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High Rate of New Infections With HPV Types Associated With a High Risk of Anal Cancer Among Gay Men Living With HIV

March 21, 2014

This article was reported by NAM aidsmap.

NAM aidsmap reported that the incidence of anal infection with strains of cancer-causing human papillomavirus (HPV) is high among HIV-positive gay men. Researchers in San Francisco conducted a prospective study to determine incidence of and risk factors for anal HPV infection among HIV-positive men who have sex with men (MSM).

The researchers recruited 369 individuals (mean age 45 years) between 1998 and 2000. They checked participants for anal HPV infection every six months for two years. More than 75 percent had a history of anal or genital warts and 92 percent had HPV infection at baseline. The researchers found low- or high-grade pre-cancerous cell changes in 78 percent of participants. Most participants (86 percent) were in treatment for HIV, 62 percent had a suppressed viral load, and 37 percent had a CD4 cell count of more than 500 cells per cubic millimeter. Of 122 participants with anal HPV infection, 80 percent had incident infection with one HPV type, 16 percent with two types, 3 percent with three types, and 1 percent with four or more types. Annual incidence of anal HPV infection was 21.3 per 100 person-years and 13.3 per 100 person-years with cancer-causing strains.

The researchers detected an association between certain anal sex behaviors and increased risk of incident anal HPV infection, including receptive sex with a higher number of recent partners, and frequency of receptive anal intercourse. The researchers concluded that HIV-positive MSM should receive counseling about anal cancer and risk factors for HPV infection as well as prevention methods such as condoms and the HPV vaccine.

The full report, "Incidence of and Risk Factors for Type-specific Anal Human Papillomavirus Infection Among HIV-positive MSM," was published online in the journal AIDS (2014; doi 10.1097/QAD.0000000000000254, 2014).

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