Anal Human Papillomavirus Infection Among HIV-Infected and Uninfected Men Who Have Sex With Men in Beijing, China

Abstract

To determine prevalence, genotypes and predictors of anal human papillomavirus (HPV) among HIV-infected and uninfected men who have sex with men (MSM) in Beijing, China. In 2010–2011, we recruited MSM (age range 18–61; median 28 years) through peer volunteers, and collected demographic/behavioral information via interviewer-administrated questionnaires. Trained health workers collected anal swabs for HPV genotyping by PCR and blood samples for HIV/syphilis serologies . We obtained anal specimens from 212 HIV-infected and 459 HIV-uninfected participants. Among HIV-infected MSM, 82.1% were HPV-infected vs. 57.5% in HIV-uninfected (p<0.01). HIV-infected men had the greatest likelihood of multiple types: 17.9% uninfected; 36.3% with one type; 36.8% with 2–3; 9.0% with >4. Oncogenic HPV prevalence was higher among HIV- infected (61.3%) than uninfected participants (39.7%; p<0.01). HIV-uninfected MSM reporting always using condoms during insertive anal intercourse (past 6 months) were less likely to be HPV-infected (OR=0.49, 95%CI: 0.31–0.77). Among HIV-uninfected MSM, HPV infection was associated with unprotected receptive anal intercourse (past 6 months; OR=1.92, 95%CI: 1.19–3.11) and being forced to have sex (previous year; OR=3.32, 95%CI: 1.10–10.0). Multivariable logistic analysis among HIV infected MSM suggested that unprotected oral intercourse (past 6 months) was associated with HPV (adjusted OR=2.12, 95%CI: 1.00–4.48). Syphilis occurred in 55.8% of HIV-infected/HPV-infected, 50.0% of HIV-infected/HPV-uninfected, 19.6% of HIV-uninfected/HPV-infected, and 13.0% of HIV-uninfected/HPV-uninfected MSM. HPV anal infections were more common among HIV-infected than uninfected MSM in China, including oncogenic and multiple types. Unprotected oral and receptive anal sex were significant HPV risk factors. Promotion of safer sex and HPV vaccination is strongly recommended among MSM.

Prevalence of Anal High-Risk Human Papillomavirus Infections Among HIV-Positive and HIV-Negative Men Who Have Sex With Men in Nigeria

“…Our baseline prevalence of anal HR-HPV infection in those co-infected with HIV, was similar to the prevalence observed in Australia (94%) [12] and higher than those reported from North America (ranging from 56% to 80%) [7-9], Europe (ranging from 65% to 79%) [10-11], Asia (ranging from 58% to 61%) [13-14], and the summary prevalence of 74% (95% CI, 64-83) from a meta-analysis [15]. Although the Australian study had a similar prevalence, its study population significantly differed in their age composition and sexual risk behavior.…”

“…Most prevalence studies of anal HR-HPV in HIV-infected MSM have occurred in North America, Europe, Australia and Asia [8-14]. A meta-analysis of cross-sectional studies primarily from the United States estimated the pooled prevalence of any HPV was higher in HIV-positive as compared to HIV-negative MSM (93% vs. 64%) [15].…”

Epidemiological study of high‑risk human papillomavirus infection in subjects with abnormal cytological findings in cervical cancer screening

“…A large-scale epidemiological survey identified age differences among HPV-infected individuals in different regions and populations (34). In line with this, the present study also found that the HR-HPV infection rate differs among different age groups.…”

Human Immunodeficiency Virus Status Differentially Associated With Genital and Anal Human Papillomavirus Infection Among Chinese Men Who Have Sex With Men: A Cross-Sectional Survey

“…The risk of HPV among men who have sex with men (MSM) is higher than among heterosexual men [3, 4]. HIV-infected MSM have an even higher risk [5–7]. Among MSM, HPV infection also varies by anatomic site: more common in the perineal/perianal region and anal canal than in the penile urethra or scrotum.…”