Anal human papillomavirus and HIV: A cross-sectional study among men who have sex with men in Moscow, Russia, 2012–2013

Wirtz, Andrea L.; Zelaya, Carla; Peryshkina, Alena; McGowan, Ian; Cranston, Ross D.; Latkin, Carl A.; Galai, Noya; Mogilniy, V; Dzhigun, P; Kostetskaya, I; Beyrer, Chris

doi:10.2807/1560-7917.es2015.20.15.21095

Cited by 11 publications

(20 citation statements)

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“…RDS was implemented from late October 2010 to April 2013 and study methods have been previously described 13. RDS recruitment continued in successive waves until the desired sample size of 1370 was reached.…”

Section: Methodsmentioning

confidence: 99%

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The HIV care continuum among men who have sex with men in Moscow, Russia: a cross-sectional study of infection awareness and engagement in care

et al. 2015

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Objectives Early diagnosis and treatment of HIV infection is critical to improving clinical outcomes for HIV-infected individuals. We sought to characterise the HIV care continuum and identify correlates of being unaware of one’s HIV infection among MSM in Moscow, Russia. Methods Participants (N=1,376) were recruited via respondent-driven sampling and completed a socio-behavioural survey and HIV testing from 2010–2013. Sample and population estimates were calculated for key steps along the HIV care continuum for HIV-infected MSM and logistic regression methods were utilized to examine correlates of being unaware of HIV infection. Results 15.6% (184/1177; population estimate:11.6%; 95%CI:8.5–14.7%) of participants were HIV infected. Of these, only 23.4% (43/184; population estimate:13.2; 95%CI:11.0–15.4) were previously aware of their infection, 8.7% (16/184 population estimate:4.7; 95%CI:1.0–8.5) were on ART, and 4.4% (8/164; population estimate:3.0; 95%CI:0.3 – 5.6) reported an undetectable viral load. Bisexual identity (reference: homosexual; AOR:3.69; 95%CI:1.19–11.43), having ≥5 sexual partners in the last 6 months (reference: ≤1; AOR:4.23; 95%CI:1.17–15.28), and employment HIV testing requirements (reference: no; AOR:15.43; 95%CI:1.62–147.01) were associated with being unaware of one’s HIV infection. HIV testing in a specialized facility (reference: private; AOR: 0.06; 95%CI: 0.01–0.53) and testing ≥2 times in the last 12 months (reference: none; AOR:0.17; 95%CI:0.04–0.73) were inversely associated with being unaware of HIV infection. Conclusion There is a steep gradient along the HIV care continuum for Moscow-based MSM beginning with low awareness of HIV infection. Efforts that improve access to acceptable HIV testing strategies, such as alternative testing facilities, and linkage to care are needed for key populations.

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Section: Methodsmentioning

confidence: 99%

“…HIV testing procedures have been previously described 13. Following completion of the survey, participants who had provided separate consent to HIV testing proceeded to biological testing using OraQuick Rapid HIV 1/2 test (OraSure Technologies, Bethlehem, Pennsylvania, USA).…”

Section: Methodsmentioning

confidence: 99%

The HIV care continuum among men who have sex with men in Moscow, Russia: a cross-sectional study of infection awareness and engagement in care

et al. 2015

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“…The most prevalent genotype in all types of mucosa was 16, which was significantly associated with anomalous histology (LSIL+). Previous studies in seropositive and seronegative populations [29], in both males and females [30], and in individuals with different sexual orientations [31] found genotype 16 to be the most prevalent virus in anal mucosa and to be associated with the presence of HSIL in patients infected with other oncogenic viruses [32]. Genotypes 18, 53, 61, and 68 were less prevalent but were also associated with the presence of HSIL+.…”

Section: Discussionmentioning

confidence: 93%

ART is key to clearing oncogenic HPV genotypes (HR-HPV) in anal mucosa of HIV-positive MSM

