J, 39, was upset when he was told that his wife had a high-risk Human Papilloma Virus (HPV) in her cervical screening test recently. “Doc, how could she get the virus when we are in a stable relationship?” he asked. “Can I have the HPV test done on me? What impact will the infection have on my health should I get it?” Prevalence of HPV in Men
HPV infection is the most common sexually transmitted infection in the world. Much of the information about HPV centres on women, since having the virus increases their risk of getting cervical cancer.
In fact, research studies have found that men are more likely to be infected with HPV than women, and they are more likely to be infected with high-risk HPV. A new study published in The Lancet Global Health in 2023 has shown that almost 1 in 3 men over the age of 15 are infected with at least one genital human papillomavirus (HPV) type, and 1 in 5 are infected with one or more of high-risk HPV that can cause cancer. Transmission of HPV
HPV is highly contagious. It is transmitted through skin-to-skin contact during vaginal, anal, or oral sex with someone who has the virus. It can also be transmitted through non-penetrative sex. Rarely, it can spread via fomites such as contaminated toilet seats or towels.
HPV infection can occur even in a monogamous marriage. For some unknown reasons, the virus can remain dormant and become active years later by showing up at the cervical screening test. It is thus impossible to work out when someone first came into contact with it, and/or when it became an active infection. Symptoms of HPV infection
HPV infection usually does not have symptoms. The infection usually goes away by itself. But, if infection persists, it can cause genital warts or cancer of the throat, penis or anus.
Symptoms include:
Genital warts
Lumps or sores around the head and neck region e.g. throat, and at the anus and external genitalia
While penile and anal cancers are rare, cancers in the throat are the most common HPV-related cancers found in men. Tests for HPV Infection in Men
There is currently no routine HPV test available for men as the test has yielded inconsistent results. This is because it is difficult to get a good cell sample to test from the thick skin on the penis. Most people will not have visible symptoms. Prevention of HPV infection
Abstinence is the only sure way to prevent HPV transmission. Risk of transmission can be lowered if a person has sex only with one person who is not infected and who is also monogamous.
Condoms can provide some protection against HPV transmission. Unfortunately, they are not 100% effective, since HPV is transmitted primarily by skin-to-skin contact. The virus can still infect skin which is not covered by the condom.
HPV vaccination. At present, the vaccine available is Gardasil 9. It protects against seven out of twenty high-risk types of HPV associated with cancer (types 16, 18, 31, 33, 45, 52, and 58) and two low-risk types associated with genital warts (types 6 and 11). Thus, it does not offer full protection for cancer. Continuous surveillance is still important.
J understood the implications and impact of HPV infection on reproductive health. He requested vaccination to improve his immunity against the virus and would update me should he discover any unusual sores or lumps in his external genitalia.