Fengyi Jin

• Ph.D.
• UNSW Sydney

Background In an era of biomedical prevention of HIV transmission, prevention of sexually transmissible infections (STIs) remains a priority for male HIV-serodiscordant couples. Three common STIs in populations of gay and bisexual men are chlamydia, gonorrhoea and syphilis. Methods We examined the incidence of these three infections in 343 male HIV...

Background Risk of anal cancer is high in certain populations and screening involves collection of anal swabs for HPV DNA and/or cytology testing. However, barriers exist, such as the need for an intimate examination, and stigma around HIV status, sexual orientation, and sexual practices. Self-collected anal swabs (SCA) are a proposed alternative t...

Anal high‐risk human papillomavirus (HRHPV) testing‐based anal cancer screening gay and bisexual men (GBM) is associated with high sensitivity, but low specificity. We report the potential role of triage use of anal cytology with HRHPV testing in detecting 12‐month persistent anal high‐grade squamous epithelial lesions (HSIL) in a cohort of GBM in...

Anal squamous cell carcinoma (ASCC) incidence is increasing globally. International consensus guidelines published in 2024 include HPV and/or cytology testing of anal swabs in those at greatest risk of ASCC. Self‐collected anal swabs may be important for increasing screening uptake, but evidence is needed as to their equivalence to clinician‐collec...

Condoms continue to be used by many gay, bisexual, and other men who have sex with men (GBM) to reduce the risk of HIV transmission. However this is impacted by condom failure events, defined here as condom breakage and slippage. In a prospective, observational cohort study of 343 HIV serodiscordant male couples recruited through high HIV caseload...

Objectives Women diagnosed with a history of lower genital tract cancer (LGTC) and precancer are at increased risk of anal cancer. Screening for anal cancer in a manner analogous to cervical cancer may detect precursor anal high-grade squamous intraepithelial lesions (HSILs) and prevent progression to cancer. Methods In a pilot study of anal cance...

We investigated factors associated with “worse than usual” anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015. Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the l...

Introduction Gonorrhoea, the sexually transmissible infection caused by Neisseria gonorrhoeae, has a substantial impact on sexual and reproductive health globally with an estimated 82 million new infections each year worldwide. N. gonorrhoeae antimicrobial resistance continues to escalate, and disease control is largely reliant on effective therapy...

Commentary Gay, bisexual and other men who have sex with men (GBM) with HIV have a 40-to 80-fold increased risk of anal cancer compared with the general population. 1 The precursor to anal cancer is high-grade squamous intra-epithelial lesion (HSIL). 2,3 We have previously reported that routine HSIL screening and treatment in GBM with HIV is unlike...

Backgrounds: Anal cancer is an uncommon condition, occurring at higher rates in specific subpopulations. Clinical experience is limited and substantial changes have recently occurred in our understanding of this condition. We, therefore, set out to characterize patients presenting with anal cancer and investigate whether there have been any change...

Male HIV serodiscordant couples have diverse relationship agreements regarding sex outside the relationship. We examined the relationship agreements as described by 343 male HIV-negative partners in HIV serodiscordant relationships in Australia, Brazil and Thailand participating in a multi-year cohort study. At baseline, 125 (34.1%) HIV-negative pa...

Background: The evidence regarding the characteristics of second primary cancer (SPC) in people living with HIV (PLWHIV) is limited. Setting: We performed a national population-based data linkage study to determine the incidence and risk factors for SPC in PLWHIV in Australia between 1982 and 2012. Methods: We conducted a probabilistic data li...

Introduction: HIV pre-exposure prophylaxis (PrEP) has been government subsidized in Australia since April 2018 and while uptake is high among men who have sex with men, rates of discontinuation are also high. The aims of this study were to examine the impact of discontinuation on overall PrEP usage, the proportion of PrEP users who discontinue and...

