? ? Introduction: As effective human papillomavirus (HPV) vaccines become available, epidemiologic research on HPV and cervical cancer will continue to be important: vaccine uptake will not be immediate or universal, and vaccines will not initially target all oncogenic types; furthermore, gains in knowledge may be relevant for other cancers. Methods: We have a time-sensitive opportunity to add substantially to our understanding of HPV transmission between young, high-risk heterosexual partners, and to clarify the controversial role of condom use and male circumcision, by adding an HPV sub-study to """"""""Dual STI Prevention Interventions for Minority Couples"""""""", a randomized controlled trial of a cognitive-behavioral intervention to reduce sexually transmitted infections (STI). This study is currently enrolling 500 minority heterosexual couples; all women have non-viral STI at baseline. All 1000 individuals will be followed for one year, with specimen collection and detailed interviews at baseline, six months, and twelve months followup. For the proposed R03 project, """"""""HPV in Heterosexual Couples"""""""", we will collect genital swab samples, and blood samples, from men and women in the parent study. These samples will provide a unique resource for an R01-scale study to evaluate transmission dynamics of HPV in a high-risk population of heterosexual minority couples. We have already submitted an R01 application to conduct genital HPV DNA typing and viral load for males and females; conduct serologic testing for HPV, Chlamydia trachomatis, and herpes simplex virus 1 and 2 for males and females; assess cervical inflammation for females; and conduct detailed statistical analyses. We are also submitting the current R03 application, in light of the possibility that the R01 may not immediately be funded. Outcomes: The major contribution of this project will be to create a valuable bank of stored specimens. These specimens can be used in the future to shed light on heterosexual transmission of HPV, and factors affecting probability of transmission. In particular, we will be able to assess the role of male circumcision, the impact of condoms using extremely detailed behavioral data, the impact of concurrent STIs in either partner, and HPV viral load in the infecting partner. This study of ethnic minorities is a cost- effective way to answer current questions about factors affecting HPV transmission between heterosexual couples. Relevance: The proposed sample collection will provide the basis for future analyses to significantly increase our understanding of heterosexual transmission of HPV in a young, high-risk minority population. We will be able to elucidate the impact of condoms, male circumcision, and concurrent STIs, as well as help to shed light on ethnic disparities in cervical cancer risk. ? ? ?
