HPV Testing in Men: Not Recommended for Routine Screening
No clinically validated HPV test exists for men, and routine screening is not recommended by the CDC. 1, 2
Why Testing Is Not Performed
The CDC explicitly advises against HPV testing in men for several critical reasons:
No FDA-approved test exists: All FDA-cleared HPV tests are designed exclusively for cervical specimens and have not been validated for penile, anal, or oral specimens in routine screening contexts. 2, 3
Most infections are transient and asymptomatic: The majority of HPV infections in men clear spontaneously without causing health problems, making screening of limited clinical utility. 3
Partners are typically already infected: Within an ongoing sexual relationship, both partners usually share HPV infection by the time one person is diagnosed, even without visible symptoms. 1, 2
High-risk HPV types rarely cause visible symptoms in men: Unlike low-risk types that cause genital warts, oncogenic HPV types seldom produce detectable manifestations in men. 1
What Should Be Done Instead
Clinical Examination
Visual inspection for genital warts is the primary diagnostic approach for symptomatic HPV in men, as this represents the most common clinical manifestation. 1, 3
Screen for other STDs if genital warts or HPV-related conditions are present in either partner. 2, 3
Special Populations Where Screening May Be Considered
Anal cytology (anal Pap tests) should be considered only in specific high-risk groups:
- HIV-infected men who have sex with men (MSM) 1, 3
- HIV-infected women with history of receptive anal intercourse 1
- Any HIV-infected person with genital warts 1
Critical caveat: Anal cytology should only be performed in settings where high-resolution anoscopy follow-up is available for abnormal results. 1, 4
Prevention Strategies to Emphasize
HPV Vaccination (Most Important Intervention)
All males aged 9-21 years should receive HPV vaccination (strong recommendation). 1, 3
Males aged 22-26 years should be vaccinated if not previously vaccinated. 1, 3
HIV-infected males should receive the three-dose series regardless of age within the 9-26 year range. 3
Risk Reduction Counseling
Condom use: Consistent use may reduce transmission risk, though HPV can infect areas not covered by condoms. 1, 3
Reassurance about transmission timing: Detection of HPV does not indicate recent infidelity, as infection can remain dormant for years before detection. 1, 2
Normalize the diagnosis: Most sexually active persons acquire HPV at some point in their lives, even those with only one lifetime partner. 1, 3
Common Pitfalls to Avoid
Do not test for low-risk HPV types (types 6 and 11): This provides no clinical benefit and should be avoided. 2
Do not use HPV testing to decide on vaccination: Vaccination decisions should follow age-based guidelines, not testing results. 2
Do not order HPV testing to "clear" a male partner: No test can determine if a man is HPV-free or when infection was acquired. 1