Background: Epidemiological research has shown that HPV infection is highly prevalent in sexually active men. This may lead to long-term consequences derived from HPV-related cancers among men and women. Therefore, an understanding of male HPV infection in a sexually active high risk group is important in terms of reducing transmission of HPV to both men and women.

Study Objectives: To develop an epidemiological profile of high-risk men attending a Sexually Transmitted Infection (STI) clinic Centro Latino Americano de Enfermedades de Transmisión Sexual (CLETS) in Puerto Rico and describe HPV-related knowledge within this group.

Methods: A cross-sectional study consisting of 206 HIV+/HIV-men 18 years and older was conducted. Subjects participated in a behavioral interview. Domains evaluated included demographic characteristics, sexual risk, and assessments of alcohol, cigarette and drug-related risk. A supplemental questionnaire, which evaluated the study participant's HPV knowledge, perceived risk and vaccine acceptability, was also administered. Those participants who reported having high-risk sexual practices (unprotected vaginal sex) in the last 90 days were categorized as high-risk men (n=44). Descriptive statistics analyses were performed in order to describe an epidemiological profile of high-risk men attending the clinic, their knowledge of HPV and related malignancies (anal, oral and penile cancer). Bivariate analysis was performed to compare high-risk (n=44) and low-risk (n=162) men in relation to HPV knowledge.

Results: Of the total study sample (n=206), 21.4% reported having high-risk sexual practices within the last 90 days prior to the interview. The mean age among high-risk sexual men was 33.0±12.0 years, in which 27.3% were men younger than 25 years old. Sociodemographic characteristics evidenced that the clinic population comes from a disadvantaged background, in which 68.1% have less than high school education, 36.4% are unemployed and 27.3% have no medical insurance. Less than half (47.7%) of the high-risk men in this sample were married. A high prevalence of alcohol, tobacco and illegal drug use was reported, with 59.1%, 70.5% and 34.1% reporting using tobacco, alcohol and illegal drugs in the last 90 days, respectively. Approximately a third of study participants (32.0%) reported having more than 2 sexual partners in the last 90 days. When evaluating specific-item related HPV knowledge, 100% of the high-risk men reported correct knowledge about HPV risk factors, yet 5% of them reported incorrect items related to knowledge of HPV infection (HPV is transmitted by skin-to skin contact (55% answered incorrectly); most of HPV infections disappear in a short period of time (60% answered incorrectly); and 15% incorrectly reported knowledge regarding HPV symptoms. Bivariate analysis showed that when compared to those men in the low sex-risk category; both groups were comparable in relation to their HPV knowledge (p-value=0.424)

Conclusions: High-risk men attending this STI clinic are likely to be young, uninsured and poor. More than half of the participants were unaware of HPV infection yet reported high sexual and drug practices that might put their sexual partners at risk for HPV infection. Among those men who knew about HPV, their knowledge about HPV risk factors related to sexual practices was high. However, increasing their knowledge regarding long-term consequences regarding exposure with HPV is necessary. Comparable HPV knowledge between high-and low-risk sex groups highlights the potential for increasing knowledge of HPV as well as cancer prevention and control strategies between two groups. Therefore, this STI clinic scenario will help us to strategically intervene among high-risk men and their partners in order to develop intervention aiming to prevent chronic clinical manifestations, primarily among vulnerable and underserved men in Puerto Rico.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B84.