Comparison of the Natural History of Genital HPV Infection among Men by Country: Brazil, Mexico, and the United States

<b>Background:</b> Male genital human papillomavirus (HPV) prevalence and incidence has been reported to vary by geographical location. Our objective was to assess the natural history of genital HPV by country among men with a median of 48 months of follow-up.<b>Methods:</b> Men ages 18-70 years were recruited from United States (<i>n</i> = 1,326), Mexico (<i>n</i> = 1,349), and Brazil (<i>n</i> = 1,410). Genital specimens were collected every 6 months and HPV genotyping identified 37 HPV genotypes. Prevalence of HPV was compared between the three countries using the Fisher exact test. Incidence rates and 95% confidence intervals were calculated. The median time to HPV clearance among men with an incident infection was estimated using the Kaplan-Meier method.<b>Results:</b> The prevalence and incidence of the genital HPV types known to cause disease in males (HPV 16 and 6) was significantly higher among men from Brazil than men from Mexico. Prevalence and incidence of those genital HPV types in the United States varied between being comparable with those of Mexico or Brazil. Although genital HPV16 duration was significantly longer in Brazil (<i>P</i> = 0.04) compared with Mexico and the United States, HPV6 duration was shortest in Brazil (<i>P</i> = 0.03) compared with Mexico and the United States.<b>Conclusions:</b> Men in Brazil and Mexico often have similar, if not higher prevalence of HPV compared with men from the United States.<b>Impact:</b> Currently, there is no routine screening for genital HPV among males and while HPV is common in men, and most naturally clear the infection, a proportion of men do develop HPV-related diseases. Men may benefit from gender-neutral vaccine policies. <i>Cancer Epidemiol Biomarkers Prev; 26(7); 1043-52. ©2017 AACR</i>.