Background: We assessed the accuracy of self obtained HPV specimens in men compared to clinician obtained specimens and determined the prevalence of HPV subtypes at different male genital sites from HM in British Columbia.
Methods: Men were recruited at the Provincial STI clinic in Vancouver, Canada. Participants were randomly assigned to conduct self collection or nurse collected specimens first. Nurses obtained specimens using emery paper followed by saline moistened Dacron swab from three genitourinary sites: glans penis/foreskin, penile shaft (ventral and dorsal surfaces) and scrotum. Participants received written instructions and took specimens from one of the three sites using same technique as clinicians. HPV testing was performed with the Roche Amplicor HPV test (Roche, Canada), and samples found to be reactive were tested with the Roche Linear Array HPV typing assay to establish the HPV genotype(s) in the sample.
Results: Overall prevalence of any HPV genotype from any site was 69.8% in clinician collected specimens, and 55.3% in patient collected specimens. Order of collection (clinician vs patient collected) did not impact on the prevalence of HPV in the specimens. Kappa scores for agreement between clinician and patient collected specimens ranged from fair to excellent. Overall, there was better agreement between patient and clinician collected specimens for HPV-18 (Range: κ = 0.88-0.92) than for HPV-16 (Range: κ=036-0.62).
Conclusion: HPV is a prevalent genital tract infection in men. Site specific agreement for specific HPV genotypes between clinicians and patients varied broadly, and neither clinicians nor patients routinely obtained samples with consistently higher or lower prevalences at specific genital sites, indicating there are continued opportunities to improve techniques for self collected male specimens for HPV.
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