External genital HPV DNA positivity and type concordance among male partners of cervical HPV-positive women: a paired cross-sectional study

Data onexternal genital human papillomavirus (HPV) infection in male partners of cervical HPV-positive women are limited in Southwest China. We conducted a single-center study of 303 heterosexual couples in Kunming, China, from January 2024 to December 2025, with a 1:1 age-matched comparison of men with versus without external genital HPV DNA detected at baseline. Women had a newly positive cervical HPV DNA test, and male partners underwent standardized external genital HPV genotyping. Concordance was assessed in all 303 couples, and factors associated with prevalent male HPV DNA positivity were examined in 149 matched case-control pairs using conditional logistic regression with prespecified behavioral/anatomic variables; female multiple-type infection and HPV16/18 positivity were evaluated only in exploratory secondary analyses. Of 303 enrolled couples, 149 men (49.2%) had external genital HPV DNA detected at baseline, including 121 (39.9%) with at least one assay-designated high-risk genotype. Any shared genotype was present in 94/303 couples (31.0%; 95% CI, 26.1–36.4) and in 94/149 male HPV-positive couples (63.1%; 95% CI, 55.1–70.4), mainly involving HPV52, HPV16, and HPV58. In the primary matched model, inconsistent condom use (adjusted odds ratio [aOR], 2.17; 95% CI, 1.35–3.47; P = 0.001), current smoking (aOR, 1.61; 95% CI, 1.02–2.54; P = 0.041), being uncircumcised (aOR, 1.82; 95% CI, 1.01–3.23; P = 0.046), and four or more lifetime female partners (aOR, 1.82; 95% CI, 1.03–3.22; P = 0.039) were associated with higher odds of male HPV positivity. In a secondary analysis, female multiple-type infection was associated with male HPV positivity (aOR, 1.62; 95% CI, 1.00-2.63; P = 0.049). External genital HPV DNA positivity was common among male partners of cervical HPV-positive women, and 63.1% of male HPV-positive couples shared at least one genotype, most often HPV52, HPV16, or HPV58. These cross-sectional findings do not establish causation or transmission direction but support partner-aware counseling about vaccination eligibility, consistent condom use, and smoking cessation.