Prevalence and incidence of anal human papillomavirus infection in Mexican men: Need for universal prevention policies

Salud Publica Mex. 2018 Nov-Dec;60(6):645-652. doi: 10.21149/8454.


Objective: Describe the natural history of anal HPV among men.

Materials and methods: Prospective study among men 18-70 years (n=665), from Cuernavaca, Mexico who completed questionnaires and provided specimens (HPV genotyped) at enrollment and 1+ follow-up visit. HPV prevalence and incidence were estimated. Prevalence ratios were calculated with Poisson regression using robust variance estimation. Person-time for incident HPV infection was estimated using number of events modeled as Poisson variable for total person-months.

Results: Anal infection prevalence: any HPV type=15%, high-risk=8.4%, HPV16=1.4%, tetravalent vaccine types (4vHPV)=4.4%, nonavalent vaccine types (9vHPV)=6.3%. Factors associated with prevalence: 50+ lifetime female sex partners (adjusted prevalence ratio, a PR=3.25, 95% CI:1.12- 9.47), 10+ lifetime male sex partners (aPR=3.06, 95%CI:1.4- 6.68), and 1+ recent male anal sex partners (aPR=2.28, 95%CI:1.15-4.5). Anal incidence rate: high-risk HPV=7.8/1000 person-months (95%CI:6.0-10.1), HPV16=1.8/1000 personmonths (95%CI:1.1-2.9),4vHPV=3.4/1000 person-months (95%CI:2.3-4.9) and 9vHPV=5.5/1000 person-months (95%CI:4.1-7.5).

Conclusions: Implementation of universal HPV vaccination programs, including men, is a public health priority.

Objetivo: Generar evidencia que apoye la vacunación universal contra VPH.

Material y métodos: Estudio prospectivo con hombres 18-70 años (n=665) de Cuernavaca, México con cuestionarios y genotipificación de VPH en muestras (2+mediciones). Se estimó prevalencia e incidencia; se calcularon tasas de prevalencia con regresión Poisson. Se estimó persona-tiempo para infecciones incidentes.

Resultados: Prevalencia de infección anal: cualquier tipo de VPH=15%, altoriesgo=8.4%, VPH16=1.4%, tipos en vacuna tetravalente=4.4% y tipos en vacuna nonavalente=6.3%. Factores asociados con infección prevalente: 50+ parejas sexuales femeninas en la vida (tasa de prevalencia ajustada, TPa=3.25, IC95%:1.12-9.47); 10+ parejas sexuales masculinas en la vida (TPa=3.06, IC95%:1.4- 6.68) y 1+ parejas masculinas (sexo anal) recientes (TPa=2.28, IC95%:1.15-4.5). Tasas de incidencia para infección anal: VPH alto-riesgo=7.8/1000 persona-meses (IC95%:6.0-10.1), VPH 16=1.8/1000 persona-meses (95%IC:1.1-2.9), tipos en vacuna tetravalente=3.4/1000 persona-meses y tipos en vacuna nonavalente=5.5/1000 persona-meses.

Conclusiones: mplementación de programas de vacunación universal (incluyendo hombres) contra VPH es una prioridad en salud pública.

Keywords: anal canal; apillomavirus vaccines; human papilloma virus; incidence; men; prevalence.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcohol Drinking / epidemiology
  • Anus Diseases / epidemiology*
  • Anus Diseases / virology
  • Circumcision, Male / statistics & numerical data
  • Condylomata Acuminata / epidemiology
  • Follow-Up Studies
  • Health Priorities
  • Humans
  • Incidence
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Vaccines
  • Prevalence
  • Procedures and Techniques Utilization
  • Prospective Studies
  • Sexual Partners
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • Unsafe Sex
  • Vaccination / statistics & numerical data
  • Young Adult


  • Papillomavirus Vaccines