HPV Infection In Men #3
Circumcision does not appear to confer reduction of risk of persistent infection with non-oncogenic HPV.
Circumcision is protective against HPV persistence. Men who are circumcised are able to spontaneously clear themselves of an HPV infection to a much greater extent then men who are not circumcised.
The greater number of lifetime sexual partners increases a man’s chance of clearing himself of high risk oncogenic HPV infection.
Men with a larger (greater than 16) lifetime number of sexual partners were 5 x more likely to clear high risk oncogenic HPV infection than men with a few number of partners.
The presence of multiple HPV infections is associated with increased risk of persistent infection.
Number of recent sexual partners is the most important risk for acquisition of HPV infection in men.
There is approximately a 30% chance of a man who is 18-44 years old who did not initially have an HPV infection will acquire an HPV infection over a 12 month period of time.
There is over a 60% chance that a young male university student will start out with no detectable HPV infection and acquire an HPV infection over a 24 month period of time.
The factors associated with HPV infection in men include lifetime number of sexual partners, number of recent sexual contacts, circumcision status, age of first sexual intercourse, condom use, smoking status, sexual frequency and the presence of genital warts all are associated with prevalent HPV infection.
The reduction in risk of HPV infection in circumcised men ranges from 60% to 80%.
The key factor associated with acquisition of HPV infection in men is lifetime number of sex partners.
Suggestive mechanisms by which circumcision may protect against persistence HPV include improved penile hygiene, keratinization of the epithelium and of the glands of penis in circumcised men which may confer resistance to abrasion during sexual intercourse. This would make men less susceptible to viral entry through abrasions under skin surface, viral shedding, and viral persistence.
Circumcision is the most significant determinant for clearance of getting an HPV infection, including infections caused by oncogenic high-risk strains.
Lifetime number of sexual partners is the most significant factor of acquisition of all categories of HPV (any, high-risk strains and low-risk strains).
Circumcision is strongly associated with clearance of any HPV infection and in addition with the clearance of high risk oncogenic HPV infection.
The lifetime number of sexual partners is significantly associated with the prevalence of oncogenic HPV infection. The greater number of lifetime sexual partners a person has the greater chance of them being a carrier of high risk HPV strains.
The increase in sexual exposure to congenital HPV infections overtime is indicated by lifetime number of sexual partners may be associated with the increasing antibodies that are able to respond to infection. Men who have had a greater lifetime number of sexual partners may be more likely to be able to detect a meaningful antibody response, something that has been observed in most women but not in men who have had a fewer number of sexual partners.
The reduction in risk of a man who is circumcised having an HPV infection can be the result of decreased acquisition of HPV infection, decreased persistence of HPV infection, or an interaction of both.
