Human Papillomavirus popularly called HPV is spreading fast among the males across the globe and doing incalculable damage to their well-being. HPV is a very common viral infection that can be spread through sexual contact. Sadly, Nigeria pays much attention to vaccinating female children and not the males. Experts fear that this could spell doom and call for inclusive vaccination to address the rising challenges of male infertility and other health challenges, CHINYERE OKOROAFOR reports
There is heightening global concern about the male reproductive health in the area of Human Papillomavirus (HPV), which is one of the most widespread sexually-transmitted infections globally. It is currently spotlighted for more than just its link to cervical cancer in women. It is increasingly implicated in male infertility; particularly through a mechanism scientists refer to as “sperm death.”
A fresh study published in Frontiers in Cellular and Infection Microbiology has drawn a potential connection between high-risk HPV strains and deteriorating sperm health, citing oxidative stress and DNA damage as likely culprits.
Conducted by researchers at the National University of Córdoba in Argentina, the study examined semen samples from 205 unvaccinated men who visited a urology and an andrology clinic between 2018 and 2021. The results were telling: 19 per cent of the samples tested positive for HPV, with a significant number infected by high-risk strains.
The analysis revealed a pattern; men infected with high-risk HPV showed increased sperm cell death, reduced white blood cell counts and higher levels of reactive oxygen species, which are known to impair fertility by damaging sperm DNA.
The study’s senior author and a Professor of Immunology at the National University of Córdoba, Virginia Rivero, reportedly told Euronews Health: “Even if we don’t have any symptoms, we could still be infected with HPV, and that infection, especially with high-risk HPV, might interfere with male fertility.”
A study conducted in Ibadan involving 316 sexually-active heterosexual men found a high burden of HPV infections, with 40.5% testing positive for penile HPV, 9.7% for anal HPV, and 7.8% for oral HPV.
These figures indicate a substantial presence of HPV infections among Nigerian men, highlighting the need for broader attention to male HPV prevalence.
HPV-related cancers in Nigerian men, although relatively rare compared to women, still pose significant health concerns. According to the International Agency for Research on Cancer (IARC) and the ICO/IARC HPV Information Centre, crude incidence rates per 100,000 men in Nigeria are estimated at 0.02 for penile cancer, 0.65 for anal cancer and 0.14 for oropharyngeal (throat) cancer.
A study examining HPV-attributable cancers in Nigerian men reported age-standardised incidence rates ranging from 1.4 to 1.7 per 100,000 men, with 55.3% to 68.4% of these cancers attributable to HPV infection.
Risk factors associated with higher HPV prevalence in Nigerian men include older age (25 years and above), multiple sexual partners and inconsistent condom use. These behavioural factors underscore the importance of targeted public health interventions.
Nigeria’s gender gap in HPV prevention
As of April 2025, the country’s national HPV prevention strategy focuses exclusively on vaccinating girls aged nine to 14 to reduce cervical cancer incidence. This is a commendable step, especially considering that HPV is responsible for over 95% of cervical cancer cases. However, the exclusion of boys from this initiative presents a dangerous blind spot.
HPV is not a female-only virus. It affects everyone, regardless of gender. While women are routinely screened for HPV through Pap smears, there is currently no reliable or widely available HPV test for men or public awareness about HPV’s impact. This means many infected men may unknowingly carry and transmit the virus. More concerning, emerging research links HPV to a range of male-specific health risks, including penile, anal, and oropharyngeal cancers.
Recent studies also suggest that certain high-risk strains of HPV may damage sperm DNA, potentially contributing to male infertility.
Despite this growing body of evidence, Nigeria offers no routine or government-supported HPV vaccination programme for boys. This omission leaves half the population vulnerable and reinforces harmful misconceptions that HPV is only a women’s health issue.
Globally, countries such as Australia, the United States, the United Kingdom, and other parts of Europe have expanded HPV vaccination to include boys, recognising the role of gender-neutral immunisation in eliminating HPV-related cancers.
By contrast, Nigeria’s approach lags, risking increased transmission, perpetuating gender-based health inequities and undermining long-term disease prevention goals.
“Urologists and andrologists typically do not request testing to determine if a man is HPV-positive, nor to identify the genotype, even when a couple is trying to conceive. I believe this test should be added to the many others that are requested to assess semen quality.” Rivero said.
Addressing this gender gap is not just a matter of equity; it’s a public health imperative. Including boys in the national HPV vaccination programme would protect them from HPV-related illnesses, reduce virus circulation and enhance herd immunity. It would also signal a progressive shift toward inclusive healthcare, where every Nigerian, regardless of gender, is protected against preventable diseases.
As the country strives to meet its Universal Health Coverage goals and reduce cancer burden, expanding HPV prevention to include boys must be prioritised. Anything less is an incomplete strategy and an injustice to future generations.
While acknowledging that HPV is not gender-specific, Consultant Urologist, University of Nigeria Nsukka, Prof. Ikenna Nnabugwu said that prevention must be inclusive.
“We’re seeing more male patients with unexplained infertility. Prevention must be inclusive,” he said.
