The high risk of reinfection may be due to either auto-inoculation, spreading the infection by repeated contact between different sites on the body, or reactivation of a latent virus.
However, if the increased risk of reinfection is due to auto-inoculation, then another effective strategy may be to vaccinate previously infected men as well.
Auto-inoculation was defined as the presence of a particular HPV type at an anatomic site in 1 partner and its absence in all sites of the other partner at a given visit, and the presence of this HPV type in a different anatomic site in the affected partner at the subsequent visit.
A total of 78 transmission events were observed in 16 couples, including 14 male-to-female, 39 female-to-male, 21 male auto-inoculation, and 4 female self-inoculation (online Appendix Table, available from www.
In men, the rate of transmission by auto-inoculation was comparable to that of transmission from women.
Auto-inoculation involving the hands may result from casual contact or masturbation.
3) This lends support to the theory that auto-inoculation
is the cause for perianal or perineal disease.
In addition, auto-inoculation
(spreading the wart virus on one's own skin by scratching, or skin-to-skin contact) is a common way that warts spread.
The VV is thought to develop in many instances as a result of auto-inoculation from cutaneous sites, particularly the skin of the hands.
Auto-inoculation from other cutaneous or anogenital sites is also possible, as has been shown in immune competent individuals.
The most interesting observation they found using the model was dynamic auto-inoculation