et al. 2019

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BackgroundAnal squamous cell carcinoma (ASCC) is one of the most frequent non-AIDS-defining neoplasias in HIV patients, mainly in MSM, and it has been associated with chronic infection with high-risk human papilloma virus (HR-HPV). Our main objective was to determine HR-HPV clearance and acquisition rates and related factors and their relationship with the incidence of HSILs and ASCC in anal mucosa of HIV+ MSM. Patients and methodsThe study included consecutive HIV-infected MSM between May 2010 and December 2018. Data were gathered at baseline and annually on their sexual behavior, CD4 and CD8 levels, plasma HIV viral load, and results of anal cytology, HPV PCR, and high-resolution anoscopy. ResultsOut of the 405 patients studied, 34.9% of patients cleared oncogenic genotypes (IQR: 37-69) within 49 months, and 42.9% acquired new genotypes within 36 months (IQR:12-60). In multivariate analysis, clearance was only significantly influenced by the duration of antiretroviral therapy (ART) (OR: 1.016, 95% CI 1.003-1.030). The incidence of HSILs was 30.86/ 1,000 patient-years and that of ASCC was 81.22/100,000 patient-years; these incidences were not influenced by the acquisition (acquired: 14.9% vs. non-acquired: 10.4%; p = 0.238) or clearance (cleared 11.4% vs. non-cleared: 13.2%; p = 0.662) rates of these viruses. ConclusionsThe duration of ART appears to positively affect oncogenic genotype clearance in the anal mucosa of HIV+ MSM, although this clearance does not affect the incidence of HSILs or ASCC. The reduction in HSIL+ rate observed in our patients may be attributable to the bundle of measures adopted at our center. Competing interests: The authors have declared that no competing interests exist. 30-50 yrs, n (%) 244 (60.2) >50 yrs n (%) 38 (9.4) Retired, n (%), 95% CI 6 (1.5) Educational level No studies 40 (9.9) Primary studies 129 (31.9) Secondary studies 230 (56.7) University studies 22 (5.4) (3-7.5) Origin Europe 387 (95.6) Central America 17 (4.2) qHPV vaccine (2012-2014), n (%), 95% CI 66 (16.3) Age at first sexual intercourse, median (IQR) 18 (16-20) Number of lifetime male sex partners, median (IQR) 50 (15-150) Number of male sex partners during previous 12 months, (IQR) 1(1-7) Habitual use of condoms, n (%), 95%CI 294 (72.6) (68.2-77.4) Total number of sexual partners during follow-up, median (P25-P75) 54.5(20-154) History of anal/genital warts, n (%), (95%CI) 128 (31.6), (27.1-36.1) Anal/genital warts at baseline, n (%), (95%CI) 93 Time since HIV diagnosis (months), median (IQR) 25 (8-84)CD4 at diagnosis of HIV (cel/uL), (± SD) 448± 298.17 HIV viral load at diagnosis of HIV (log), mean (IQR) 4.61 (4.07-5.12) CD4 nadir (cells/uL), (± SD) 367.93±233.85 CD4 nadir < 200 cells/uL, n(%), 95% CI 97 (23.9), (20-28.5) CD4 cell count at baseline (cells/uL), (± SD) 689.64± 475.03 CD8 cell count at baseline (cells/uL), (± SD) 981.5±531.5 CD4 /CD8 ratio, mean, (± SD) 0.77±0.70 HIV viral load at baseline (log), median, IQR 0 (0-1.72) Undetectable: < 50 HIV RNA copies/mL of plasma n (%) 348 (85.9) History of AIDS ...

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“…Taking advantage of a larger cross-sectional study where participants were invited for HIV and syphilis tests after completion of the behavioural, interviewer-administered survey, Wirtz et al embedded a study to look into anal cytology and HPV genotyping as well as to obtain additional specimens for possible urethral, oral and rectal gonorrhoea and chlamydia infections. Again, infections with highrisk HPV types were more common in HIV-positive MSM and were strongly associated with behavioural risk and low healthcare access [15].…”

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confidence: 99%

European men who have sex with men still at risk of HIV infection despite three decades of prevention efforts

Haar

Amato‐Gauci

2015

Eurosurveillance

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Anal human papillomavirus and HIV: A cross-sectional study among men who have sex with men in Moscow, Russia, 2012–2013

Abstract: Binary file ES_Abstracts_Final_ECDC.txt matches

Cited by 11 publications

References 31 publications

The HIV care continuum among men who have sex with men in Moscow, Russia: a cross-sectional study of infection awareness and engagement in care

The HIV care continuum among men who have sex with men in Moscow, Russia: a cross-sectional study of infection awareness and engagement in care

ART is key to clearing oncogenic HPV genotypes (HR-HPV) in anal mucosa of HIV-positive MSM

European men who have sex with men still at risk of HIV infection despite three decades of prevention efforts

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