.46-20.4) and private versus no insurance (OR = 15.9, CI = 3.06-83.3); and among unvaccinated participants was gonorrhea history (OR = 1.83, CI = 1.03-3.24). CONCLUSIONS Anogenital HPV prevalence was high and vaccination rates low among young men 2-4 years after vaccine introduction, underscoring the urgency of increasing vaccination rates and vaccinating according to national guidelines.
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Affiliation(s)
- Emmanuel Chandler
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Ave Cincinnati, OH 45229
| | - Lili Ding
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Ave Cincinnati, OH 45229
| | - Pamina Gorbach
- Department of Epidemiology, University of California, Los Angeles, CA, CHS 41–295, Conference Room: 46-070A, Box 951772, Los Angeles, CA 90095-1772
| | - Eduardo L. Franco
- Departments of Oncology and Epidemiology & Biostatistics, McGill University, 5100 Maisonneuve Blvd West, Suite 720; Montreal, QC, Canada H4A3T2
| | - Darron A. Brown
- Department of Medicine, Indiana University, 545 Barnhill Dr. Emerson Hall, Suite 305 Indianapolis, IN 46202
| | - Lea E. Widdice
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Ave Cincinnati, OH 45229
| | - David I. Bernstein
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Ave Cincinnati, OH 45229
| | - Jessica A. Kahn
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, 3333 Burnet Ave Cincinnati, OH 45229
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Ebrahimi A, Moradi MR, Rezaei M, Kavoussi H, Madani H, Mohammadamini K, Kavoussi R. Comparison of the risk factors and HPV types in males with anogenital warts with and without involvement of the urethral meatus in western Iran. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018; 26:55-58. [PMID: 28941262 DOI: 10.15570/actaapa.2017.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Human papillomavirus (HPV)-induced lesions rarely develop in the urethral meatus (UM); however, their eradication can be problematic. METHODS A total of 22 patients with anogenital warts (AGWs) in the UM region and 22 patients with AGWs located at other anatomical sites were included in this cross-sectional study. The presence of human papillomavirus (HPV) types in biopsy samples was determined using the HPV Easy typing kit (GenID GmbH, Germany). RESULTS Although the patients in the AGW group with involvement of the UM had a higher incidence of reported multiple sexual partners (63.6% vs. 40.9%), larger meatus size (81.8% vs. 36.4%), and more frequent anal (36.4% vs. 18.2%) or unprotected sexual contact (68.2% vs. 36.4%) than those in the AGW group without UM involvement, only the duration of lesions (p = 0.04) and meatus size (p = 0.004) were significantly different in both groups. Low-risk HPV types were found in 75.0% and 69.2% of patients in the AGW groups with and without UM involvement, respectively. CONCLUSION We found that a larger UM size was more prone to the development of meatus AGWs; however, being married, delaying sexual debut, and avoidance of multiple sexual partners seemed to be associated with a decreased risk of development of AGWs, especially within the UM region.
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Affiliation(s)
- Ali Ebrahimi
- Dermatology Department, Hajdaie Dermatology Clinic, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Mahmood Reza Moradi
- Imam Reza Hospital, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Mansour Rezaei
- Health School, Family Health Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Hossein Kavoussi
- Dermatology Department, Hajdaie Dermatology Clinic, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Hamid Madani
- Pathology Department, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Kiarash Mohammadamini
- Dermatology Department, Hajdaie Dermatology Clinic, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Reza Kavoussi
- Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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Nweke MC, Okolo CA, Daous Y, Esan OA. Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries. Arch Pathol Lab Med 2018; 142:696-699. [PMID: 29848027 DOI: 10.5858/arpa.2017-0565-ra] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes.
Objectives.—
To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries.
Data Sources.—
Peer-reviewed literature and experience of some of the authors.
Conclusions.—
Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.
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Affiliation(s)
| | | | | | - Olukemi Ayotunde Esan
- From the Department of Pathology, University College Hospital Ibadan, Ibadan, Nigeria (Messrs Nweke and Okolo); and the Department of Pathology, West Virginia University, Morgantown (Drs Daous and Esan)
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College women, HPV genotyping and sexual behavior before HPV vaccination: Results from samples stored for a long time. J Infect Public Health 2017; 11:286-289. [PMID: 28993170 DOI: 10.1016/j.jiph.2017.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/03/2017] [Accepted: 08/04/2017] [Indexed: 11/21/2022] Open
Abstract
HPV is the sexually transmitted agent most common among young people, like college students. The aim of study was to associate sexual behavior characteristics of women with HPV, detected in genital samples taken before the introduction of the HPV vaccine. Female students during 2001-2005 donated genital samples and the samples were re-analyzed in 2013 for HPV genotyping by RT-PCR. The frozen storage of the students' genital samples allowed the detection of HPV DNA and its genotyping after years of sample collection. HPV prevalence was 22%, HPV16 3.9%, and HPV18 1.1%. Age, multiple sexual partners and the partner's age at first sexual intercourse were significantly associated to HPV. Students with ≥ 3 sexual partners and who did not use condom had 12.8 higher odds of being HPV positive. These results made possible the analysis of HPV prevalence changes, before HPV vaccine introduction.
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Zhu YP, Jia ZW, Dai B, Ye DW, Kong YY, Chang K, Wang Y. Relationship between circumcision and human papillomavirus infection: a systematic review and meta-analysis. Asian J Androl 2017; 19:125-131. [PMID: 26975489 PMCID: PMC5227661 DOI: 10.4103/1008-682x.175092] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Male circumcision (MC) is reported to reduce human papillomavirus (HPV) prevalence in men. However, the efficacy remains imprecise. The aim of this study was to conduct a systematic review and meta-analysis to assess the relationship between MC and genital HPV infection and genital warts. PUBMED, EMBASE, and Web of Science were searched from inception to March 22, 2015. We identified 30 papers, including a total of 12149 circumcised and 12252 uncircumcised men who were evaluated for the association of circumcision with genital HPV or genital warts. Compared with men who were not circumcised, circumcised men may have had significantly reduced odds of genital HPV prevalence (odds ratio [OR]: 0.68; 95% confidence interval [95% CI]: 0.56-0.82). There was no significant association between MC and genital HPV acquisition of new infections (OR: 0.99; 95% CI: 0.62-1.60), genital HPV clearance (OR: 1.38; 95% CI: 0.96-1.97), and prevalence of genital warts (OR: 1.17; 95% CI: 0.63-2.17). This meta-analysis suggests that circumcision reduces the prevalence of genital HPV infections. However, no clear evidence was found that circumcision was associated with decreased HPV acquisition, increased HPV clearance, or decreased the prevalence of genital warts. More studies are required to evaluate adequately the effect of MC on the acquisition and clearance of HPV infections and prevalence of genital warts.
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Affiliation(s)
- Yi-Ping Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
| | - Zhong-Wei Jia
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
| | - Bo Dai
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
| | - Yun-Yi Kong
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Kun Chang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
| | - Yue Wang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
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16
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Nguyen NP, Nguyen LM, Thomas S, Hong-Ly B, Chi A, Vos P, Karlsson U, Vinh-Hung V. Oral sex and oropharyngeal cancer: The role of the primary care physicians. Medicine (Baltimore) 2016; 95:e4228. [PMID: 27428229 PMCID: PMC4956823 DOI: 10.1097/md.0000000000004228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/29/2016] [Accepted: 06/20/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND We aimed to study the prevalence of oral sex and its possible association with human papillomavirus (HPV) 16 infection in the development of oropharyngeal cancer in the US population for possible prevention. METHODS We conduct a systemic review on the prevalence of oral sex among Americans among different age groups, the prevalence of HPV 16 infection reported in oropharyngeal cancer, and correlation between oral sex and oropharyngeal cancer. RESULTS Oral sex is prevalent among adolescents and sexually active adults. Sixty percent of oropharyngeal cancer reported in the United States is associated with HPV 16 infections. Individuals who practiced oral sex with multiple partners are at risk for developing oropharyngeal cancer and need to be informed about practicing safe sex or getting vaccination. CONCLUSION Family physicians will play a key role in prevention and educating the public about the risk of oral sex.
