HPV Screening and Prevention for Men: Key Insights

Male HPV screening and

Dear Director Huang,
I would like to explain my experience with gynecological outpatient visits.

a.
In 2019 and 2020, I underwent Pap smear tests, and the results were negative for intraepithelial lesion or malignancy, with findings indicating reactive changes: inflammation, repair, radiation, and others.
After the 2020 examination, the physician diagnosed no cancer cells but noted vaginal inflammation, which was subsequently treated.
b.
In August 2022, I completed the three doses of the nine-valent HPV vaccine.
c.
In early May of this year (2023), I underwent a self-paid health check, which included a thin-layer Pap smear and HPV testing.
The results showed positive for HPV type 16 and another type (the hospital did not specify which type), along with ASCUS.
The physician has arranged for a colposcopy to further assess the situation.
I would like to ask you:
1.
Based on the experiences I provided, do the abnormal Pap smear results from 2019 or 2020 indicate that I may have already had HPV at that time? (I am concerned that I may have been infected with HPV for several years without detection...)
2.
I understand that after receiving the nine-valent HPV vaccine, its effectiveness may diminish after about 8 years, necessitating a booster.
I would like to know if, after completing this vaccination series, I could potentially be reinfected with the same type of HPV? (In other words, would receiving the HPV vaccine again still not provide protection against type 16?)
Additionally, since my partner has not yet received the HPV vaccine (but will do so soon), I am uncertain about whether he is also infected with HPV and am concerned about the possibility of cross-infection in the future.
Therefore, I would like to ask:
3.
How can males be screened for HPV?
4.
What treatment should both partners undergo to prevent future cross-infection?
Thank you in advance for your response! Wishing you smooth consultations.

Xiang, 20~29 year old female. Ask Date: 2023/05/18

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
HPV may not necessarily be present at that time; even if HPV is present, regular Pap smears are sufficient.
2.
It is possible, but the chances are very low.
3.
The same local sampling applies.
4.
After receiving the vaccine, maintaining local hygiene and having regular Pap smears is all that is needed.

Reply Date: 2023/05/18

More Info

Human Papillomavirus (HPV) is a significant public health concern that affects both men and women. While much of the focus has traditionally been on women due to the link between HPV and cervical cancer, it is crucial for men to also be aware of HPV, its potential health implications, and the importance of screening and vaccination.

1. HPV Detection in Previous Pap Smears: Regarding your concern about whether the abnormal Pap smear results from 2019 indicated a prior HPV infection, it is important to note that not all abnormal results are directly indicative of HPV. The findings of "Reactive changes: Inflammation, repair, radiation, and others" suggest that there was some form of irritation or inflammation, but it does not confirm the presence of HPV. HPV can remain dormant for years without causing noticeable symptoms, so it is possible that you may have been infected at some point without it being detected. Regular screenings are essential for monitoring any changes over time.

2. Re-infection After Vaccination: The nine-valent HPV vaccine is designed to protect against nine strains of HPV, including the high-risk types that can lead to cancer. While the vaccine significantly reduces the risk of infection, it does not provide 100% protection against all strains, especially if a person has already been exposed to a type before vaccination. After completing the vaccination series, the likelihood of re-infection with the same type of HPV is low, but not impossible. The vaccine's effectiveness can wane over time, which is why booster doses may be recommended in the future.

3. HPV Screening for Men: Currently, there is no routine HPV screening test for men like there is for women. However, men can be evaluated for HPV-related conditions, such as genital warts or lesions, through physical examination by a healthcare provider. If a man has symptoms or a partner with known HPV, he should consult a healthcare professional, such as a urologist or an infectious disease specialist, for further evaluation. In some cases, anal Pap smears may be recommended for men who are at higher risk, such as those with HIV or men who have sex with men.

4. Preventing Cross-Transmission: To prevent cross-infection between partners, both individuals should be vaccinated against HPV if they have not already done so. This is particularly important if one partner has been diagnosed with HPV. Practicing safe sex, including the use of condoms, can reduce the risk of HPV transmission, although it does not eliminate it entirely since HPV can be present in areas not covered by condoms. Regular health check-ups and open communication about sexual health are vital for both partners.

In conclusion, HPV is a significant health issue that requires attention from both men and women. Regular screenings, vaccinations, and safe sexual practices are essential components of prevention and management. If you have further concerns about HPV or your health, it is advisable to consult with a healthcare provider who can offer personalized guidance and support.

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