Background Gay, bisexual and other men who have sex with men (GBM) living with HIV have a substantially elevated risk of anal cancer (85 cases per 100,000 person-years vs 1–2 cases per 100,000 person-years in the general population). The precursor to anal cancer is high-grade squamous intraepithelial lesion (HSIL). Findings regarding the cost-effec...

Background: Gay and bisexual men (GBM) are at increased risk of human papillomavirus (HPV) associated anal high-grade squamous-intraepithelial-lesions (HSIL). Understanding fractions of HSIL attributable to HPV genotypes is important to inform potential impacts of screening and vaccination strategies. However, multiple infections are common, makin...

Gay, bisexual, and other men who have sex with men (GBM) have developed community norms for regular HIV/STI testing. We investigated factors associated with self-reported COVID-19 testing in response to reported COVID-19 cases and public health restrictions. Participants responded to weekly cohort surveys between 10th May 2021 and 27th September 20...

Background Most HIV seroconversions in people who have initiated pre-exposure prophylaxis (PrEP) occur in the context of insufficient adherence. We describe participants who seroconverted after being dispensed PrEP in a large PrEP implementation study in Australia. Methods Expanded PrEP Implementation in Communities in New South Wales was an imple...

Objectives: Anal cancer is preceded by high-risk human papillomavirus (HRHPV) infection, predominantly HPV16. No HPV assay is licenced for use in anal screening. We aimed to determine the sensitivity and specificity of four anal canal swab HPV assays to predict high grade squamous epithelial lesions (HSIL). Methods: In a cohort of Australian HIV...

Introduction COVID-19 related lockdowns have impacted the sexual activity of gay and bisexual men (GBM). We investigated trends in sexual behaviors and the COVID-19 context in which they occurred (COVID-notification rates and jurisdictional restrictions) to understand changes in the duration and severity of periods of lockdown on the sexual behavio...

Background The use of pre-exposure prophylaxis (PrEP) for the prevention of HIV has raised concerns of increased sexual risk behaviours. These behaviours may be associated with increased incidence of sexually acquired hepatitis C (HCV) among gay and bisexual men (GBM). Methods The Expanded PrEP Implementation in Communities–New South Wales (EPIC-N...

Human papillomavirus (HPV) is detected in up to 96% of anal squamous cell cancers, where screening programs needed. However, the best methodology is still undetermined. Host DNA methylation markers CADM1, MAL and miR124 have been identified in cervical disease, but not anal disease. Anal swabs varying by disease grade were assessed for DNA methylat...

Background It is unknown whether reactivation of human papillomavirus (HPV) after latency occurs in the anus. We measured incidence and predictors of incident anal HPV in sexually inactive gay and bisexual men (GBM) as a surrogate of HPV reactivation. Methods The Study of the Prevention of Anal Cancer collected data on sexual behavior, anal cytolo...

Background Overseas-born people who are ineligible for government-subsidised health care experience barriers to accessing HIV pre-exposure prophylaxis (PrEP) in Australia. This study aimed to assess a program providing free PrEP to overseas-born adults at risk of acquiring HIV. Methods Medicare-Ineligible Expanded Implementation in Communities (MI...

The use of undetectable viral load (VL) to negotiate condomless anal intercourse (CLAI) in HIV serodiscordant male relationships has become more common as more data regarding the effectiveness of antiretroviral treatments for the prevention of HIV transmission has been described. We examined viral load agreements (VLAs) for condomless sex in the pr...

Few studies have examined changes in sexual behaviour following HIV pre-exposure prophylaxis (PrEP) initiation among gay, bisexual and other men who have sex with men (GBM) in relationships. In a national, online, prospective study of GBM in Australia, we compared sexual behaviours prior to and after PrEP initiation among HIV-negative and unknown-H...

COVID-19 may threaten the already poor mental health outcomes of Australian gay and bisexual men and cut ties to important social/sexual networks and community. Qualitative research into the experiences of gay and bisexual men during COVID-19 regulations is currently sparse. We report on 489 responses to a qualitative free-text question asking Aust...

