PREVALENCE AND RISK-FACTORS OF GENITAL HUMAN PAPILLOMAVIRUS (HPV) INFECTIONS IN HEALTHY-MALES - A STUDY ON FINNISH CONSCRIPTS

Background and objectives: Prevalence of genital human papillomavirus (HPV) infection in the general population is not known. No one test al one can detect all HPV infections. Goal of this study: To determine th e prevalence of and risk factors for genital human papillomavirus (HPV ) infections in healthy males. Voluntary Finnish Army conscripts were examined using peniscopy, cytology (PAP smear) and polymerase chain re action (PCR) in brush cytology samples. Study design: A total of 1,471 (99.6%) males completed the questionnaire soliciting their sexual hab its, and 432 of them enrolled in the clinical study. Results: The stud y group differed from the nonattenders in that they reported more ofte n genitourinary symptoms (P < 0.001), had more casual sexual partners (P = 0.002), and previous STDs (P < 0.001). Classical genital warts we re present in 24/432 (5.6%) and papular lesions in 8/432 (1.9%) males. Acetowhite lesions were disclosed in 151/432 (35.0%) cases, of which 61 (14.1%) had peniscopically typical flat HPV lesions. Koilocytes wer e found in 13/201 (6.5%) PAP smears. HPV DNA was disclosed by PCR in 1 6.5% (47/285) of the adequate cell smears, and in 7.1% of the males wi th no peniscopic abnormalities. When considering the men with HPV-posi tive PCR findings and/or typical peniscopic pattern as HPV-infected (2 6.2%), many casual partners, previous STDs and no use of condom were s ignificant risk factors for genital HPV infections in the logistic reg ression analysis. Conclusions: The reliable assessment of the prevalen ce of genital HPV infections in healthy males is not only skewed by th e selection of the study group by symptoms and promiscuity, but also b y the lack of a universally acceptable screening method. The data conf irm sexual promiscuity as the most important risk factor for genital H PV infections.