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Affiliation(s)
- Nam P. Nguyen
- Department of Radiation Oncology, Howard University, Washington, DC
| | | | - Sroka Thomas
- Department of Radiation Oncology, Darmouth College of Medicine, New Lebanon, NH
| | - Bevan Hong-Ly
- Department of Radiation Oncology, University of Miami, Miami, FL
| | - Alexander Chi
- Department of Radiation Oncology, University of West Virginia, Morgantown, WV
| | - Paul Vos
- Department of Biostatistics, East Carolina University, Greenville, NC
| | - Ulf Karlsson
- Department of Radiation Oncology, Marshfield Clinic, Marshfield, WI
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, University of Martinique, Martinique, France
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17
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Rosario M, Li F, Wypij D, Roberts AL, Corliss HL, Charlton BM, Frazier AL, Austin SB. Disparities by Sexual Orientation in Frequent Engagement in Cancer-Related Risk Behaviors: A 12-Year Follow-Up. Am J Public Health 2016; 106:698-706. [PMID: 26794176 DOI: 10.2105/ajph.2015.302977] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We examined sexual-orientation disparities in frequent engagement in cancer-related risk indicators of tobacco, alcohol, diet and physical activity, ultraviolet radiation, and sexually transmitted infections (STIs). METHODS We used longitudinal data from the national Growing Up Today Study (1999-2010). Of the analytic sample (n = 9958), 1.8% were lesbian or gay (LG), 1.6% bisexual (BI), 12.1% mostly heterosexual (MH), and 84.5% completely heterosexual (CH). RESULTS More sexual minorities (LGs, BIs, and MHs) than CHs frequently engaged in multiple cancer-related risk behaviors (33%, 29%, 28%, and 19%, respectively). Sexual-minority young women, especially BI and MH, more frequently engaged over time in substance use and diet and physical activity risk than CH women. More young gay than CH men frequently engaged over time in vomiting for weight control (odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.1, 9.4), being physically inactive (OR = 1.7; 95% CI = 1.2, 2.4), and using tanning booths (OR = 4.7; 95% CI = 3.0, 7.4), and had a higher prevalence of ever having an STI (OR = 3.5; 95% CI = 2.0, 6.4). Individual analyses were generally comparable to the group-level analyses. CONCLUSIONS Young sexual minorities are at risk for cancer through frequent exposure to cancer-related risk behaviors over time. Long-term, longitudinal studies and surveillance data are essential and warranted to track frequent engagement in the risk behaviors and cancer-related morbidity and mortality.
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Affiliation(s)
- Margaret Rosario
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Fei Li
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - David Wypij
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Andrea L Roberts
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Heather L Corliss
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Brittany M Charlton
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - A Lindsay Frazier
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - S Bryn Austin
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
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18
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Gola M, Miyakoshi M, Sescousse G. Sex, Impulsivity, and Anxiety: Interplay between Ventral Striatum and Amygdala Reactivity in Sexual Behaviors. J Neurosci 2015; 35:15227-9. [PMID: 26586811 PMCID: PMC6605490 DOI: 10.1523/jneurosci.3273-15.2015] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, La Jolla, California 92093-0559, Institute of Psychology, Polish Academy of Science, 00-378 Warsaw, Poland, and
| | - Makoto Miyakoshi
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, La Jolla, California 92093-0559
| | - Guillaume Sescousse
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, 6525 EZ Nijmegen, The Netherlands
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19
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Burchell AN, Rodrigues A, Moravan V, Tellier PP, Hanley J, Coutlée F, Franco EL. Determinants of prevalent human papillomavirus in recently formed heterosexual partnerships: a dyadic-level analysis. J Infect Dis 2014; 210:846-52. [PMID: 24683197 PMCID: PMC4192056 DOI: 10.1093/infdis/jiu200] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 03/11/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We studied features that predict the presence of human papillomavirus (HPV) in a new sexual partnership. METHODS We analyzed data from the "HPV Infection and Transmission Among Couples Through Heterosexual Activity" (HITCH) Cohort Study of recently formed partnerships ("dyads"). Women aged 18-24 and their male partners were recruited during 2005-2010 in Montreal, Canada. We tested genital swabs for detection of 36 HPV types. We defined HPV in a partnership as the presence of 1 or more HPV types in either or both partners. Using baseline data from 482 dyads, we calculated prevalence ratios to evaluate candidate risk factors. RESULTS Most women (88%) were unvaccinated. Sixty-seven percent of dyads harbored HPV. For 49% of dyads, both partners were HPV+. HPV was least prevalent in dyads who were in their first vaginal sex relationship (17%) and was virtually ubiquitous in dyads for which both partners had concurrent partners (96%). Dyads that always used condoms with previous partner(s) were 27% (95% confidence interval, 9%-42%) less likely to have HPV. CONCLUSIONS The finding that condom use limited onward spread to future partners is in support of condom promotion to prevent sexually transmitted infections. Ongoing monitoring of HPV in sexual networks is needed, particularly in populations with suboptimal vaccine coverage.
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Affiliation(s)
- Ann N. Burchell
- Ontario HIV Treatment Network
- Dalla Lana School of Public Health, University of Toronto, Ontario
- Department of Oncology
| | | | | | | | - James Hanley
- Department of Epidemiology, Biostatistics and Occupational Health
| | - François Coutlée
- Department of Oncology
- Département de Microbiologie et Infectiologie, Centre Hospitalier de l'Université de Montréal
- Département de Microbiologie et Immunologie, Université de Montréal, Quebec, Canada
| | - Eduardo L. Franco
- Department of Oncology
- Department of Epidemiology, Biostatistics and Occupational Health
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20
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Rosario M, Corliss HL, Everett BG, Russell ST, Buchting FO, Birkett MA. Mediation by peer violence victimization of sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors: pooled youth risk behavior surveys. Am J Public Health 2014; 104:1113-23. [PMID: 24825215 PMCID: PMC4061994 DOI: 10.2105/ajph.2013.301764] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We examined the role of adolescent peer violence victimization (PVV) in sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors. METHODS We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex sexual attraction, partners, or identity as sexual minority and the remainder as heterosexual. We had 4 indicators of tobacco and alcohol use and 4 of sexual risk and 2 PVV factors: victimization at school and carrying weapons. We stratified associations by gender and race/ethnicity. RESULTS PVV was related to disparities in cancer-related risk behaviors of substance use and sexual risk, with odds ratios (ORs) of 1.3 (95% confidence interval [CI] = 1.03, 1.6) to 11.3 (95% CI = 6.2, 20.8), and to being a sexual minority, with ORs of 1.4 (95% CI = 1.1, 1.9) to 5.6 (95% CI = 3.5, 8.9). PVV mediated sexual orientation disparities in substance use and sexual risk behaviors. Findings were pronounced for adolescent girls and Asian/Pacific Islanders. CONCLUSIONS Interventions are needed to reduce PVV in schools as a way to reduce sexual orientation disparities in cancer risk across the life span.