Men who have sex with men (MSM) living with HIV have a high prevalence and incidence of anal high-risk human papillomavirus (hrHPV) and anal cancer. We conducted an open-label, single-arm pilot study to examine the tolerability of imiquimod cream among MSM aged ≥18 years, living with HIV, who tested positive for anal hrHPV at Melbourne Sexual Healt...

Objectives The aim of the study was to describe time trends in cancer incidence in people living with HIV (PLHIV) in Australia between 1982 and 2012. Methods A population-based prospective study was conducted using data linkage between the national HIV and cancer registries. Invasive cancers identified in PLHIV were grouped into AIDS-defining canc...

Background: HIV pre-exposure prophylaxis (PrEP) with fixed-dose tenofovir disoproxil fumarate (TDF) and emtricitabine has been associated with low rates of renal impairment in clinical trials. Large-scale PrEP implementation may result in higher rates, as the prevalence of associated risk factors may be higher than in trial populations. Methods:...

Background Daily pre-exposure prophylaxis (PrEP) is effective in preventing HIV, but few long-term data are available on effectiveness and adherence in real-world settings. Here, we report trends in HIV incidence over 3 years in individuals at high risk who were prescribed PrEP in New South Wales (NSW), as well as adherence before the transition to...

Objectives: To examine patterns of long-term PrEP adherence and its association with HIV seroconversion in NSW, Australia. Design: Population-based HIV PrEP implementation study. Methods: EPIC-NSW was an open-label study of daily oral PrEP which recruited participants from March 2016 to April 2018. Adherence was measured using dispensing recor...

Background: Pre-exposure prophylaxis (PrEP) prevents HIV infection but relies on good adherence at times of risk, termed 'prevention-effective adherence'. Most studies assess adherence without reference to sexual behaviour, making it challenging to determine if poor adherence coincides with HIV risk. Setting: We examined data from a behavioural...

Objective High-risk human papillomavirus (HRHPV) causes anal cancer, which disproportionately affects gay and bisexual men (GBM). We examined sexual behaviours associated with incident anal HRHPV in an observational cohort study of GBM in Sydney, Australia. Methods GBM aged 35 years and above were enrolled in the Study of the Prevention of Anal Ca...

Background Anal symptoms may indicate serious pathology. Receptive anal intercourse (RAI) and sexually transmissible infections (STIs) may contribute to a higher prevalence of symptoms among gay and bisexual men (GBM). This study investigated associations with anal symptoms among GBM. Methods: The Study of the Prevention of Anal Cancer was a longit...

Importance There have been concerns that HIV preexposure prophylaxis (PrEP) may be associated with increases in sexually transmitted infections (STIs) because of subsequent reductions in condom use and/or increases in sexual partners. Objective To determine trends in STI test positivity among high-risk men who have sex with men (MSM) before and af...

Recreational drug use (RDU) among gay and bisexual men (GBM) is associated with higher-risk sexual behaviours, however this has not been well defined among older GBM. We investigated the association between RDU and sexual behaviours among older GBM in Sydney, Australia. 617 GBM aged 35–79 years self-reported their RDU in the past 6 months and sexua...

Objectives Incidence of anal cancer is highest in gay and bisexual men (GBM). A better understanding of the natural history of anal high-risk human papillomavirus (HRHPV) infection is needed for anal cancer prevention. Methods The Study of the Prevention of Anal Cancer was a 3-year study of Australian GBM, aged 35 years or older. We examined incid...

Background Despite combination antiretroviral therapy (cART), the incidence of lymphomas remains elevated in persons with HIV/AIDS (PWHA). While the risk of subsequent primary cancers (SPCs) in the general population is well understood, these data are lacking for PWHA. Underlying aetiologic factors in PWHA, including oncogenic viruses and immunodef...

