Epidemiologic burden, clinical attribution, and implications for immunization strategies of HPV infection among males in Sichuan, China: a large-sample cross-sectional study.

BACKGROUND: This study aimed to explore the prevalence, genotyping, and the complex association between HPV infection and genitourinary disorders in male patients from Sichuan Province, providing a basis for developing targeted HPV prevention strategies. METHODS: A cross-sectional study was conducted on 7,534 male patients who attended Sichuan Provincial People's Hospital between July 2020 and July 2023. HPV genotyping was performed using real-time polymerase chain reaction (RT-PCR). RESULTS: Among 3,226 HPV-positive male patients, the overall infection rate was 42.8%. Of these, 29.5% were mono-infected, and 13.3% had multiple infections. HPV types 6, 11, 16, 52, and 43 were the most prevalent, with single infections predominating. In terms of vaccine-related multiple infections (bivalent, quadrivalent, and 9-valent HPV vaccines), the highest infection rates occurred in the ≤ 20 and > 60-year groups, while the lowest was seen in the 51-60-year group (P < 0.05). Co-infections between HPV-16, HPV-52, and HPV-59, as well as HPV-6 and HPV-11, were particularly frequent. Among patients diagnosed with warts, balanitis, rash, dermatitis, urethritis, prostatitis, sexually transmitted diseases (STDs), and other conditions, HPV detection rates were 26.2%, 64.1%, 35.0%, 28.9%, 28.7%, 39.3%, 28.0%, and 35.4%, respectively (P < 0.001). Low-risk HPV types 6/11 were predominant in patients with warts (87.6%), while balanitis was more common with single high-risk infections (40.7%). CONCLUSION: This study developed a three-dimensional model of age, HPV type, and disease risk in male patients in Sichuan, highlighting the high prevalence of HPV infection in this population.