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Affiliation(s)
- Margaret Rosario
- Margaret Rosario is with the Department of Psychology, City College and Graduate Center, City University of New York, NY. Heather L. Corliss is with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Bethany G. Everett is with the Department of Sociology, University of Illinois at Chicago. Stephen T. Russell is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Francisco O. Buchting is with the Horizons Foundation, CA. Michelle A Birkett is with the Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
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21
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Type-specific human papillomavirus infections among young heterosexual male and female STI clinic attendees. Sex Transm Dis 2014; 39:72-8. [PMID: 22183851 DOI: 10.1097/olq.0b013e318235b3b0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Baseline genotype-specific human papillomavirus (HPV) prevalence rates and associated risk factors per gender enable future assessment of the impact of vaccination on HPV dynamics. METHODS Before the start of national HPV vaccination for girls, data were collected cross-sectionally in nationwide Dutch sexually transmitted infections (STI) clinics among heterosexual males (n = 430) and females (n = 1136) aged 16 to 24 years. Self-collected vaginal or penile swabs were analyzed by a sensitive polymerase chain reaction (SPF10) and genotyped with line probe assay. Logistic regression was applied to estimate determinants of HPV prevalent infections. RESULTS HPV prevalence was 54% among males and 72% among females. High-risk (HR) HPV was present in males and females, 40% and 58%, respectively. Independent risk factors for HR-HPV infection were female gender, number of lifetime sex partners and a history of chlamydia or gonorrhea. In addition, not having a casual partner and consistent condom use were protective factors in women, but not in men. For low-risk (LR) HPV, the odds were smaller. Multiple HR-HPV and sexual risk behavior showed a stronger association compared with a single HR-HPV infection. CONCLUSIONS Prevalence of HR-HPV is high in both genders. Infection with multiple HR-HPV types was more associated with high-risk sexual behavior than infection with LR-HPV types or a single HR-HPV type.
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22
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Navarro-Illana P, Aznar J, Díez-Domingo J. Ethical considerations of universal vaccination against human papilloma virus. BMC Med Ethics 2014; 15:29. [PMID: 24708813 PMCID: PMC3996512 DOI: 10.1186/1472-6939-15-29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 03/05/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND From an epidemiological perspective, the practice of universal vaccination of girls and young women in order to prevent human papilloma virus (HPV) infection and potential development of cervical cancer is widely accepted even though it may lead to the neglect of other preventive strategies against cervical cancer. DISCUSSION It is argued that removing the deterrent effect--the fear of developing cancer--could encourage teenage sex. This paper reflects on the ethical legitimacy of the universal vaccination of girls and young women against HPV infection, especially regarding safety issues, the need to vaccinate people who have opted to abstain from sex, the presumption of early onset of sexual relations, the commercial interests of the companies that manufacture the vaccine, and the recommendation of universal vaccination in males. SUMMARY Based on the aforementioned information, we believe that the universal vaccination against HPV in young women is acceptable from an ethical point of view, given the medical advantages it presents.
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Affiliation(s)
- Pedro Navarro-Illana
- Facultad de Enfermería, Universidad Católica de Valencia “San Vicente Mártir”, Valencia, Spain
| | - Justo Aznar
- Instituto de Ciencias de la Vida, Universidad Católica de Valencia “San Vicente Martir”, Valencia, Spain
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23
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Sadlier C, Rowley D, Morley D, Surah S, O'Dea S, Delamere S, O'Leary J, Smyth P, Clarke S, Sheils O, Bergin C. Prevalence of human papillomavirus in men who have sex with men in the era of an effective vaccine; a call to act. HIV Med 2014; 15:499-504. [PMID: 24655896 DOI: 10.1111/hiv.12150] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The incidence of human papillomavirus (HPV)-associated anal cancer is increasing. Men who have sex with men (MSM), particularly those coinfected with HIV, are disproportionately affected. Documenting the molecular epidemiology of HPV infection is important in guiding policy makers in formulating universal and/or targeted vaccine guidelines. METHODS A prospective cohort study was conducted. HIV-positive and HIV-negative MSM > 18 years old were invited to participate. Provider-performed anal swabs were collected and anal HPV infection was detected using consensus primer solution phase polymerase chain reaction (PCR) followed by type-specific PCR for high-risk (HR)-HPV types 16, 18 and 31. Between-group differences were analysed using χ(2) tests and Wilcoxon rank tests. RESULTS One hundred and ninety-four MSM [mean (standard deviation (SD)) age 36 (10) years; 51% HIV-positive) were recruited. The median number of sexual contacts in the preceding 12 months was 4 (interquartile range 2-10). HIV-positive subjects had a mean (SD) CD4 count of 557 (217) cells/μL, and 84% were on highly active antiretroviral therapy (HAART). Thirty-one samples were B-globin negative and thus excluded from further analysis. A total of 113 subjects (69%) had detectable HPV DNA. Sixty-eight subjects (42%) had an HR-HPV type detected. HR HPV type 16 was detected in 44 samples (27%), HR-HPV type 18 in 26 samples (16%) and HR-HPV type 31 in 14 samples (23%). Twenty-eight subjects (17%) had more than one type of HR-HPV type detected. When HPV and HR-HPV were stratified by age, those > 35 years had a higher prevalence (P = 0.001 and P = 0.028, respectively). HIV-positive subjects were more likely than HIV-negative subjects to have any detectable HPV (77% vs. 61%, respectively; P = 0.04), to have HR-HPV type 18 or 31 (P = 0.05 and P = 0.006, respectively) and to be infected with more than one HR-HPV type (31% vs. 3%, respectively; P < 0.001). Within the HIV-positive group, the prevalence of HPV was higher in those not on HAART (P = 0.041), although it did not differ when stratified by CD4 count. CONCLUSIONS The identified prevalence of anal HPV infection was high. Emerging patterns of HPV-related disease strengthen the call for universal vaccination of boys and girls with consideration of catch-up and targeted vaccination of high-risk groups such as MSM and those with HIV infection.
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Affiliation(s)
- C Sadlier
- Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland
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24
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Albero G, Castellsagué X, Lin HY, Fulp W, Villa LL, Lazcano-Ponce E, Papenfuss M, Abrahamsen M, Salmerón J, Quiterio M, Nyitray AG, Lu B, Bosch FX, Giuliano AR. Male circumcision and the incidence and clearance of genital human papillomavirus (HPV) infection in men: the HPV Infection in men (HIM) cohort study. BMC Infect Dis 2014; 14:75. [PMID: 24517172 PMCID: PMC3925013 DOI: 10.1186/1471-2334-14-75] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/05/2014] [Indexed: 12/05/2022] Open
Abstract
Background Reported associations of male circumcision (MC) with human papillomavirus (HPV) infection in men have been inconsistent. Methods 4,033 healthy men were examined every six months for a median of 17.5 months. In each study visit, exfoliated cell specimens from the coronal sulcus/glans penis, penile shaft, and scrotum were collected and combined into one sample per person for HPV DNA detection. Samples were tested for 37 HPV types. Cox proportional hazards models were used to evaluate the association between MC and the incidence and clearance of HPV infections and specific genotypes. Results The overall incidence of new HPV infections did not differ by MC status (for any HPV, adjusted hazard ratio (aHR) 1.08, 95% confidence interval (CI) 0.91-1.27). However, incidence was significantly lower among circumcised versus uncircumcised men for HPV types 58 (p = 0.01), 68 (p < 0.001), 42 (p = 0.01), 61 (p < 0.001), 71 (p < 0.001), 81 (p = 0.04), and IS39 (p = 0.01), and higher for HPV types 39 (p = 0.01) and 51 (p = 0.02). Despite the lack of an overall association in the risk of HPV clearance by MC (for any HPV, aHR 0.95, 95% CI 0.88-1.02), median times to clearance were significantly shorter among circumcised than uncircumcised men for HPV types 33 (p = 0.02) and 64 (p = 0.04), and longer for HPV types 6 (p < 0.001), 16 (p < 0.001), and 51 (p = 0.02). Conclusions MC is not associated with the incidence and clearance of genital HPV detection, except for certain HPV types. The use of a single combined sample from the penis and scrotum for HPV DNA detection likely limited our ability to identify a true effect of MC at the distal penis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Anna R Giuliano
- H, Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
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Vera-Uehara C, Sánchez-Alemán MA, Uribe-Salas FJ, Ramos-Castañeda J, Olamendi-Portugal ML, Conde-Glez CJ. HPV infection, risk factors and viral load among Mexican male college students. Braz J Infect Dis 2014; 18:71-6. [PMID: 24055311 PMCID: PMC9425270 DOI: 10.1016/j.bjid.2013.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/02/2013] [Accepted: 05/23/2013] [Indexed: 11/28/2022] Open
Abstract
Objectives To determine the prevalence of HPV and the risky sexual behaviors associated to it in a sample of male college students, taking into account genotype and viral load. Methods From 2002 to 2003, male students from the Autonomous University of Morelos State completed a questionnaire and provided self-collected genital samples to detect and quantify HPV. We performed a bivariate and a multivariate logistic regression analysis to identify correlates associated with the infection and to assess the viral load as a function of the viral infecting type. The fragments of β-globin gene and L1 of HPV, were amplified, purified and cloned, to evaluate viral load. Results Among 253 subjects, HPV prevalence was 19.4%, and HPV16 was the most common subtype. History of STIs (OR = 4.8; 95% CI 1.2–18.9), contraceptive pill use by female partner (OR = 2.6; 95% CI 1.1–6.3) and exchanging sex for money (OR = 4.9; 95% CI 1.2–20) were associated to the HPV infection. HPV16 viral load was 7.8 copies (HPV/beta-globin) compared to 0.9 copies for other HPV types. Discussion HPV16 displayed the highest viral load, and it was the most prevalent. It was found that using contraceptive pills by female partners was associated with HPV infection.