Oropharyngeal cancer (OPC) is rare and, in some countries, more than 70% of all cases are caused by human papillomavirus (HPV).¹ The type HPV16 accounts for more than 85% of all cases of HPV–associated oropharyngeal cancer (HPV-OPC).¹ Antibodies to the HPV16 E6 oncoprotein are biomarkers for determining the HPV status of OPC cases, with reported se...

Background: In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV pre-exposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM). Methods: Participants in an ongoing onli...

Human papillomavirus (HPV) causes anal warts and anal squamous cell carcinoma (SCC). A higher incidence of anal cancer has been found among individuals previously diagnosed with anogenital warts. We aimed to investigate the association between anal warts and the presumed anal SCC precursor high-grade squamous intraepithelial lesion (HSIL), among pa...

Background Anal high-grade squamous intraepithelial lesion (HSIL) can be histomorphologically categorized into anal intraepithelial neoplasia (AIN) grade 2 (AIN2) and grade 3 (AIN3). Different risk factors for these two categories have been described. We investigated whether there were also differences in lesion-specific human papillomavirus (HPV)...

Use of crystal methamphetamine (crystal) among gay and bisexual men (GBM) has been associated with condomless anal intercourse with casual partners (CLAIC) and HIV infection. Pre-exposure prophylaxis (PrEP) and undetectable viral load (UVL) are important biomedical HIV prevention strategies. We investigate the relationship between crystal use and H...

BACKGROUND Men who have sex with men in Australia are currently ineligible to donate blood (are “deferred”) for 12 months since last oral or anal sexual contact with another man. In Australia and overseas, there has been limited research on attitudes and perceptions related to blood donation in this population. STUDY DESIGN AND METHODS Questions o...

Background: Gay and bisexual men (GBM) are disproportionately affected by anal cancer. Prevention is hindered by incomplete understanding of the natural history of its precursor, anal high-grade squamous intraepithelial lesions (HSIL). Methods: The Study of the Prevention of Anal Cancer, conducted between 2010 and 2018, enrolled human immunodefi...

Background and aims: Gay, bisexual and other men who have sex with men (GBM) use alkyl nitrites ('poppers') at higher rates than other populations to functionally enhance sexual experiences. Their use has been associated with HIV sexual risk behaviours including receptive anal sex. We investigate the prevalence, frequency, and motivations for popp...

Objectives: To investigate factors associated with larger burden of intra-anal high-grade squamous intraepithelial lesions (HSIL) in a natural history study of HSIL. Methods: 617 gay and bisexual men (GBM) attended a baseline visit. High-resolution anoscopy-directed biopsy was performed of suspected HSIL. GBM with biopsy-confirmed HSIL (bHSIL) a...

Background: Many gay and bisexual men (GBM) experience HIV anxiety, particularly around condomless anal intercourse. HIV pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that may reduce HIV anxiety among GBM. Methods: The Following Lives Undergoing Change (Flux) Study is a national, online, open-prospective observational s...

Objective Gay, bisexual and other men who have sex with men (GBMSM), particularly HIV-positive GBMSM, are at increased anal cancer risk compared with the general population. This study examined the psychological and quality of life (QoL) impact of receiving abnormal anal cancer screening results during the baseline visit of the Study of the Prevent...

Background Gay and bisexual men (GBM) increasingly use HIV Pre-exposure prophylaxis (PrEP) to prevent HIV infection. Eligibility for PrEP in Australia is based on behavioral criteria including methamphetamine use or condomless sex. It is unclear what proportions of GBM initiating PrEP meet these criteria over time. Methods The Flux prospective coh...

Background Trans and gender diverse (TGD) individuals are at higher risk of HIV than the general population. TGD individuals are under-represented among HIV pre-exposure prophylaxis (PrEP) users, hence little is known about their pill-taking behaviours. We describe demographic characteristics and PrEP adherence by TGD individuals in the EPIC-NSW st...

