Rayleen M Lewis, Sarah K Brewer, Julia W Gargano, Troy D Querec, Elizabeth R Unger, Lauri E Markowitz
{"title":"2013-2016年美国性经历成年男性中高危HPV患病率与包皮环切状况的关系","authors":"Rayleen M Lewis, Sarah K Brewer, Julia W Gargano, Troy D Querec, Elizabeth R Unger, Lauri E Markowitz","doi":"10.1097/OLQ.0000000000002207","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Randomized control trials in sub-Saharan countries found that male circumcision may prevent high-risk human papillomavirus (HR-HPV) acquisition. Using 2013-2016 National Health and Nutrition Examination Survey data, we explored the association between circumcision and HR-HPV among sexually experienced 18- to 59-year-old men.</p><p><strong>Methods: </strong>Self-collected penile specimens were tested for HPV DNA. We estimated weighted HR-HPV prevalence (positivity to ≥1 HR type: HPV-16/18/31/33/35/39/45/51/52/56/58/59/66/68) by circumcision status. The association between circumcision and HR-HPV was assessed using multivariable logistic regression models. Effect modification by circumcision on the association between number of lifetime sex partners and HR-HPV was explored.</p><p><strong>Results: </strong>Overall, 77.7% of men reported being circumcised, with large variation by race/ethnicity and country of birth. High-risk HPV prevalence was significantly higher among circumcised (25.7%) than uncircumcised (20.4%) men; this was attenuated after adjustment for lifetime and new past-year sex partners (adjusted prevalence ratio, 1.10; 95% confidence interval, 0.92-1.32). There was evidence that circumcision modified the association between lifetime partners and HR-HPV, but HR-HPV prevalence increased with increasing number of partners in circumcised and uncircumcised men.</p><p><strong>Conclusions: </strong>Our observed lack of statistical association between circumcision and HR-HPV may differ from randomized trial results because of the differences between circumcised and uncircumcised men or differences in anatomic site sampled or timing of circumcision.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"699-705"},"PeriodicalIF":1.7000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302073/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association Between High-Risk Human Papillomavirus Prevalence and Circumcision Status Among Sexually Experienced Adult Men, 2013 to 2016, United States.\",\"authors\":\"Rayleen M Lewis, Sarah K Brewer, Julia W Gargano, Troy D Querec, Elizabeth R Unger, Lauri E Markowitz\",\"doi\":\"10.1097/OLQ.0000000000002207\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Randomized control trials in sub-Saharan countries found that male circumcision may prevent high-risk human papillomavirus (HR-HPV) acquisition. Using 2013-2016 National Health and Nutrition Examination Survey data, we explored the association between circumcision and HR-HPV among sexually experienced 18- to 59-year-old men.</p><p><strong>Methods: </strong>Self-collected penile specimens were tested for HPV DNA. We estimated weighted HR-HPV prevalence (positivity to ≥1 HR type: HPV-16/18/31/33/35/39/45/51/52/56/58/59/66/68) by circumcision status. The association between circumcision and HR-HPV was assessed using multivariable logistic regression models. Effect modification by circumcision on the association between number of lifetime sex partners and HR-HPV was explored.</p><p><strong>Results: </strong>Overall, 77.7% of men reported being circumcised, with large variation by race/ethnicity and country of birth. High-risk HPV prevalence was significantly higher among circumcised (25.7%) than uncircumcised (20.4%) men; this was attenuated after adjustment for lifetime and new past-year sex partners (adjusted prevalence ratio, 1.10; 95% confidence interval, 0.92-1.32). There was evidence that circumcision modified the association between lifetime partners and HR-HPV, but HR-HPV prevalence increased with increasing number of partners in circumcised and uncircumcised men.</p><p><strong>Conclusions: </strong>Our observed lack of statistical association between circumcision and HR-HPV may differ from randomized trial results because of the differences between circumcised and uncircumcised men or differences in anatomic site sampled or timing of circumcision.</p>\",\"PeriodicalId\":21837,\"journal\":{\"name\":\"Sexually transmitted diseases\",\"volume\":\" \",\"pages\":\"699-705\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302073/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sexually transmitted diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/OLQ.0000000000002207\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexually transmitted diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/OLQ.0000000000002207","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Association Between High-Risk Human Papillomavirus Prevalence and Circumcision Status Among Sexually Experienced Adult Men, 2013 to 2016, United States.
Background: Randomized control trials in sub-Saharan countries found that male circumcision may prevent high-risk human papillomavirus (HR-HPV) acquisition. Using 2013-2016 National Health and Nutrition Examination Survey data, we explored the association between circumcision and HR-HPV among sexually experienced 18- to 59-year-old men.
Methods: Self-collected penile specimens were tested for HPV DNA. We estimated weighted HR-HPV prevalence (positivity to ≥1 HR type: HPV-16/18/31/33/35/39/45/51/52/56/58/59/66/68) by circumcision status. The association between circumcision and HR-HPV was assessed using multivariable logistic regression models. Effect modification by circumcision on the association between number of lifetime sex partners and HR-HPV was explored.
Results: Overall, 77.7% of men reported being circumcised, with large variation by race/ethnicity and country of birth. High-risk HPV prevalence was significantly higher among circumcised (25.7%) than uncircumcised (20.4%) men; this was attenuated after adjustment for lifetime and new past-year sex partners (adjusted prevalence ratio, 1.10; 95% confidence interval, 0.92-1.32). There was evidence that circumcision modified the association between lifetime partners and HR-HPV, but HR-HPV prevalence increased with increasing number of partners in circumcised and uncircumcised men.
Conclusions: Our observed lack of statistical association between circumcision and HR-HPV may differ from randomized trial results because of the differences between circumcised and uncircumcised men or differences in anatomic site sampled or timing of circumcision.
期刊介绍:
Sexually Transmitted Diseases, the official journal of the American Sexually Transmitted Diseases Association, publishes peer-reviewed, original articles on clinical, laboratory, immunologic, epidemiologic, behavioral, public health, and historical topics pertaining to sexually transmitted diseases and related fields. Reports from the CDC and NIH provide up-to-the-minute information. A highly respected editorial board is composed of prominent scientists who are leaders in this rapidly changing field. Included in each issue are studies and developments from around the world.