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Rosario M, Corliss HL, Everett BG, Reisner SL, Austin SB, Buchting FO, Birkett M. Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys. Am J Public Health 2013; 104:245-54. [PMID: 24328632 DOI: 10.2105/ajph.2013.301506] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES We examined sexual orientation disparities in cancer-related risk behaviors among adolescents. METHODS We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex orientation as sexual minority and the remainder as heterosexual. We compared the groups on risk behaviors and stratified by gender, age (< 15 years and > 14 years), and race/ethnicity. RESULTS Sexual minorities (7.6% of the sample) reported more risk behaviors than heterosexuals for all 12 behaviors (mean = 5.3 vs 3.8; P < .001) and for each risk behavior: odds ratios (ORs) ranged from 1.3 (95% confidence interval [CI] = 1.2, 1.4) to 4.0 (95% CI = 3.6, 4.7), except for a diet low in fruit and vegetables (OR = 0.7; 95% CI = 0.5, 0.8). We found sexual orientation disparities in analyses by gender, followed by age, and then race/ethnicity; they persisted in analyses by gender, age, and race/ethnicity, although findings were nuanced. CONCLUSIONS Data on cancer risk, morbidity, and mortality by sexual orientation are needed to track the potential but unknown burden of cancer among sexual minorities.
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Affiliation(s)
- Margaret Rosario
- Margaret Rosario is with the Department of Psychology, City College and Graduate Center, City University of New York. Heather L. Corliss and S. Bryn Austin are with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA. Bethany G. Everett is with the Department of Sociology, University of Illinois at Chicago. Sari L. Reisner is with the Fenway Institute, Boston. Francisco O. Buchting is with Buchting Consulting, Oakland, CA. Michelle Birkett is with the Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago
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Van Wagoner NJ, Geisler WM, Sizemore JM, Whitley R, Hook EW. Herpes simplex virus in African American heterosexual males: the roles of age and male circumcision. Sex Transm Dis 2013; 37:217-22. [PMID: 19910861 DOI: 10.1097/olq.0b013e3181c17b65] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Male circumcision is protective against human immunodeficiency virus (HIV) and select other STIs. The protective role of male circumcision in genital herpes simplex virus (HSV) infection and disease, however, remains controversial. METHODS We evaluated data from a sample of heterosexual black men attending a sexually transmitted diseases clinic to determine if circumcision status influenced HSV-1 and HSV-2 seroprevalence, clinical genital disease, or asymptomatic shedding. Consenting participants answered questionnaires detailing sexual history, then underwent a focused physical examination, serological testing for HSV-1 and HSV-2, and collection of genital swabs for virus detection. Univariate and multivariate analyses were performed to assess the relationship of circumcision status to HSV seroprevalence. RESULTS Of 460 men, 335 (73%) were circumcised and 125 (27%) were not circumcised; 61% were HSV-1 positive and 46% were HSV-2 positive. HSV-2 seroprevalence did not significantly differ between circumcised and uncircumcised men. However, uncircumcised men had a significantly higher HSV-1 seroprevalence than circumcised men (OR: 1.85; CI: 1.15-2.96). This difference in seroprevalence occurred only in men between 18 and 25 years of age (OR: 2.83; CI: 1.38-5.83) with men over 26 years of age having similar HSV-1 seroprevalence. Lack of circumcision remained independently associated with higher HSV-1 seroprevalence after adjusting for age, years since sexual debut, and lifetime number of sexual partners. For both groups, 20% of men had genital lesions on physical examination. Of circumcised and uncircumcised men with genital lesions, 33% and 31% were actively shedding HSV-1 or HSV-2 from lesions, respectively. Asymptomatic HSV shedding was observed in 12 participants, all of whom were circumcised. CONCLUSIONS Lack of male circumcision is associated with higher HSV-1, but not HSV-2, seroprevalence in young black heterosexual men.
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Affiliation(s)
- Nicholas J Van Wagoner
- Division of Infectious Diseases, Department of Medicine, University of Alabama, Birmingham, AL, USA.
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The prevalence of genital HPV and factors associated with oncogenic HPV among men having sex with men and men having sex with women and men: the HIM study. Sex Transm Dis 2013; 38:932-40. [PMID: 21934568 DOI: 10.1097/olq.0b013e31822154f9] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Comparative studies of genital human papillomavirus (HPV) among men having sex with men (MSM), men having sex with women and men (MSWM), and men having sex with women (MSW) have not been conducted so far; however, such comparisons may be important for planning prevention strategies like vaccination. METHODS Men, aged 18 to 70 years, were enrolled in a study of genital HPV in São Paulo, Brazil; Cuernavaca, Mexico; and Tampa, FL. Men were classified as MSM (n = 170), MSWM (n = 214), and MSW (n = 3326) based on self-reported sexual behavior. Genotyping for HPV was conducted on cells from the penis and scrotum. Prevalence data were adjusted by country. Factors potentially associated with genital HPV were assessed using multivariable Poisson regression. RESULTS Genital HPV prevalence was typically higher among MSWM than among MSM or MSW for groups of HPV genotypes including nononcogenic types (51%, 36%, and 42%, respectively), and multiple types (37%, 24%, and 29%, respectively). Age and alcohol consumption in the past month were associated with oncogenic HPV among both MSM and MSWM; however, there were no statistically significant associations between sexual behaviors and genital HPV among MSM or MSWM. CONCLUSIONS Prevalence of genital HPV may be higher among MSWM than among MSW or MSM. Number of female sex partners was associated with genital HPV among MSW, but number of male anal sex partners was not associated with genital HPV among MSM and MSWM.