Background Many gay and bisexual men (GBM) experience anxiety about HIV, particularly in relation to sex. Use of HIV pre-exposure prophylaxis (PrEP) as an HIV prevention strategy may affect levels of HIV-related anxiety among GBM. Methods Flux is an Australian online prospective study of GBM enrolled between 2014 and 2018. We measured anxiety usin...

Background HIV PrEP is highly effective at preventing HIV, but not STI, acquisition. We examined the use of condoms to prevent STIs among PrEP-users in the EPIC-NSW trial. Methods Between March 2016 and April 2018, 9,708 individuals were enrolled. Analysis was restricted to participants who completed the optional end-of-study survey and were on-st...

Objectives Sexually transmitted infection (STI) notifications are increasing among older individuals. Many older gay and bisexual men (GBM) are sexually active and have multiple partners. We aimed to investigate the prevalence, incidence and predictors of anal chlamydia, anal gonorrhoea and syphilis in older GBM. Methods The Study for the Preventi...

Introduction There are few data about the range of strategies used to prevent sexual HIV transmission within gay male serodiscordant couples. We examined HIV prevention strategies used by such couples and compared differences between countries. Methods Opposites Attract was a cohort study of male serodiscordant couples in Australia, Brazil and Tha...

Background: Anal cancer incidence increased markedly in people living with HIV (PLWHIV) after the introduction of HAART, but in a few setting settings, recent declines have been reported. We report the incidence and time trends of anal cancer in PLWHIV in Australia. Study design: A data linkage study between the National HIV Registries and the A...

Background: HIV pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention strategy, yet some gay and bisexual men (GBM) who are eligible to access PrEP are not using it. We report the incidence of PrEP uptake, factors predicting its initiation, and identify characteristics associated with non-uptake of PrEP among Australian GB...

Background: Gay and bisexual men (GBM) report distinctive patterns and contexts of drug use, yet little has been published about their attitudes toward drug use. Objectives: We developed measures of attitudes and perceived social norms toward drug use, and examined covariates of more accepting attitudes and norms among GBM in Australia. Methods...

We investigated the racial or ethnic partner preferences among Australian gay and bisexual men (GBM) as part of a large study of sexual preferences among GBM, to identify whether racial bias was a factor in how GBM expressed their partner preferences. We surveyed 1853 Australian GBM about their partner preferences and preferred sex practices. We us...

Background: HIV pre-exposure prophylaxis (PrEP) is highly effective in men who have sex with men (MSM) at the individual level, but data on population-level impact are lacking. We examined whether rapid, targeted, and high-coverage roll-out of PrEP in an MSM epidemic would reduce HIV incidence in the cohort prescribed PrEP and state-wide in Austra...

Background: Evidence on viral load and HIV transmission risk in HIV-serodiscordant male homosexual couples is limited to one published study. We calculated transmission rates in couples reporting condomless anal intercourse (CLAI), when HIV-positive partners were virally suppressed, and daily pre-exposure prophylaxis (PrEP) was not used by HIV-neg...

Background The majority of anal carcinomas are caused by human papillomavirus (HPV) 16. Identifying which of the high-grade squamous intraepithelial lesions (HSIL) are caused by HPV16 may enable targeted management of those most likely to progress. Methods In a natural history study of anal HPV-related lesions in gay and bisexual men, HPV typing o...

Background Intra-anal lesions caused by human papillomavirus (HPV) can be classified as low-grade squamous intraepithelial lesions (LSIL) or high-grade squamous intraepithelial lesion (HSIL). The latter can be further subclassified histomorphologically as anal intraepithelial neoplasia (AIN)2 or AIN3. It is not known whether morphological differenc...

Background: We report prevalence and incidence of drug use initiation in Australian gay and bisexual men (GBM) participating in an online cohort study. Methods: Between September 2014 and June 2015, 1,710 GBM were enrolled in the Following Lives Undergoing Change Study and followed-up six monthly. Participants were asked about measures of lifeti...

