November 2023 | George M. Pikler, M.D., Ph.D., FACP
The human papillomavirus (HPV) is the most common sexually transmitted biological agent and is the cause of many conditions in men and women, including precancer lesions and cancer.
The HPV vaccine can protect against cancers in men and women, but it is being given to boys and men in only one-third of the countries where it is available. The argument is that vaccinating only women creates a herd-immunity effect that also protects men. But this approach provides little protection for men who have sex with men. Critics say it also unfairly stigmatizes women for infecting men with HPV, when men are also a reservoir for the disease.
Almost one in three men worldwide are infected with at least one genital HPV type and around one in five men are infected with one or more of the twelve HR (high-risk)-HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56,. 58, and 59).
A systematic review and meta-analysis to assess the prevalence of genital HPV infection in the general male population was reported in a recent article (1). This was a global, and regional pooled overall, type-specific, and age-specific prevalence estimate of genital HPV infection in men. The authors searched Embase, Ovid MEDLINE, and the Global Index Medicus for studies published between Jan 1, 1995, and June 1, 2022. It reports that HPV prevalence is high in men over the age of 15 years and supports sexually active men, regardless of age, are an important reservoir of HPV genital infection.
These estimates emphasize the importance of incorporating men in comprehensive HPV prevention strategies to reduce HPV-related morbidity and mortality in men and ultimately achieve elimination of cervical cancer and other HPV-related diseases. (2)
