The impact of human immunodeficiency virus on human papillomavirus transmission in heterosexually active couples.

OBJECTIVES

This study investigated HPV transmission and the factors influencing it in heterosexually active couples in South Africa.

METHODS

A total of 486 heterosexual couples were recruited at a health facility and returned at 6-monthly intervals. Cervical and penile HPV types were determined by Roche Linear Array HPV genotyping assay. HPV transmission was defined as the detection of a new HPV type in an individual whose partner was infected with the same type at the date of acquisition.

RESULTS

The female-to-male HPV transmission rate was 2.80/100 person-months (95% confidence interval (CI): 2.03-3.86) while the male-to-female HPV transmission rate was 1.17/100 person-months (95% CI: 0.82-1.67). HIV-positive women were found to be at higher risk of HPV infection transmitted from their male partners compared to HIV-negative women (RR (relative risk): 2.31, 95% CI: 1.08-4.92, P = 0.03). HIV-positive men with CD4 counts <350/mL had a higher risk of HPV infection transmitted from their female partners compared to HIV-positive men with CD4 counts ≥350/mL (RR: 3.17, 95% CI: 1.05-9.55, P = 0.04).

CONCLUSIONS

HIV infection and low CD4 counts increase the rate of HPV acquisition from sexual partner.