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Pierce Campbell CM, Lin HY, Fulp W, Papenfuss MR, Salmerón JJ, Quiterio MM, Lazcano-Ponce E, Villa LL, Giuliano AR. Consistent condom use reduces the genital human papillomavirus burden among high-risk men: the HPV infection in men study. J Infect Dis 2013; 208:373-84. [PMID: 23644283 DOI: 10.1093/infdis/jit191] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Data supporting the efficacy of condoms against human papillomavirus (HPV) infection in males are limited. Therefore, we examined the effect of consistent condom use on genital HPV acquisition and duration of infection. METHODS A prospective analysis was conducted within the HPV Infection in Men Study, a multinational HPV cohort study. Men who were recently sexually active (n = 3323) were stratified on the basis of sexual risk behaviors and partnerships. Using Cox proportional hazards regression, type-specific incidence of HPV infection and clearance were modeled for each risk group to assess independent associations with condom use. RESULTS The risk of HPV acquisition was 2-fold lower among men with no steady sex partner who always used condoms, compared with those who never used condoms (hazard ratio, 0.54), after adjustment for country, age, race, education duration, smoking, alcohol, and number of recent sex partners. The probability of clearing an oncogenic HPV infection was 30% higher among nonmonogamous men who always used condoms with nonsteady sex partners, compared with men who never used condoms (hazard ratio, 1.29), after adjustment for country, age, race, education duration, marital status, smoking, alcohol, and number of recent sex partners. No protective effects of condom use were observed among monogamous men. CONCLUSIONS Condoms should be promoted in combination with HPV vaccination to prevent HPV infection in men.
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Sexually transmitted infections and male circumcision: a systematic review and meta-analysis. ISRN UROLOGY 2013; 2013:109846. [PMID: 23710368 PMCID: PMC3654279 DOI: 10.1155/2013/109846] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/22/2013] [Indexed: 01/19/2023]
Abstract
The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.
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Albero G, Villa LL, Lazcano-Ponce E, Fulp W, Papenfuss MR, Nyitray AG, Lu B, Castellsagué X, Abrahamsen M, Smith D, Bosch FX, Salmerón J, Quiterio M, Giuliano AR. Male circumcision and prevalence of genital human papillomavirus infection in men: a multinational study. BMC Infect Dis 2013; 13:18. [PMID: 23327450 PMCID: PMC3554597 DOI: 10.1186/1471-2334-13-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 01/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accumulated evidence from epidemiological studies and more recently from randomized controlled trials suggests that male circumcision (MC) may substantially protect against genital HPV infection in men. The purpose of this study was to assess the association between MC and genital HPV infection in men in a large multinational study. METHODS A total of 4072 healthy men ages 18-70 years were enrolled in a study conducted in Brazil, Mexico, and the United States. Enrollment samples combining exfoliated cells from the coronal sulcus, glans penis, shaft, and scrotum were analyzed for the presence and genotyping of HPV DNA by PCR and linear array methods. Prevalence ratios (PR) were used to estimate associations between MC and HPV detection adjusting for potential confounders. RESULTS MC was not associated with overall prevalence of any HPV, oncogenic HPV types or unclassified HPV types. However, MC was negatively associated with non-oncogenic HPV infections (PR 0.85, 95% confident interval: 0.76-0.95), in particular for HPV types 11, 40, 61, 71, and 81. HPV 16, 51, 62, and 84 were the most frequently identified genotypes regardless of MC status. CONCLUSIONS This study shows no overall association between MC and genital HPV infections in men, except for certain non-oncogenic HPV types for which a weak association was found. However, the lack of association with MC might be due to the lack of anatomic site specific HPV data, for example the glans penis, the area expected to be most likely protected by MC.
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Affiliation(s)
- Ginesa Albero
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Program (CERP), Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat 08908, Barcelona, Spain
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Figliuolo G, Maia J, Jalkh AP, Miranda AE, Ferreira LC. Prevalence of and risk factors for penile infection by high-risk human papillomavirus among men infected with HIV. J Med Virol 2013; 85:413-8. [DOI: 10.1002/jmv.23505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2012] [Indexed: 11/08/2022]
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Abstract
Male circumcision consists of the surgical removal of some, or all, of the foreskin (or prepuce) from the penis. It is one of the most common procedures in the world. In the United States, the procedure is commonly performed during the newborn period. In 2007, the American Academy of Pediatrics (AAP) convened a multidisciplinary workgroup of AAP members and other stakeholders to evaluate the evidence regarding male circumcision and update the AAP's 1999 recommendations in this area. The Task Force included AAP representatives from specialty areas as well as members of the AAP Board of Directors and liaisons representing the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention. The Task Force members identified selected topics relevant to male circumcision and conducted a critical review of peer-reviewed literature by using the American Heart Association's template for evidence evaluation. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks; furthermore, the benefits of newborn male circumcision justify access to this procedure for families who choose it. Specific benefits from male circumcision were identified for the prevention of urinary tract infections, acquisition of HIV, transmission of some sexually transmitted infections, and penile cancer. Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction. It is imperative that those providing circumcision are adequately trained and that both sterile techniques and effective pain management are used. Significant acute complications are rare. In general, untrained providers who perform circumcisions have more complications than well-trained providers who perform the procedure, regardless of whether the former are physicians, nurses, or traditional religious providers. Parents are entitled to factually correct, nonbiased information about circumcision and should receive this information from clinicians before conception or early in pregnancy, which is when parents typically make circumcision decisions. Parents should determine what is in the best interest of their child. Physicians who counsel families about this decision should provide assistance by explaining the potential benefits and risks and ensuring that parents understand that circumcision is an elective procedure. The Task Force strongly recommends the creation, revision, and enhancement of educational materials to assist parents of male infants with the care of circumcised and uncircumcised penises. The Task Force also strongly recommends the development of educational materials for providers to enhance practitioners' competency in discussing circumcision's benefits and risks with parents. The Task Force made the following recommendations:Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and the benefits of newborn male circumcision justify access to this procedure for those families who choose it. Parents are entitled to factually correct, nonbiased information about circumcision that should be provided before conception and early in pregnancy, when parents are most likely to be weighing the option of circumcision of a male child. Physicians counseling families about elective male circumcision should assist parents by explaining, in a nonbiased manner, the potential benefits and risks and by ensuring that they understand the elective nature of the procedure. Parents should weigh the health benefits and risks in light of their own religious, cultural, and personal preferences, as the medical benefits alone may not outweigh these other considerations for individual families. Parents of newborn boys should be instructed in the care of the penis, regardless of whether the newborn has been circumcised or not. Elective circumcision should be performed only if the infant's condition is stable and healthy. Male circumcision should be performed by trained and competent practitioners, by using sterile techniques and effective pain management. Analgesia is safe and effective in reducing the procedural pain associated with newborn circumcision; thus, adequate analgesia should be provided whenever newborn circumcision is performed.Nonpharmacologic techniques (eg, positioning, sucrose pacifiers) alone are insufficient to prevent procedural and postprocedural pain and are not recommended as the sole method of analgesia. They should be used only as analgesic adjuncts to improve infant comfort during circumcision. If used, topical creams may cause a higher incidence of skin irritation in low birth weight infants, compared with infants of normal weight; penile nerve block techniques should therefore be chosen for this group of newborns. Key professional organizations (AAP, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American Society of Anesthesiologists, the American College of Nurse Midwives, and other midlevel clinicians such as nurse practitioners) should work collaboratively to:Develop standards of trainee proficiency in the performance of anesthetic and procedure techniques, including suturing; Teach the procedure and analgesic techniques during postgraduate training programs; Develop educational materials for clinicians to enhance their own competency in discussing the benefits and risks of circumcision with parents; Offer educational materials to assist parents of male infants with the care of both circumcised and uncircumcised penises. The preventive and public health benefits associated with newborn male circumcision warrant third-party reimbursement of the procedure. The American College of Obstetricians and Gynecologists has endorsed this technical report.