Although the World Health Organisation (WHO) recognises male infertility as a major contributor to global reproductive health challenges, citing male factors in roughly 50% of all infertility cases, it does not provide a separate global prevalence rate for men. This lack of data is concerning, especially given that unvaccinated men can unknowingly transmit high-risk viruses such as HPV to their partners, potentially leading to infertility or reproductive cancers in men and women.
On the issue of gender prioritisation, the National President of the Association of Medical Laboratory Scientists of Nigeria (AMLSN) and infectious disease/public health expert, Dr. Casmir Ifeanyi explained the rationale behind focusing on girls.
He said: “With limited doses, the priority must be on the most at-risk population. Cervical cancer is a female-specific disease and thousands of Nigerian girls and women have died from it.”
How men can detect that they have HPV
Despite being one of the world’s most common sexually transmitted infections, HPV often goes undetected in men.
According to Prof. Nnabugwu, the silent nature of the virus in males means many unknowingly carry and transmit it.
He said: “Most men who contract HPV may never know they have it. The virus often presents no symptoms in men, making it difficult to detect without specific medical tests. Unlike women, who are routinely screened for HPV during Pap smears, there is currently no approved general HPV test for men.”
This lack of routine testing, he explained, allows the virus to circulate quietly, often coming to light only when complications arise.
“In some cases, men may notice visible signs of HPV, particularly genital warts.
“These are small, flesh-coloured or grey growths that appear on the penis, scrotum, groin, thighs or around the anus. They might be flat or raised, single or clustered, and can resemble a cauliflower. Though caused by low-risk HPV types, such warts can be the first and sometimes the only visible clue of infection.”
Prof. Nnabugwu noted that for many men, the first time HPV becomes a concern is during investigations for infertility.
“Emerging research has linked high-risk HPV to sperm abnormalities, such as low motility and sperm death due to oxidative stress and DNA damage,” he said. “HPV may be detected during semen analysis or through advanced testing, especially when recommended by a urologist or fertility specialist.”
Another common route to diagnosis, he added, is through a partner’s test results. “If a woman is diagnosed with HPV, especially a high-risk strain associated with cervical or throat cancer, there’s a strong chance her male partner has also been exposed, even if he shows no symptoms.”
While there’s still no routine HPV test for the general male population, Prof. Nnabugwu pointed out that targeted swab tests; from the urethra, anus, or throat, may be conducted for men in high-risk groups, such as those living with HIV or men who have sex with men.
“For men who notice unexplained growths, it’s important to consult a dermatologist or urologist to determine whether these are HPV-related warts,” he advised.
He said that prevention remains the most effective strategy, especially with the availability of the HPV vaccine.
“The HPV vaccine, now approved for males up to age 45 in many countries, offers protection against low-risk and high-risk HPV types,” Prof. Nnabugwu said, adding that “combined with consistent condom use and routine medical checkups, vaccination is crucial to reducing the risk of complications like genital warts, infertility and certain cancers.”
He urged more Nigerian men to seek information, protect themselves, and break the silence around HPV.
Beyond the physical and emotional toll, HPV-related diseases carry a significant economic burden for Nigerian families and the health system. Treatment for genital warts, which can cost between N50,000 and N150,000 per episode in private hospitals, is just the tip of the iceberg. Managing HPV-related cancers, such as anal, penile, oropharyngeal and cervical cancer, can cost hundreds of thousands to millions of naira per patient annually, sums many Nigerians cannot afford.
Fresh studies now link high-risk HPV strains to male infertility, leading affected couples to pursue expensive fertility treatments like IVF, which can cost upwards of N1.5 million per cycle. The emotional toll on families navigating these challenges is immeasurable, often compounded by stigma and silence around sexual health.
Preventing these costs through the inclusion of boys in national HPV vaccination programmes could drastically reduce the financial strain on the healthcare system and families while promoting gender equity in preventive care.
But can Nigeria handle HPV vaccination for boys? Nigeria already has an established vaccine supply chain under the National Primary Health Care Development Agency (NPHCDA), which recently facilitated the nationwide rollout of the HPV vaccine for girls aged nine to 14.
According to a public health expert, Dr. Adaeze Nwokolo, the same infrastructure, cold chain, trained personnel, and community outreach mechanisms, can be leveraged to include boys with minimal additional cost.
While the exact cost of expanding the program is yet to be publicly estimated, UNICEF and Gavi-supported vaccine procurement can reduce expenses significantly.
She suggested that adding boys to the schedule could cost less than 10% more than the current programme, a modest investment considering the long-term savings from reduced cancer and fertility treatment costs.
Across Europe, the tide is turning. Most EU nations now recommend HPV vaccination for both boys and girls, aiming for at least 90% coverage by 2030. The vaccine, first approved in 2006 for females, has only recently been endorsed for males. Yet Nigeria still recommends it only for girls.
A call for inclusion
HPV doesn’t discriminate by gender, and neither should Nigeria’s prevention strategies. Public health campaigns must educate parents and boys on the risks of HPV, including its impact on fertility. The vaccine should be subsidised or made free for all genders, and school-based programmes must be expanded to include boys.
Infertility can have devastating emotional and social consequences, particularly in a culture where child-bearing is seen as central to marriage.
Including boys in HPV vaccination efforts isn’t just good science, its good policy and it’s long overdue.