Background: Gay and bisexual men (GBM) are at disproportionately high risk of anal cancer. The precursor lesions, high-grade squamous intraepithelial lesions (HSIL), are very common and it is evident that not all HSIL progresses to cancer. The serologic response to anal human papillomavirus (HPV) in GBM has not been well characterized. Methods: The...

Introduction: Gay and bisexual men (GBM) often use illicit drugs to enhance sexual pleasure, commonly referred to as 'chemsex' or 'party n play'. In particular, the use of methamphetamine and Viagra™, and other erectile dysfunction medications, both together and separately are strongly predictive of subsequent HIV infection. Truvada™, as pre-expos...

After publication of the article [1], it has been brought to our attention that one of the members of the EPIC-NSW study group has had their name spelt incorrectly in the acknowledgements. The article mentions "Muhammad Hammoud" when in fact the correct spelling is "Mohamed Hammoud".

Background: The New South Wales (NSW) HIV Strategy 2016-2020 aims for the virtual elimination of HIV transmission in NSW, Australia, by 2020. Despite high and increasing levels of HIV testing and treatment since 2012, the annual number of HIV diagnoses in NSW has remained generally unchanged. Pre-exposure prophylaxis (PrEP) is highly effective in...

Background: Compared to the general population, among gay and bisexual men (GBM) prevalence rates of anxiety and depression, and of drug use, are high. Objective: This paper explores the relationship between mental health, sexual risk behavior, and drug use among Australian GBM. We identify factors associated with indicators of poor mental healt...

Introduction: HIV pre-exposure prophylaxis (PrEP) has been increasingly adopted by gay and bisexual men (GBM). Little is known about whether individual GBM are more likely to change their sexual behavior following PrEP initiation. Methods: Following Lives Undergoing Change is a national, online, prospective observational study among Australian GBM....

Background Gamma-hydroxybutyrate (GHB) use among gay and bisexual men (GBM) has increased in recent years. It is commonly cited as a sexual-enhancement drug. There is, however, little evidence for factors associated with GHB use or the consequences of its use among GBM. Aim: Factors associated with GHB use, its relationship to sexual risk behaviour...

Background: Longitudinal studies of histological outcomes after anal cytological screening in men who have sex with men (MSM) are rare. This study measured the positive predictive values (PPVs) of each level of baseline cytological abnormality in MSM in Sydney, Australia, over a 12-month period. Methods: The Study of the Prevention of Anal Cance...

Background: Gay and bisexual men (GBM) use illicit drugs at higher rates than most other population groups and their use has been associated with sexual risk behavior. The measure of sexual sensation-seeking has been a useful tool for understanding sexual risk behavior in this population, but there is no equivalent measure for sensation-seeking in...

Objective: HPV causes ~90% of anal cancer and HPV16 is the type most commonly associated with anal cancer. Gay and bisexual men (GBM) are at greatly increased risk. We investigated patterns of vaccine-preventable anal HPV in older GBM. Methods: The Study of the Prevention of Anal Cancer (SPANC) is an ongoing, prospective cohort study of HIV-posi...

Anal cytology has been suggested as a screening test for the anal cancer precursor high-grade squamous intraepithelial lesion (HSIL). We aimed to assess the prevalence and predictors of initial unsatisfactory anal cytology tests ('unsats'). The Study of the Prevention of Anal Cancer is a natural history study of anal human papillomavirus (HPV) and...

Background Among gay and bisexual men (GBM), ‘serosorting’ is common and involves restricting sex, or at least condomless sex, to partners of the same HIV status. The prevalence of men conveying their serosorting preferences regarding partners they meet online remains unclear. Methods: This study reviewed 57 178 Australian online profiles obtained...

Background: We evaluate the performance of human papillomavirus (HPV) biomarkers in prediction of anal histological high-grade squamous intraepithelial lesions (HSIL) in gay and bisexual men (GBM) in Sydney, Australia. Design: Baseline analysis of a three-year cohort study METHODS:: The Study of the Prevention of Anal Cancer (SPANC) is natural h...