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Jenkins M, Chiriva-Internati M, Mirandola L, Tonroy C, Tedjarati SS, Davis N, D'Cunha N, Tijani L, Hardwick F, Nguyen D, Kast WM, Cobos E. Perspective for prophylaxis and treatment of cervical cancer: an immunological approach. Int Rev Immunol 2012; 31:3-21. [PMID: 22251005 DOI: 10.3109/08830185.2011.637254] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
As the second most common cause of cancer-related death in women, human papilloma virus (HPV) vaccines have been a major step in decreasing the morbidity and mortality associated with cervical cancer. An estimated 490,000 women are diagnosed with cervical cancer each year. Increasing knowledge of the HPV role in the etiology of cervical cancer has led to the development and introduction of HPV-based vaccines for active immunotherapy of cervical cancer. Immunotherapies directed at preventing HPV-persistent infections. These vaccines are already accessible for prophylaxis and in the near future, they will be available for the treatment of preexisting HPV-related neoplastic lesions.
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Affiliation(s)
- Marjorie Jenkins
- Division of Hematology & Oncology, Texas Tech University Health Sciences Center and Southwest Cancer Treatment and Research Center, Lubbock, Texas 79430, USA
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Male circumcision and genital human papillomavirus: a systematic review and meta-analysis. Sex Transm Dis 2012; 39:104-13. [PMID: 22249298 DOI: 10.1097/olq.0b013e3182387abd] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) infection is the principal cause of invasive cervical cancer. There is some evidence that male circumcision (MC) may protect against HPV infection and related disease in both men and women. The purpose of this study was to conduct a systematic review of the literature to assess the association between MC and genital HPV infection indicators including genital warts. METHODS A systematic search of Medline was conducted to identify all relevant studies from February 1971 to August 2010. Effect estimates were included in random effects models. RESULTS A total of 21 studies with 8046 circumcised and 6336 uncircumcised men were included in the meta-analysis. MC was associated with a statistically significant reduced odds of genital HPV prevalence (odds ratio = 0.57, 95% confidence interval: 0.42-0.77). This association was also observed for genital high-risk HPV prevalence in 2 randomized controlled trials (odds ratio = 0.67, 95% confidence interval: 0.54-0.82). No associations were found between MC and genital HPV acquisition of new infections, genital HPV clearance, or genital warts. CONCLUSIONS This meta-analysis shows a robust inverse association between MC and genital HPV prevalence in men. However, more studies are needed to adequately assess the effect of MC on the acquisition and clearance of HPV infections. MC could be considered as an additional one-time preventative intervention likely to reduce the burden of HPV-related diseases both in men and women, particularly among those countries in which HPV vaccination programs and cervical screening are not available.
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Repp KK, Nielson CM, Fu R, Schafer S, Lazcano-Ponce E, Salmerón J, Quiterio M, Villa LL, Giuliano AR. Male human papillomavirus prevalence and association with condom use in Brazil, Mexico, and the United States. J Infect Dis 2012; 205:1287-93. [PMID: 22396601 DOI: 10.1093/infdis/jis181] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Reported associations of condom use and human papillomavirus (HPV) infection have been inconsistent. We investigated self-reported frequency of condom use and detection of genital HPV among men. METHODS A cross-sectional analysis was conducted in men aged 18-70 years from Brazil, Mexico, and the United States. Men completed questionnaires on sexual history, condom use, and sociodemographic characteristics. Among 2621 men reporting recent vaginal sex, prevalence of any HPV, any oncogenic type, and nononcogenic types only was estimated by frequency of condom use ("always" or "not always"). Multivariable models were used to estimate prevalence ratios (PRs) for HPV according to frequency of condom use. RESULTS The prevalence of any HPV was 70.5%; any oncogenic type, 34%, and nononcogenic types only, 22.2%. The adjusted PR for always vs not always using condoms was 0.87 (95% confidence interval [CI], .77-.97) for all countries combined. The association was stronger in the United States (PR, 0.70; CI, .55-.90) than in Brazil (PR, 0.84; CI, .71-1.01) or Mexico (PR, 1.05; CI, .89-1.25) (P for interaction = .025). CONCLUSIONS HPV prevalence was high even among those who reported always using condoms, and its associations with always using condoms varied among countries.
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Affiliation(s)
- Kimberly K Repp
- Department of Public Health and Preventive Medicine, Oregon Health and Science University
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Stock ML, Peterson LM, Houlihan AE, Walsh LA. Influence of oral sex and oral cancer information on young adults' oral sexual-risk cognitions and likelihood of HPV vaccination. JOURNAL OF SEX RESEARCH 2012; 50:95-102. [PMID: 22236342 DOI: 10.1080/00224499.2011.642904] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Public health information and educational interventions regarding human papillomavirus (HPV) have focused on the link between vaginal sex and cervical cancer among women. Many people are unaware that HPV can be transmitted through oral sex or that HPV causes oral cancers. Given that HPV infections and unprotected oral sex are increasing, research on oral sex-related HPV risk is important. This study examined the effect of a brief informational intervention regarding HPV and oral sex on the sexual risk cognitions of young adults. College students (N = 238) read information on HPV, oral sex, and oral cancer or no information. Participants then completed measures of oral sex and HPV knowledge, oral sex willingness, HPV vaccination likelihood, and risk perceptions. Participants who read the information on HPV and oral sex and cancer (compared to those who did not) reported greater knowledge, perceived risk and concern, and lower willingness to engage in oral sex. These effects were only significant among women. However, men reported a higher likelihood of future HPV vaccination compared to women who had not yet received the vaccine. Focusing on oral sex and cancer, this study adds to research investigating ways to reduce HPV infections.
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Affiliation(s)
- Michelle L Stock
- Department of Psychology, George Washington University, Washington, DC 20052, USA.
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Morris BJ, Wodak AD, Mindel A, Schrieber L, Duggan KA, Dilley A, Willcourt RJ, Lowy M, Cooper DA, Lumbers ER, Russell CT, Leeder SR. Infant male circumcision: An evidence-based policy statement. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojpm.2012.21012] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Cardona-Arias J, Puerta-Suárez J, Flórez-Duque J. Prevalencia del virus papiloma humano y sus factores de riesgo en hombres: revisión sistemática. INFECTIO 2011. [DOI: 10.1016/s0123-9392(11)70741-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Larke N, Thomas SL, Dos Santos Silva I, Weiss HA. Male circumcision and human papillomavirus infection in men: a systematic review and meta-analysis. J Infect Dis 2011; 204:1375-90. [PMID: 21965090 DOI: 10.1093/infdis/jir523] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND We systematically reviewed the evidence for an association between male circumcision and Human Papillomavirus (HPV) infection and genital warts in men. METHODS PubMed and Embase were searched to 15 September 2010. The measure of effect was the adjusted odds ratio (OR) or rate ratio (RR) when present and the crude estimate otherwise. Random effects meta-analyses were used to calculate summary measures of effect. RESULTS We identified 23 papers about the association between circumcision and HPV DNA. Circumcised men were less likely to have prevalent genital HPV infection than uncircumcised men (summary OR, 0.57, 95% confidence interval [CI], 0.45-0.71) with between-study heterogeneity (P-heterogeneity = 0.006; I(2) = 50.5%; 19 studies). Similar summary associations were seen in clinical and methodological subgroups. The effect of circumcision was stronger at the glans/corona (OR, 0.47; 95% CI, 0.37-0.60) and urethra (OR, 0.35; 95% CI, 0.12-1.05) compared with sites more distal to the foreskin. There was weak evidence that circumcision was associated with decreased HPV incidence (summary RR, 0.75, 95% CI, 0.57-0.99; 3 studies) and increased HPV clearance (summary RR, 1.33; 95% CI, 0.89-1.98; 3 studies) but no evidence of an association with prevalent genital warts (OR, 0.93, 95% CI, 0.65-1.33; 15 studies). CONCLUSIONS Several countries are expanding access to voluntary medical male circumcision to reduce HIV prevalence. This could provide additional benefit in reducing HPV prevalence.
