Background Human papillomavirus is a common STI which causes genital warts and cancers in males. Studies of HPV in adult males are underway, but the epidemiology and natural history of HPV in adolescent males has not been investigated. The purpose of this study is to describe genital and oral HPV infections in young men.
Methods A subset of young men was recruited from an ongoing study of the male adolescent penile and urethral microbiome and sexual behaviours. Participant consent and parental permission were obtained. This study was approved by the Institutional Review Board at Indiana University. Approximately every 3 months, genital swabs and an oral rinse sample were collected from each participant. Genital swabs were collected using saline wetted cotton swabs rubbed over the entire skin surface of the participant's glans penis, penile shaft, and scrotum. Participants provided oral samples by a swish and spit method using 15 ml of mouthwash. Samples were tested for HPV using the 37 HPV type Linear Array HPV Genotyping Test (Roche). Participants completed daily cell phone diary entries and quarterly surveys about their sexual behaviours. Descriptive statistical analysis was performed using SPSS.
Results A total of 34 adolescent males were recruited, ages 14–18 at enrolment (mean 15.8; SD 1.18). The racial/ethnic identity of participants was: 19 (55.9%) black, 12 (35.3%) white, and 3(8.8%) other. At the time of their first HPV sample collection, 19 participants (55.9%) reported ever having vaginal sex, 8 participants (23.5%) reported ever giving oral sex, 16 participants (47.1%) reported ever receiving oral sex, and 5 (14.7%) reported ever having anal sex. In their enrolment genital samples, HPV (high risk (HR) plus low risk (LR)) was detected in 13 of 34 participants (38.2%); HR types were detected in nine participants and LR types were detected in eight participants. Seven participants had >1 HPV type. HPV was detected in both sexually active participants and those denying prior sexual contact. One participant had trichomonas at enrolment; no participants had gonorrhoea or chlamydia. In the enrolment oral samples, HPV was detected in one participant (HPV 6).
Conclusions This study provides the first information about HPV genital and oral infections in adolescent males. Genital HPV can be detected in adolescent males, and is not predicted by prior vaginal or oral sex. Oral HPV was infrequently detected in this small sample.
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