Penile HPV prevalence and associated factors among 20–70-year-old men in Sri Lanka: A Study in a Lower& Middle-Income Country

Background Human papillomavirus (HPV) is the most common sexually transmitted infection globally. Each year, persistent High Risk (HR) HPV infection causes 69,400 cancers in males, with a rising incidence across the world. While contributing significantly to the disease burden in men and plays a crucial role in transmitting the infection to women. Estimating male HPV genotype prevalence and associated factors is crucial for developing effective HPV preventive strategies. Method A community-based descriptive-cross-sectional study was conducted to estimate the penile HPV prevalence and identify the significant associated factors for HPV infection among 20–70-year-old clinically normal men in Sri Lanka. Multi-stage probability proportionate cluster sampling was done to recruit a sample of 579 study subjects. The chi-square test was used with a significance level of p < 0.05, and bivariate analysis followed by multivariate (logistic regression) analysis was conducted to explore possible determinants of HPV infection and calculate adjusted Odds Ratios (OR). Results Penile HPV genotype prevalence for any genotype was 5.7% (n = 33, 95% CI:3.9–7.9) and HR genotype prevalence was 1.7% (n = 10 ,95% CI: 0.3–3.1) among clinically normal men. Identified HR HPV genotypes were HPV-59 (n = 4), HPV-16 (n = 3), HPV-45 (n = 2) and HPV-33 (n = 1) however, HPV-18 was not detected. The significant associated factors for HPV infection were having > 1 female partner/s lifetime (p = 0.02) (Adjusted OR, 2.4,95%CI:1.1–4.9) and having sexual relationships being unmarried (p = 0.04) (Adjusted OR, 3.5,95% CI:1.04–12.1). Conclusion High-risk sexual behaviours are significantly associated with HPV infection. Promoting safe sex practices, along with ongoing detection and monitoring of vaccine-preventable HPV genotypes among males are vital for decision-making for HPV preventive strategies.