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Affiliation(s)
- Natasha Larke
- Medical Research Council Tropical Epidemiology Group, United Kingdom.
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Tota JE, Chevarie-Davis M, Richardson LA, Devries M, Franco EL. Epidemiology and burden of HPV infection and related diseases: implications for prevention strategies. Prev Med 2011; 53 Suppl 1:S12-21. [PMID: 21962466 DOI: 10.1016/j.ypmed.2011.08.017] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human papillomavirus (HPV) infection is a necessary, although not sufficient cause of cervical cancer. Globally, HPV infection accounts for an estimated 530,000 cervical cancer cases (~270,000 deaths) annually, with the majority (86% of cases, 88% of deaths) occurring in developing countries. Approximately 90% of anal cancers and a smaller subset (<50%) of other cancers (oropharyngeal, penile, vaginal, vulvar) are also attributed to HPV. In total, HPV accounts for 5.2% of the worldwide cancer burden. HPVs 16 and 18 are responsible for 70% of cervical cancer cases and, especially HPV 16, for a large proportion of other cancers. Prophylactic vaccination targeting these genotypes is therefore expected to have a major impact on the burden of cervical cancer as well as that of other HPV-related cancers. Over the past 50 years, organized or opportunistic screening with Papanicolaou (Pap) cytology has led to major reductions in cervical cancer in most developed countries. However, due to lack of resources or inadequate infrastructure, many countries have failed to reduce cervical cancer mortality through screening. HPV DNA testing recently emerged as a likely candidate to replace Pap cytology for primary screening. It is less prone to human error and more sensitive than Pap in detecting high-grade cervical lesions. For countries with national vaccination programs, HPV testing may also serve as a low cost strategy to monitor long term vaccine efficacy. Introduction of well organized vaccination and screening programs should be a priority for all countries. Increased support from donors is needed to support this cause.
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Affiliation(s)
- Joseph E Tota
- McGill University, Division of Cancer Epidemiology, 546 Pine Avenue West, Montreal, QC, Canada
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No JH, Kim MK, Jeon YT, Kim YB, Song YS. Human papillomavirus vaccine: widening the scope for cancer prevention. Mol Carcinog 2011; 50:244-53. [PMID: 21465574 DOI: 10.1002/mc.20657] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Human papillomavirus (HPV) is the necessary cause of cervical cancer. The HPV oncoproteins E6 and E7 have crucial roles in various steps of carcinogenesis, inducing degradation of p53 and destabilization of pRb. Several clinical trials show that recombinant HPV vaccines are safe and effective in preventing persistent infection of HPV and associated anogenital lesions. Although most clinical studies to date have investigated the effectiveness of HPV vaccines in young female subjects, elderly females and males may also be candidates for HPV vaccines. Prophylactic HPV vaccination may be an ideal preventive method for other HPV-associated cancers in addition to cervical carcinoma. Carcinogenesis by HPV, efficacy trials of currently available HPV vaccines, and the possible roles of HPV vaccines in the prevention of HPV-associated cancers are reviewed in this article.
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Affiliation(s)
- Jae Hong No
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
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Smith JS, Gilbert PA, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of human papillomavirus infection in males: a global review. J Adolesc Health 2011; 48:540-52. [PMID: 21575812 DOI: 10.1016/j.jadohealth.2011.03.010] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/17/2011] [Accepted: 03/19/2011] [Indexed: 11/29/2022]
Abstract
PURPOSE Global data on age-specific prevalence of human papillomavirus (HPV) infection in males, especially for oncogenic HPV types 16 and 18, are essential for future efforts to prevent HPV-related diseases, including expanded access to HPV prophylactic vaccines for boys and young men. METHODS A systematic review of peer-reviewed publications was conducted to summarize worldwide data on genital HPV-DNA prevalence in men. Studies using polymerase chain reaction or hybrid capture detection assays were included. RESULTS Approximately 6,600 abstracts were identified. Of them, 64 reported age-specific HPV prevalence and were included in the review. Of these, 38 were from populations at high risk of HPV infections, such as sexually transmitted infection clinic attendees, human immunodeficiency virus-positive males, and male partners of women with HPV infection or abnormal cytology. The largest proportions of studies were from Europe (38%) and North America (25%), with smaller proportions from Central and South America (19%), Asia (11%), and Africa (5%). Across all regions, data on HPV prevalence were generally limited to men >18 years of age. HPV prevalence was high among sexually active men in all regions but with considerable variation, from 1% to 84% among low-risk men and from 2% to 93% among high-risk men. Peak HPV prevalence spanned a wide range of ages and was generally not concentrated in the younger age groups. Age-specific prevalence curves were relatively flat or declined only slightly following peak prevalence. CONCLUSIONS Genital HPV infection in men varies widely, both between and within high- and low-risk groups and by geographic region. Compared with that in women, HPV prevalence in men seems to peak at slightly older ages and remains constant or decreases slightly with increasing age, suggesting persistent HPV infection or a higher rate of reinfection.
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Affiliation(s)
- Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
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Morris BJ, Gray RH, Castellsague X, Bosch FX, Halperin DT, Waskett JH, Hankins CA. The Strong Protective Effect of Circumcision against Cancer of the Penis. Adv Urol 2011; 2011:812368. [PMID: 21687572 PMCID: PMC3113366 DOI: 10.1155/2011/812368] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/09/2011] [Indexed: 01/30/2023] Open
Abstract
Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV), which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening impeding the passage of urine) is confined to uncircumcised men, in whom balanitis (affecting 10%) is more common than in circumcised men. Each is strongly associated with risk of penile cancer. These findings have led to calls for promotion of male circumcision, especially in infancy, to help reduce the global burden of penile cancer. Even more relevant globally is protection from cervical cancer, which is 10-times more common, being much higher in women with uncircumcised male partners. Male circumcision also provides indirect protection against various other infections in women, along with direct protection for men from a number of genital tract infections, including HIV. Given that adverse consequences of medical male circumcision, especially when performed in infancy, are rare, this simple prophylactic procedure should be promoted.
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Affiliation(s)
- Brian J. Morris
- School of Medical Sciences and Bosch Institute, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ronald H. Gray
- Population and Family Planning, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Xavier Castellsague
- Institut Català d'Oncologia (ICO), IDIBELL, CIBERESP, RTICC, 08908 L'Hospitalet de Llobregat, Catalonia, Spain
| | - F. Xavier Bosch
- Institut Català d'Oncologia (ICO), IDIBELL, CIBERESP, RTICC, 08908 L'Hospitalet de Llobregat, Catalonia, Spain
| | - Daniel T. Halperin
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA
| | - Jake H. Waskett
- Circumcision Independent Reference and Commentary Service, Radcliffe, Manchester M261JR, UK
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Association of low-risk human papillomavirus infection with male circumcision in young men: results from a longitudinal study conducted in Orange Farm (South Africa). Infect Dis Obstet Gynecol 2011; 2011:567408. [PMID: 21584275 PMCID: PMC3092496 DOI: 10.1155/2011/567408] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/08/2010] [Accepted: 02/17/2011] [Indexed: 12/20/2022] Open
Abstract
Background. Low-Risk Human Papillomavirus (LR-HPV) genotypes 6 and 11 cause genital warts. This study investigated the association of LR-HPV infection with male circumcision (MC). Methods. We used data from the South African MC trial conducted among young men. Urethral swabs, collected among intervention (circumcised) and control (uncircumcised) groups, were analyzed using HPV linear array. Adjusted LR-HPV prevalence rate ratio (aPPR) and Poisson mean ratio (aPMR) of number of LR-HPV genotypes were estimated using log-Poisson regression, controlling for background characteristics, sexual behaviour, and HIV and HSV-2 statuses. Results. Compared to controls, LR-HPV prevalence and mean number of genotypes were significantly lower among the intervention group ((8.5% versus 15.8%; aPRR: 0.54, P < .001) and (0.33 versus 0.18; aPMR: 0.54, P < .001), resp.). Mean number of LR-HPV genotypes increased with number of lifetime sexual partners and decreased with education level and consistent condom use. Conclusions. This study shows a reduction in LR-HPV infection among circumcised men.