Anal canal cancer is a generally uncommon cancer that has been increasing in incidence for several decades. In most geographic locations, squamous cell carcinoma (SCC) accounts for 70% or more of cases, and incidence is slightly higher in women than in men. The remaining cases are mainly adenocarcinoma, but the degree to which this represents miscl...

We aimed to compare rates of illicit drug-related hospitalisations in HIV-negative (HIV−ve) (n = 1325) and HIV-positive (HIV+ve) (n = 557) gay and bisexual men (GBM) with rates seen in the general male population and to examine the association between self-reported illicit drug use and drug-related hospitalisation. Participants were asked how often...

Incidence and mortality rates of anal cancer are increasing globally. More than 90% of anal squamous cell carcinomas (ASCC) are associated with human papillomavirus (HPV). Studies on HPV-related anogenital lesions have shown that patterns of methylation of viral and cellular DNA targets could potentially be developed as disease biomarkers. Lesion-s...

Background: Prevalence of anxiety and mood disorders (AMDs) in HIV-infected individuals has varied widely due to the variety of measurements used and differences in risk factor profiles between different populations. We aimed to examine the relationship between HIV-status and hospitalisation for AMDs in GBM. Design: and Methods: HIV-infected (n=...

Background: In a cytology-based screening program intended to prevent anal cancer, the anal transformation zone (TZ) should be adequately sampled because it is the site most susceptible to the development of the cancer precursor, high-grade squamous intraepithelial lesion (HSIL). An adequate TZ component is defined as comprising at least 10 rectal...

Background: Anal intraepithelial neoplasia grade 2 (AIN2) and AIN grade 3 (AIN3) are commonly grouped together as high grade squamous intraepithelial lesions (HSIL). We assessed risk factors for HSIL-AIN2 and HSIL-AIN3 in a cohort of homosexual men. Methods: At the baseline visit in the Study for the Prevention of Anal Cancer (SPANC), all men co...

Background: There is debate about the accuracy of anal cytology and high-resolution anoscopy (HRA), in the diagnosis of anal human papillomavirus (HPV)-related squamous intraepithelial lesions (SIL). Few studies have performed both simultaneously in a large sample of high-risk individuals. Methods: At baseline in a community-based cohort of HIV-inf...

Background: Studies regarding the performance of anal cytology in which both the screening test (cytology) and the diagnostic test (high-resolution anoscopy [HRA]) are performed in all members of a screening population are rare. The authors evaluated the performance of liquid-based anal cytology in a cohort of homosexual men in Sydney, New South W...

Background Anal cancer is increasing in incidence, has very high rates in specific populations and shares many similarities with cervical cancer. High-grade squamous intraepithelial lesions (HSIL) are regarded as precursors to anal cancer. High resolution anoscopy (HRA), which is derived from colposcopy, is the only currently available tool that ca...

Background: The ThinPrep Imaging System (TIS) is an accurate time-saving method of reading cervical ThinPrep slides in screening programs. As anal and cervical cytology are morphologically similar, TIS can potentially be used for anal cytology. We assessed the performance of TIS on anal ThinPrep slides from homosexual men in a natural history stud...

In a natural history study of anal human papillomavirus (HPV) infection and HPV-related lesions among homosexual men in Sydney, Australia, we identified 15 examples of papillary immature metaplasia (PIM) in anal biopsy samples. PIM has previously been described in the cervix, but not in the anal canal. PIM is a form of exophytic low-grade squamous...

Objectives: Men who have sex with men (MSM) living with HIV are at high risk of infection with high-risk human papillomavirus (HPV), the cause of anal cancer. We assess whether anal HPV DNA detection is related to recent anal sexual activity, what types of anal sexual activity or the persistence of HPV genotypes. Methods: We analysed anal swabs...