Age-specific prevalence of multiple human papillomavirus infections in a clinical cohort of men: a cross-sectional study in Shenzhen, China

Currently, 9-valent Human Papillomavirus (HPV) vaccines are recommended for males aged 16-26 years in China. Herein, we evaluated the impact of Human Immunodeficiency Virus (HIV) on the prevalence of multiple HPV infections across different age groups of males, including men who have sex with men (MSM), to inform future vaccination strategies. A cohort of 5,033 HPV-infected males were selected from Shenzhen Third People's Hospital between 2018 and 2023. HIV status and basic clinical information were collected. Among this cohort, 766 individuals were identified as MSM. Increasing age was associated with a higher prevalence of multiple HPV infections among HIV⁺ males. In contrast, among HIV^- males, the prevalence of multiple HPV infections demonstrated a bimodal distribution with age. The highest prevalence was observed in the ≤20 years group (49.3%), followed by a second peak in the >50 years group (47.3%). Among HPV-infected individuals over 50 years old, the prevalence of infection with at least one vaccine-covered HPV type was higher in HIV⁺ men (97.8%) than the average level across all groups. Our analysis revealed distinct age-related patterns of multiple HPV infections between HIV⁺ and HIV^- males. Furthermore, HPV types covered by the vaccine remained highly prevalent among older adults in both HIV⁺ and HIV^- males. These findings support expanding the age eligibility criteria for male HPV vaccination programmes in China and underscore the need to prioritize vaccination for high-risk groups, including HIV⁺ men, MSM, and older males.