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Influence of partner's infection status on prevalent human papillomavirus among persons with a new sex partner. Sex Transm Dis 2010; 37:34-40. [PMID: 19704391 DOI: 10.1097/olq.0b013e3181b35693] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We evaluated the influence of the partner's human papillomavirus (HPV) status and sexual practices on prevalent HPV infection among new couples to study HPV transmission. METHODS Women attending university or college in Montreal, Canada, and their male partners (N = 263 couples) were enrolled in 2005-2008. HPV typing was done in self-collected vaginal swabs and clinician-collected penis and scrotum swabs. The outcome measures were overall and type-specific HPV prevalence. RESULTS HPV was detected in 56% of women and men. Prevalence was higher among persons with infected partners (85%) than in those whose partners were negative (19%). Type-specific detection was substantially higher among women (OR = 55.2, 95% CI: 38.0-80.1) and men (OR = 58.7, 95% CI: 39.8-86.3) if their partner harbored the type under consideration. Prevalence among women and men with 10 or more lifetime partners was 15.4 (95% CI: 5.9-40.2) and 9.5 (95% CI: 4.4-19.8) times higher than among those with 1 partner. Frequent condom use was protective in men, particularly if his partner was HPV-infected (OR = 0.64, 95% CI: 0.50-0.82). This effect was attenuated among women with an infected partner (OR = 0.88, 95% CI: 0.69-1.11). CONCLUSIONS The current partner's status was the most important risk factor for prevalent HPV infection. Condoms exerted a stronger protective effect among men than among women.
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Allen JD, Coronado GD, Williams RS, Glenn B, Escoffery C, Fernandez M, Tuff RA, Wilson KM, Mullen PD. A systematic review of measures used in studies of human papillomavirus (HPV) vaccine acceptability. Vaccine 2010; 28:4027-37. [PMID: 20412875 DOI: 10.1016/j.vaccine.2010.03.063] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 03/23/2010] [Accepted: 03/26/2010] [Indexed: 12/31/2022]
Abstract
BACKGROUND The recent proliferation of studies describing factors associated with HPV vaccine acceptability could inform health care providers in improving vaccine coverage and support future research. This review examined measures of HPV and HPV-vaccine knowledge, attitudes, beliefs and acceptability, described psychometric characteristics, and provided recommendations about their use. METHODS A systematic search of Medline, CINAHL, PsychoInfo, and ERIC through May 2008 for English language reports of quantitative data from parents, young adults or adolescents yielded 79 studies. RESULTS The majority of studies were cross-sectional surveys (87%), self-administered (67%), conducted before prophylactic vaccines were publicly available (67%) and utilized convenience samples (65%). Most measured knowledge (80%), general attitudes about HPV vaccination (40%), and willingness to vaccinate one's daughter (26%). Two-thirds did not report reliability or validity of measures. The majority did not specify a theoretical framework. CONCLUSIONS Use of a theoretical framework, consistent labeling of constructs, more rigorous validation of measures, and testing of measures in more diverse samples are needed to yield measurement instruments that will produce findings to guide practitioners in developing successful community and clinical interventions.
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Affiliation(s)
- Jennifer D Allen
- Center for Community-Based Research, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA.
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48
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Hernandez BY, Shvetsov YB, Goodman MT, Wilkens LR, Thompson P, Zhu X, Ning L. Reduced clearance of penile human papillomavirus infection in uncircumcised men. J Infect Dis 2010; 201:1340-3. [PMID: 20350160 DOI: 10.1086/651607] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The relationship between circumcision and the acquisition and clearance of human papillomavirus (HPV) infection was examined in a cohort of 357 men followed up at 2-month intervals for an average of 431 days. There were no differences in HPV acquisition by circumcision status. Clearance of HPV infection, including infection with oncogenic types, was slower in the glans/coronal sulcus of the penis of uncircumcised men than circumcised men. The median duration of HPV infection of the glans/coronal sulcus was significantly longer in uncircumcised men (154 days) than circumcised men (91 days) (P=.04). Circumcision may protect against HPV-associated disease by enhancing the resolution of infection.
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Affiliation(s)
- Brenda Y Hernandez
- Cancer Research Center of Hawaii, 1236 Lauhala St, Honolulu, HI 96813, USA.
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Palefsky JM. Human papillomavirus-related disease in men: not just a women's issue. J Adolesc Health 2010; 46:S12-9. [PMID: 20307839 PMCID: PMC2871537 DOI: 10.1016/j.jadohealth.2010.01.010] [Citation(s) in RCA: 156] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 01/11/2010] [Accepted: 01/11/2010] [Indexed: 11/30/2022]
Abstract
The most common cause of mortality related to human papillomavirus (HPV) infection is cervical cancer. However, male HPV infection is also an important concern, both for the disease burden in men and for the risk of transmission to women. HPV is associated with a variety of cancers in men, including anal cancer and a subset of penile and oral cancers. The incidence of anal and oral cancers related to HPV is increasing in the general population and is growing even faster among individuals who are immunocompromised because of human immunodeficiency virus (HIV) infection. Penile HPV infection is very common among heterosexual men and remains high throughout a wide range of ages. Likewise, anal HPV infection and anal intraepithelial neoplasia are very common throughout a wide range of ages in both HIV-negative and HIV-positive men who have sex with men. Other HPV-related diseases of clinical importance in men include condylomata acuminata (genital warts) and recurrent respiratory papillomatosis. The quadrivalent HPV vaccine has been shown to be highly efficacious in the prevention of genital warts in women and precancerous lesions of the cervix, vulva, and vagina. In addition, recent interim data have shown that the quadrivalent HPV vaccine is highly effective in reducing external genital lesions in young men. Although the protective efficacy of HPV vaccination in men has not yet been fully established-pending the outcome of public policy discussions and cost-efficacy studies-there may be a strong rationale for vaccinating boys, similar to girls, at an early age when they have had limited or no prior sexual activity.
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Affiliation(s)
- Joel M Palefsky
- Department of Medicine, University of California, San Francisco, California 94143, USA.
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Ott MA. Examining the development and sexual behavior of adolescent males. J Adolesc Health 2010; 46:S3-11. [PMID: 20307842 PMCID: PMC2858917 DOI: 10.1016/j.jadohealth.2010.01.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 01/19/2010] [Accepted: 01/21/2010] [Indexed: 11/17/2022]
Abstract
A careful examination of young men's sexuality by health professionals in pediatrics, primary care, and reproductive health is foundational to adolescent male sexual health and healthy development. Through a review of existing published data, this article provides background and a developmental framework for sexual health services for adolescent boys. The article first defines and provides an overview of adolescent boys' sexual health, and then discusses developmentally focused research on the following topics: (1) early romantic relationships and the evolution of power and influence within these relationships; (2) developmental "readiness" for sex and curiosity; (3) boys' need for closeness and intimacy; (4) adopting codes of masculinity; (5) boys' communicating about sex; and (6) contextual influences from peers, families, and providers. This article concludes by examining the implications of these data for sexual health promotion efforts for adolescent males, including human papillomavirus vaccination.
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Affiliation(s)
- Mary A Ott
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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