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Volume 14, Number 6—June 2008

CME ACTIVITY - Research

Transmission of Human Papillomavirus in Heterosexual Couples

Brenda Y. Hernandez*Comments to Author , Lynne R. Wilkens*, Xuemei Zhu*, Pamela Thompson*, Katharine McDuffie*, Yurii B. Shvetsov*, Lori E. Kamemoto†, Jeffrey Killeen‡, Lily Ning*, and Marc T. Goodman*
Author affiliations: *University of Hawaii, Manoa, Hawaii, USA; †University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, USA; ‡Kapi'olani Medical Center for Women and Children, Honolulu, Hawaii, USA;

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Table 2

Rate of HPV transmission by source and target site in male-female couples*

Source site Target site No. transmission events
Duration of exposure, mo†
Transmission rate/100 person-months (95% CI)
Overall Oncogenic Overall Oncogenic Overall Oncogenic‡
Male to female
Penis only Cervix/urine 2 1 102 41 1.9 (0.2–5.4) 2.4 (0.06–9.0)
Penis only Anus 3 3 102 41 2.9 (0.6–7.1) 7.3 (1.5–17.6)
Penis only Hand 2 1 102 41 1.9 (0.2–5.4) 2.4 (0.06–9.0)
Any penis Cervix/urine 5 1 102 41 4.9 (1.6–10.0) 2.4 (0.06–9.0)
Any penis Anus 6 5 102 41 5.9 (2.2–11.4) 12.2 (3.9–24.9)
Any penis Hand 3 2 102 41 2.9 (0.6–7.1) 4.9 (0.6–13.5)
Any scrotum Cervix/urine 3 0 50 6.0 (1.2–14.5)
Any scrotum Anus 3 2 50 27 6.0 (1.2–14.5) 7.5 (0.9–20.9)
Any genital Cervix/urine 5 1 111 51 4.5 (1.5–9.3) 2.0 (0.1–7.2)
Any genital
Anus
6
5

111
51

5.4 (2.0–10.6)
9.8 (3.2–20.0)
Female to male
Cervix only Penis 3 0 61 5.0 (1.0–11.9)
Cervix only Scrotum 1 0 61 1.6 (0.04–6.1)
Cervix only Any genital 4 0 61 6.6 (1.8–14.5)
Urine only Penis 2 1 55 36 3.7 (0.4–10.2) 2.8 (0.1–10.4)
Urine only Scrotum 3 2 55 36 3.7 (.04–10.2) 5.6 (0.7–15.7)
Urine only Any genital 5 3 55 36 9.2 (3.0–18.8) 8.4 (1.7–20.3)
Cervix/urine only Penis 6 2 115 83 5.2 (1.9–10.1) 2.4 (0.3–6.7)
Cervix/urine only Scrotum 5 3 115 83 4.3 (1.4–8.9) 3.6 (0.7–8.7)
Any cervix/urine Penis 20 12 115 83 17.4 (10.6–25.8) 14.6 (7.5–23.9)
Any cervix/urine Scrotum 12 8 115 83 10.4 (5.4–17.1) 9.7 (4.2–17.4)
Any cervix/urine Any genital 32 20 115 83 27.8 (19.0–38.3) 24.2 (14.8–35.9)
Any cervix/urine Anus 1 1 115 83 0.9 (0.02–3.2) 1.2 (0.03–4.50
Any cervix/urine Hands 1 1 115 83 0.9 (0.02–3.2) 1.2 (0.03–4.5)
Anus only Scrotum 3 1 51 36 5.9 (1.2–14.2) 2.7 (0.1–10.1)
Any anus Any genital 24 16 51 36 47.1 (30.2–67.7) 44.0 (25.1–68.0)
Any hands
Any genital
4
2

426
373

28.2 (7.7–61.8)
16.1 (1.9–44.8)
Self-inoculation
Male§
Penis only Scrotum 5 1 102 41 4.9 (1.6–10.0) 2.4 (0.1–9.0)
Scrotum only Penis 3 2 50 27 6.0 (1.2–14.5) 7.5 (0.9–20.9)
Any genital Any genital 15 6 111 51 13.6 (7.6–21.3) 11.7 (4.3–22.8)
Any genital Hands 3 2 111 51 2.7 (0.6–6.5) 3.9 (0.5–10.9)
Anus only Any genital 3 2 29 21 10.2 (2.1–24.6) 9.3 (1.1–26.0)
Female
Cervix/urine only Anus 1 1 115 83 0.9 (0.02–3.2) 1.2 (0.03–4.5)
Cervix/urine/anus Hand 3 2 166 119 1.8 (0.4–4.4) 1.7 (0.2–4.7)

*HPV, human papillomavirus; CI, confidence interval.
†Based on the duration of infection in the source site. When HPV was detected at a given visit followed by the absence of that HPV type at the successive visit, the exposure period was estimated at half of the visit interval.
‡Includes probable oncogenic types.
§Includes penis-to-penis subsite inoculations.

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