Epidemiology of genital human papillomavirus infections in sequential male sex partners of young females

Abstract

ABSTRACTObjectivesCouple-based studies have considered human papillomavirus (HPV) transmission between current heterosexual partners (male↔female). Using data from young women and their sequential male partners in the HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) study, we analysed HPV transmission from upstream sexual partnerships (male 1↔female) to downstream sex partners (→male 2).MethodsAmong 502 females enrolled in the HITCH study (2005-2011, Montréal, Canada), 42 brought one male sex partner at baseline (male 1) and another during follow-up (male 2). Female genital samples, collected at 6 visits over 24 months, and male genital samples, collected at 2 visits over 4 months, were tested for 36 HPV types (n=1512 detectable infections). We calculated observed/expected ratios with 95% confidence intervals (CIs) for type-specific HPV concordance between males 1 and 2. Using mixed-effects regression, we estimated odds ratios (ORs) with 95% CIs for male 2 testing positive for the same HPV type as male 1.ResultsDetection of the same HPV type in males 1 and 2 occurred 2.6 times (CI:1.9-3.5) more often than chance. The OR for male 2 positivity was 4.2 (CI:2.5-7.0). Adjusting for the number of times the linking female tested positive for the same HPV type attenuated the relationship between male 1 and 2 positivity, suggesting mediation.ConclusionsHigh type-specific HPV concordance between males 1 and 2 confirms HPV’s transmissibility in chains of sequential young adult sexual partnerships. HPV positivity in an upstream partnership predicted positivity in a downstream male when the linking female partner was persistently positive.