2070 • JID 2004:190 (15 December) • Chin-Hong et al.
M A J O R A R T I C L E
Age-Specific Prevalence of Anal Human Papillomavirus
Infection in HIV-Negative Sexually Active Men Who
Have Sex with Men: The EXPLORE Study
Peter V. Chin-Hong,1Eric Vittinghoff,2Ross D. Cranston,5Susan Buchbinder,1,2,4Daniel Cohen,6Grant Colfax,1,2
Maria Da Costa,1Teresa Darragh,3Eileen Hess,10Franklyn Judson,8Beryl Koblin,9Maria Madison,7
and Joel M. Palefsky1
Health, San Francisco, and
Center, Boston, and
2Epidemiology and Biostatistics, and
5Department of Medicine, University of California at Los Angeles, Los Angeles, California;6Fenway Community Health
7Abt Associates, Cambridge, Massachusetts;
10Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington
3Pathology, University of California at San Francisco,
4Department of Public
8Department of Public Health, Denver, Colorado;
9New York Blood Center, New
cervical cancer in women. Human papillomavirus (HPV) is causally linked to the development of anal and cervical
cancer. In women, cervical HPV infection peaks early and decreases after the age of 30. Little is known about the
age-specific prevalence of anal HPV infection in human immunodeficiency virus (HIV)–negative MSM.
We studied the prevalence and determinants of anal HPV infection in 1218 HIV-negative MSM, 18–89
years old, who were recruited from 4 US cities. We assessed anal HPV infection status by polymerase chain reaction.
HPV DNA was found in the anal canal of 57% of study participants. The prevalence of anal HPV
infection did not change with age or geographic location. Anal HPV infection was independently associated with
receptive anal intercourse (odds ratio [OR], 2.0;
P ! .0001
during the preceding 6 months (OR, 1.5; ).P ! .0001
Urban, HIV-negative MSM have a stable, high prevalence of anal HPV infection across all age
groups. These results differ substantially from the epidemiologic profile of cervical HPV infection in women. This
may reflect differences between these populations with respect to the number of new sex partners after the age
of 30 and may explain the high incidence of anal cancer in MSM.
In the United States, anal cancer in men who have sex with men (MSM) is more common than
) during the preceding 6 months and with 15 sex partners
Anal cancer is increasing in incidence in women and
men in the general population [1, 2]. Such subpopu-
lations as men who have sex with men (MSM), HIV-
positive women and men, transplant recipients, and
women with cervical squamous intraepithelial lesions
are at an even higher risk than the general population
[3, 4]. Before the HIV epidemic, US MSM were esti-
mated to have an incidence of anal cancer of up to 35
cases/100,000 person-years (py)—similar to the inci-
dence of cervical cancer in US women before the in-
troduction of cervical cytology testing .
Received 29 March 2004; accepted 24 June 2004; electronically published 10
Reprints or correspondence: Dr. Peter V. Chin-Hong, University of California at
San Francisco, Box 0654, 521 Parnassus Ave., Rm. C-443, San Francisco, CA94143-
The Journal of Infectious Diseases
? 2004 by the Infectious Diseases Society of America. All rights reserved.
Human papillomavirus (HPV) is one of the most
common sexually transmitted infections. The causal
link between HPV infection and cervical cancer has
been well established . HPV is also believed to be
Presented in part: Human Papillomavirus 21st International Conference, Mexico City,
Mexico, 20–26 February 2004 (abstract 538).
by the US Public Health Service, Division of Research Resources(grant5-M01-RR-00079
to the General Clinical Research Center, University of California at San Francisco[UCSF])
and by Cytyc; HIV Network for Prevention Trials, sponsored by the National Institute of
Allergy and Infectious Diseases (NIAID) and the National Institute of Alcohol Abuse and
Alcoholism, NIH, Department of Health and Human Services (DHHS) (through contract
Research Center, and subcontracts with the Denver Department of Health and Hospitals
[DDHH], the Fenway Community Health Center [FCHC], the New York Blood Center
[NYBC], and the Public Health Foundation); HIV Prevention Trials Network, sponsoredby
the NIAID, the National Institute of Child Health and Human Development, the National
Institute of Drug Abuse, the National Institute of Mental Health, and the Office of AIDS
Research, NIH, DHHS (through a cooperative agreementwithFamilyHealthInternational
[5-U01-AI46749]; subsequent subcontracts to Abt Associates and the DDHH; and co-
operative agreements with the FCHC [U01-AI48040], Columbia University [U01-AI48016;
includes a subagreement with the NYBC], and UCSF [U01-AI47995]).
by guest on February 2, 2016
2076 • JID 2004:190 (15 December) • Chin-Hong et al.
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