The human papillomavirus (HPV) infection is commonly found in the genital tract of both men and women with or without any clinical lesion. However, chronic infection with HPV is what drives approximately 99% of cervical cancer cases. While HPV infections are publicly synonymous with women, it is important to note that this virus also affects men. However, the persistence of HPV oncogenic infections in men appears to be shorter, with approximately 75% of HPV virulence factors able to clear in a year. HPV has two essential oncoproteins, namely E6 and E7, important for the initial establishment and progression of cervical cancer. Notably, this virus alone cannot transform cervical epithelium into a malignant tumour. However, the two oncoproteins interact with the host’s genetic actors to induce cell immortalization and promote malignancy.

While most information about HPV is on women, this virus can also cause health problems in men. There are reported links between HPV and several different anal-genital cancers, including vulva, anal, and penile cancers. About 80–85% of anal cancers and approximately 50% of penile cancers are also associated with HPV infection. Additionally, HPV DNA has also been identified in head and neck cancers, especially those arising in the upper aerodigestive tract (oral cavity, oropharynx, hypopharynx, and larynx) in both sexes. In men, 33-72% of oropharyngeal cancers and 10% of cancers of the larynx are attributed to HPV infection. Besides cancer, genital HPV infection can cause a broad spectrum of lesions, including genital warts. Although having genital warts is not associated with mortality, the lesions are often associated with both clinical symptoms (burning, bleeding, and pain) and psychosocial problems (embarrassment, anxiety, and decreased self-esteem).

Routine testing of men to check for infection with high-risk HPV strains is not a common practice. To accurately assess HPV infection in men, exfoliated cytology or biopsy specimens and molecular techniques like quantitative polymerase chain reaction (qPCR) can be used. The use of anal pap tests for men, who are at higher risk of anal cancer caused by HPV, has also been reported. The sites where more than 95% of genital HPV infection is detected among asymptomatic heterosexual men include the penile shaft, the coronal sulcus/glans penis (including prepuce in uncircumcised men), and the scrotum. There are two methods of male genital sampling, which are reproducible and provide adequate samples for HPV DNA detection. This includes abrading the genital skin before sampling with a Dacron swab and collection of the exfoliated cells in a standard transport medium and direct sampling of the genital epithelium with a saline pre-wetted Dacron swab followed by collection in a standard transport medium.

There is limited data on the natural history and HPV-related diseases in the genital tract in men and on the efficacy of HPV vaccines in the prevention of HPV infection and disease among men, although studies are ongoing with some positive outcomes. For example, in North America, Gardasil, a HPV vaccine, has been approved for use to prevent HPV infection, cervical and anal cancer in both men and women. In Kenya, cervical cancer significantly contributes to the country’s disease burden. While vaccinating young girls is one of the preventive mechanisms, we must encourage HPV screening of Kenyan men to combat cervical cancer effectively.