Anal Human Papillomavirus Infection Among Thai Men Who Have Sex With Men With and Without HIV Infection

ArticleinJAIDS Journal of Acquired Immune Deficiency Syndromes 63(4) · March 2013with95 Reads
DOI: 10.1097/QAI.0b013e3182918a5a · Source: PubMed
Background: HIV-positive men who have sex with men (MSM) have a higher prevalence of anal human papillomavirus (HPV) infection and anal cancer incidence than HIV-negative MSM. High-risk HPV persistence is an important risk factor for the development of anal cancer. Methods: A total of 123 HIV-positive and 123 HIV-negative MSM were enrolled from the Thai Red Cross AIDS Research Centre in Bangkok, Thailand, and followed for 12 months. Anal sample collection for HPV genotyping was performed at every visit. HPV prevalence, incidence, clearance, and persistence were calculated. A logistic regression model was used to study factors associated with high-risk HPV persistence. Results: The prevalence of any anal HPV infection was 85% in HIV-positive and 58.5% in HIV-negative MSM (P < 0.0001). The prevalence of high-risk HPV infection was 57.5% in HIV-positive and 36.6% in HIV-negative MSM (P = 0.001). HPV 16 was the most common high-risk HPV type. HIV-positive MSM had a higher prevalence (22.5% vs. 9.8%, P = 0.008) and persistence (16.7% vs. 1.3%, P < 0.001) of HPV 16 than HIV-negative MSM and a trend for higher incidence (16.1 vs. 6.1 episodes/1000 person-months, incidence rate ratio 2.6, P = 0.058). HIV infection (odds ratio: 4.45, 95% confidence interval: 2.11 to 9.4, P < 0.001) and smoking in HIV-positive MSM (odds ratio: 2.3, 95% confidence interval: 1.17 to 4.5, P = 0.015) were independently associated with high-risk HPV persistence in multivariate models. Conclusions: In addition to targeting HIV-positive MSM who are at higher risk for anal, high-risk HPV persistence, anal cancer prevention programs should also integrate behavioral interventions such as smoking cessation to modify risk for high-risk HPV persistence.
    • "* Participants that use alcohol at last penetrative sex are three times more likely to engage in receptive UAI with elective male partners (24/53, 45%) than participants that do not use alcohol (10/46, 22%). ** p-Value is calculated from the Fisher's exact test. is generally high, in this sample smoking is coupled with high rates of oral STIs, particularly high rates of oral gonorrhea (Vu, Giang, Nguyen, Clatts, & Goldsamt, 2013) as well as high rates of Human Papilloma Virus (Clatts, Giang, Goldsamt, & Yu, 2014) is of concern because, particularly when combined with smoking , high rates of HPV infection are generally associated with increased risk of oral, penile, and anal cancer (Phanuphak et al., 2013). This highlights the urgent need to develop models for effectively engaging these groups in early interventions (particularly targeted health services with which to engage and retain MSWs in HPV vaccination programs and related preventative health ser- vices). "
    [Show abstract] [Hide abstract] ABSTRACT: HIV research in Vietnam has focused primarily on its large heroin injector population. Data on men who have sex with men [MSM], particularly the large and growing population of men who exchange sex for money or other material rewards, male sex workers [MSWs], is very limited.Methods Data derive from a cross-sectional study of MSW, age 16-35, recruited using community sampling methods in three cities in 2010-2011, including Hanoi, Ho Chi Minh City [HCMC], and Nha Trang City (n = 710). Assessments included demographic characteristics, substance use, sexual risk, and use of health services. A series of “event” questions were used to assess the influence of alcohol and drugs on sexual risk.ResultsBoth tobacco and alcohol are initiated at a young age and most participants currently use both substances overall across all three cities. While alcohol and tobacco use precede the initiation of sex work, stimulant and opiate use are initiated following the initiation of sex work. There was substantial overlap between substance use and sexual risk, and this overlap was strongest in sexual events involving male and female elective partners rather than sex work clients.Conclusion Although rates of HIV infection in this group are low, this may be an artifact of the young age of the sample. High rates of drug use, including alcohol, tobacco and illicit drugs, coupled with high rates of ulcerative STIs such as HPV, suggest the potential for rapid amplification of STI/HIV risk among MSW and their complex sex partnering networks.
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    • "Pornjarim Nilyanimit et al Asian Pacific Journal of Cancer Prevention, Vol 14, 2013 5520 (Phanuphak et al., 2013 "
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    Full-text · Article · Sep 2013
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    Article · Aug 2013
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