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

Qian, Han-Zhu; Hu, Yanyan; Carlucci, James G.; Lu, Yin; Li, Xiangwei; Giuliano, Anna R.; Li, Dongliang; Gao, Lei; Shao, Yiming; Vermund, Sten H.

doi:10.1097/olq.0000000000000672

Cited by 13 publications

(13 citation statements)

References 29 publications

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“…It is also lower compared with a recent study that included MSM in China that was also recruited from the community but with extra effort to include more HIV-infected individuals and identified only 26 HPV types. 6 In Qian’s study, 68% had at least one HPV type detected out of 671 valid anal samples and 37.8% out of 611 valid genital samples. However, considering the high proportion of HIV-infected individuals in Qian’s sample (37.8%), the prevailing HPV detection in our low HIV risk community sample should not be overlooked.…”

Section: Discussionmentioning

confidence: 94%

Prevalence and risk factors of anogenital human papillomavirus infection in a community sample of men who have sex with men in Taiwan: baseline findings from a cohort study

Strong

Zou

et al. 2019

Sex Transm Infect

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ObjectivesMen who have sex with men (MSM) are a highly neglected population in the current recommendation of girls-only human papillomavirus (HPV) vaccination programmes in many countries. To better assess the cost effectiveness of HPV vaccination among men requires data on the prevalence of HPV infection in MSM using a community sample, which is still sparse in several regions. We examined the prevalence of and factors associated with anogenital HPV infection among MSM in Taiwan.MethodsMSM 20 years of age and older were recruited from the community and social media in Taiwan in 2015–2016 and screened for HPV infection to detect 37 genotypes. MSM were seen at baseline and were/will be seen at 6, 12, 24 and 36 months. Men completed a questionnaire regarding their sexual experiences. Multivariable regression analyses were conducted to identify associated behavioural risk factors using the baseline data.ResultsA total of 253 MSM were recruited; 87 % were below 35 years of age. Diagnosis of HIV was reported in 4% of men; just over 20% had three or more anal sex partners in the past year. The prevalence of any tested HPV type was 29.4% at the anal site and 11% at the penile site. One quarter of MSM were infected with any of the 9-valent vaccine HPV types. Anal HPV detection was associated with having three or more receptive anal sex partners in the past year (adjusted odds ratio (aOR)=2.92, 95% CI 1.29 to 6.61) and having older sex partners (aOR=2.51, 95% CI 1.07 to 5.90).ConclusionsOur data provide the base to calculate the reproductive rate for HPV transmission in a low-risk community sample and cost-effectiveness to include men in HPV vaccination policies. Adding evidence from a community sample adds comprehensiveness for future estimates of disease transmission and vaccine effectiveness.

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Section: Discussionmentioning

confidence: 94%

Prevalence and risk factors of anogenital human papillomavirus infection in a community sample of men who have sex with men in Taiwan: baseline findings from a cohort study

Strong

Zou

et al. 2019

Sex Transm Infect

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“…We identified 67 publications that were eligible for our anal ysis, 13-50,63-91 arising from 62 independent observational studies (119 248 participants). 33 17 reported STIs other than HIV as outcomes, 16,20,23,33,35,36,40,43,[46][47][48][49][50]65,68,70,74 and 12 reported both HIV infection and other STIs as outcomes. 17,25,27,32,34,39,41,[71][72][73]79,87,88,91 Four studies-two for HIV 15, 29 and two for other STIs 65,70were excluded from the meta-analysis because they did not report data necessary to calculate ORs (figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Cumulative meta-analysis Men (n) Kreiss et al (1993) 73 Lafferty et al (1997) 74 Mor et al (2007) 79 Templeton et al (2009) 88 Jameson et al (2010) 71 Jozkowski et al (2010) 72 Zou et al (2010) 91 Goldstone et al (2011) 68 Mor et al (2012) 16 van Aar et al (2013) 27 van Aar et al (2013) 27 Pando et al (2013) 25 Canadas et al (2013) 20 Hu et al (2013) 23 Hu et al (2013) 23 Zeng et al (2014) 32 Zou et al (2014) 33 Liu et al (2015) 34 Okafor et al (2015) 35 Rebe et al (2015) 36 Qian et al (2016) 41 Crosby et al (2016) 39 Lee et al (2016) 40 Somia et al (2016) 43 Raghavendran et al (2017) 47 Qian et al (2017) 46 Tian et al (2017) 48 Xin et al (2017) 50 Wahome et al (2017) 49 Overall Heterogeneity I 2 =8% 496 744 20 832 1396 3828 24 900 390 589 448 310 453 482 450 204 446 520 163 690 423 200 1095 346 133 49 274 650 500 88 312 61 411…”

