Epidemiology of Anal HPV Infection in High-Risk Men Attending a Sexually Transmitted Infection Clinic in Puerto Rico

Colón‐López, Vivian; Ortiz, Ana P.; Toro-Mejías, Lizbeth Del; Clatts, Michael C.; Palefsky, Joel M.

doi:10.1371/journal.pone.0083209

Cited by 24 publications

(27 citation statements)

References 13 publications

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“…These results are similar to studies from different geographic areas [7, 23]. However, Colon-Lopez et al detected mostly HPV-58, 31 and 51 in high-risk men attending a sexually transmitted infection clinic in Puerto Rico [25]. The different prevalence and distribution of anal HPV subtypes in different study populations is of interest since it might reflect different geographic distributions of HPV genotypes or heterogeneous host susceptibility to the pathogens.…”

Section: Discussionsupporting

confidence: 84%

Human papillomavirus infection in anal intraepithelial lesions from HIV infected Cuban men

Limia

Soto

García

et al. 2017

Infect Agents Cancer

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BackgroundAn association between HPV infection and progression to anal squamous intraepithelial lesions (ASIL) has been established, specifically in high-risk populations such as HIV-infected men. In this population, anal cancer is one of the most common non-AIDS-defining malignancies.MethodsA cross-sectional study to detect anal lesions and HPV infection was performed. Anal mucosa samples were collected from 56 HIV-infected men from Cuba. The cytological diagnosis was done according to Bethesda 2001 System. HPV DNA detection was determined by qPCR for six high-risk HPV types and end point PCR for low-risk HPV types (6 and 11). The end point PCR with nucleotide sequencing technique was achieved to detect other genotypes of HPV not included in the qPCR in those samples negative for HPV- 6 and 11 or negative for the six genotypes identified in the qPCR.ResultsCytological diagnosis identified 53 of 56 (95%) men with abnormal anal cytology. Among those, 26% (14/53) had atypical squamous cells of undetermined significance (ASC-US), 4% (2/53) had atypical squamous cells of undetermined significance cannot exclude high-grade lesions (ASC-H), 64% (34/53) had low-grade squamous intraepithelial lesions (LSIL), and 6% (3/53) had high-grade squamous intraepithelial lesions (HSIL). HPV DNA was detected in 89% (50/56) of men and 79% had at least one of the high-risk HPV types. HPV- 16 was the most common genotype (52%), while HPV-18 was the most frequently detected genotype in men with HSIL. We found statistically significant differences in the HPV viral loads with respect to the cytology results (p = 0.0006) and that the practice of receptive anal sex was a risk factor for anal HPV infection (p = 0.032).ConclusionThis study shows a high prevalence of ASIL and high-risk HPV infections in the study group and is the first study showing the distribution of HPV genotypes in HIV infected Cuban men with abnormal anal cytology. This information may be of importance for local decision makers to improve prevention strategies, including the introduction of HPV vaccine in Cuba.

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Section: Discussionsupporting

confidence: 84%

Human papillomavirus infection in anal intraepithelial lesions from HIV infected Cuban men

Limia

Soto

García

et al. 2017

Infect Agents Cancer

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“…In Russia, the adult HIV prevalence of 1.1% has been reported, with an increase in HIV distribution affecting heterosexuals . Although it has not yet formally proven that anal cancer screening programs will lead to a decline of anal cancer incidence, screening for anal cancer is recommended for all HIV‐infected men in the United States and some European countries (eg, Germany and Austria), regardless of their sexual orientation as the presence of any HPV type is more than three times as common among HIV‐positive as compared to HIV‐negative subjects …”

Section: Discussionmentioning

confidence: 99%

“…Men infected with human immunodeficiency virus (HIV) who have sex with men (MSM) are at increased risk of HPV infection and anal cancer and are at the focus of the research on anal HPV epidemiology. The only limited range of studies, most from the Americas (Brazil, Mexico, United States and Puerto‐Rico) and 1 from Asia (Korea), have reported on the detection of the HPV in the anal canal of HIV‐negative men practicing sex with women (MSW).…”