Section: Meta-analysismentioning

confidence: 99%

Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data

Yuan

Fitzpatrick

et al. 2019

The Lancet Global Health

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Background Men who have sex with men (MSM) are disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. Previous reviews investigating the role of circumcision in preventing HIV and other STIs among MSM were inconclusive. Many new studies have emerged in the past decade. To inform global prevention strategies for HIV and other STIs among MSM, we reviewed all available evidence on the associations between circumcision and HIV and other STIs among MSM.Methods In this systematic review and meta-analysis, we searched PubMed, Web of Science, BioMed Central, Scopus, ResearchGate, Cochrane Library, Embase, PsycINFO, Google Scholar, and websites of international HIV and STI conferences for studies published before March 8, 2018. Interventional or observational studies containing original quantitative data describing associations between circumcision and incident or prevalent infection of HIV and other STIs among MSM were included. Studies were excluded if MSM could not be distinguished from men who have sex with women only. We calculated pooled odds ratios (ORs) and their 95% CIs using random-effect models. We assessed risk of bias using the Newcastle-Ottawa scale. (0·99, 0·90-1·09; k=20; I²=40%). Circumcision was associated with reduced odds of herpes simplex virus (HSV) infection among MSM overall (0·84, 0·75-0·95; k=5; I²=0%) and penile human papillomavirus (HPV) infection among HIV-infected MSM (0·71, 0·51-0·99; k=3; I²=0%). Findings We identified 62 observational studies including 119 248 MSM. Circumcision was associated with 23% reduced odds of HIV infection among MSM overall (OR 0·77, 95% CI 0·67-0·89; number of estimates [k]=45; heterogeneity I²=77%). Circumcision was protective against HIV infection among MSM in countries of low and middle income (0·58, 0·41-0·83; k=23; I²=77%) but not among MSM in high-income countries Interpretation We found evidence that circumcision is likely to protect MSM from HIV infection, particularly in countries of low and middle income. Circumcision might also protect MSM from HSV and penile HPV infection. MSM should be included in campaigns promoting circumcision among men in countries of low and middle income.In view of the substantial proportion of MSM in countries of low and middle income who also have sex with women, well designed longitudinal studies differentiating MSM only and bisexual men are needed to clarify the effect of circumcision on male-to-male transmission of HIV and other STIs.

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“…Our study collected samples from 3 sites, which is not very common in such studies. [ 3 , 11 , 17 , 19 , 32 , 43 ] Limited studies have focused on HPV infection in external genital sites in HIV-infected subjects in Asia, including Taiwan. In our study, external genital swab HPV prevalence in HIV-uninfected, compared to HIV-infected subjects was 11.6% vs 45.0%.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 – 16 ] The prevalence of anal HPV is higher than that of external and oral sites. [ 17 – 19 ] For oral HPV infection, a meta-regression analysis showed a 17.1% pooled prevalence in HIV-uninfected MSM, and 28.9% in HIV-infected MSM. [ 20 ] Importantly, anal HPV infection can cause more serious diseases among HIV-infected men than in HIV-negative ones.…”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus prevalence and behavioral risk factors among HIV-infected and HIV-uninfected men who have sex with men in Taiwan

Lin¹,

Hsieh

Hung

et al. 2018

Medicine

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Human papillomavirus (HPV) infection is associated with cancer and can be prevented through vaccination. Few studies from Taiwan have reported on HPV infection among human immunodeficiency virus (HIV)-infected subjects. The aim of this study was to examine the prevalence of HPV infection among men who have sex with men (MSM) with and without HIV infection in Taiwan, and explore the behavioral risk factors thereof.We conducted a cross-sectional study in Taiwan during 2013 to 2016 to collect data on MSM aged 20 years or older. We used a questionnaire in a face-to-face interview, and subsequently collected oral, anal, and genital specimens from HIV-infected and HIV-uninfected subjects. Multivariate analysis was performed to predict factors associated with high-risk HPV (HR-HPV) positivity.Overall, 279 subjects, including 166 (59.5%) HIV-uninfected and 113 (40.5%) HIV-infected men were enrolled. Compared to HPV-negative subjects, HPV-positive subjects had significantly higher rates of receptive anal sex (91.3% vs 75.6%), substance use (22.6% vs 11%), history of sexually transmitted infections (75.7% vs 38.4%), anogenital or oral warts (39.1% vs 6.72%), syphilis (32.2% vs 11.6%), and HIV infection (69.6% vs 20.1%). We detected 489 HPV deoxyribonucleic acid (DNA) types (through 379 viable specimens), of which 43.6%, 5.7%, 56.4%, and 10.4% were HR-HPV type, HPV type 16, low-risk HPV types, and HPV type 6, respectively. In multivariate analysis, HIV-infected subjects had a significantly higher prevalence of HR-HPV infection (adjusted odds ratio, 5.80; 95% confidence interval, 2.57–13.11), compared to HIV-uninfected subjects.These results suggest that the prevalence of HPV infection was high among HIV-infected MSM. Additionally, anal HPV infection was observed to be common among both HIV-infected and HIV-uninfected MSM in Taiwan. The prevalence of oral and genital HPV infection, HR-HPV DNA types, and multiple HPV types was higher in HIV-infected subjects than in HIV-uninfected subjects. As only 35% of subjects practiced safe sex, we recommend routine HPV vaccination with 4-valent HPV or 9-valent HPV vaccines for both MSM, and HIV-infected subjects.

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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

Cited by 13 publications

References 29 publications

Prevalence and risk factors of anogenital human papillomavirus infection in a community sample of men who have sex with men in Taiwan: baseline findings from a cohort study

Prevalence and risk factors of anogenital human papillomavirus infection in a community sample of men who have sex with men in Taiwan: baseline findings from a cohort study

Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data

Human papillomavirus prevalence and behavioral risk factors among HIV-infected and HIV-uninfected men who have sex with men in Taiwan

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