Section: Introductionmentioning

confidence: 99%

Determinants of the presence of human papillomaviruses in the anal canal of Russian men

Smelov

Elfström

Eklund

et al. 2018

Journal of Medical Virology

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Knowledge of determinants of anal human papillomavirus (HPV) infections among men is still limited as most of the studies are focused on high-risk populations and geographically narrowed. Such knowledge obtained in different populations is essential for better understanding of HPV natural history, transmission dynamics, and its role in the development and prevention of anogenital malignancies in different regions. Here we tested anal canal swab samples from 359 Russian heterosexual (323 human immunodeficiency virus [HIV]-negative and 27 HIV-positive, aged 18-67 years) men attending a sexually transmitted infection clinic 36 HPV types using a proficient Luminex assay. HPV-positivity in anal samples was common for 332 HIV-negative heterosexual men for overall HPV (15.7%, n = 52), oncogenic HPV (9.6%, n = 32), nononcogenic HPV (8.1%, n = 27), and multiple HPV infections (4.5%, n = 14). The most common anal HPV types were HPV16 (5.7%), HPV45, and HPV51 (1.8% each), HPV66, and HPV87 (1.8% each). No association was found with the number of lifetime sexual partners, age of participants at the time of the study, or their sexual debut. Although anal HPV positivity was more common among HIV-positive men, the current study provides additional evidence that anal HPV can be frequently detected in heterosexual HIV-negative men favoring further studies on transmission routes to discriminate between contamination and true HPV infection.

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“…Therefore, there is a need to consider conducting future qualitative studies targeting parents and children from different age-gender subgroups. Specifically, future efforts should focus among young men, where a wide area of research in Puerto Rico has shown a higher burden of HPV infection as well as HPV-related cancers (Colón-López et al 2015; Colón-López et al 2014; Colón-López et al 2013; Colón-López et al 2012; Colón-López et al 2010). …”

Section: Conclusion and Implications For Practicementioning

confidence: 99%

Communication about sex and HPV among Puerto Rican mothers and daughters

Colón‐López

Fernández-Espada

Vélez³

et al. 2016

Ethnicity & Health

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Objective Although opportunities to vaccinate against human papillomavirus (HPV), are available, vaccination rates in Puerto Rico remain low. Communication between parents and adolescents about sexual topics may influence decisions about HPV vaccination uptake, particularly among young women; yet few studies have addressed this issue. This qualitative study explored Puerto Rican mothers and daughters communication on sex-related topics, and HPV, including the HPV vaccine. Design Thirty participants, including 9 mothers and 21 daughters, participated in seven focus groups. Participants were divided into groups of mothers and daughters, and further stratified by vaccination status. Transcripts were analyzed using a modified grounded theory approach to identify emergent themes. Results Focus group data revealed four main themes: 1) limited parent–daughter communication about sex-related topics; 2) daughters’ discomfort discussing sex-related topics with their parents; 3) parental focus on abstinence; and, 4) limited parent–daughter communication about HPV and the HPV vaccine. Conclusion Although daughters in this study struggled with feelings of embarrassment, invasion of privacy, encouragement of abstinence, and the fear of parents reaction to them being sexually active prior to marriage, they also recognized the need to increase the parent-daughter communication about sex-related topics including HPV and the HPV vaccine. Educational efforts should target both daughters and parents to increase communication skills and self-efficacy and to enable them to discuss sexual health in open and nonjudgmental conversations.

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Epidemiology of Anal HPV Infection in High-Risk Men Attending a Sexually Transmitted Infection Clinic in Puerto Rico

Cited by 24 publications

References 13 publications

Human papillomavirus infection in anal intraepithelial lesions from HIV infected Cuban men

Human papillomavirus infection in anal intraepithelial lesions from HIV infected Cuban men

Determinants of the presence of human papillomaviruses in the anal canal of Russian men

Communication about sex and HPV among Puerto Rican mothers and daughters

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