Prevalence and Risk Factors of Anal HPV Infection in MSM Living With HIV: Identifying the Target Groups to Prioritize for Immunization

J Acquir Immune Defic Syndr. 2022 Oct 1;91(2):226-231. doi: 10.1097/QAI.0000000000003057.

Abstract

Background: Aims of this study are assessing prevalence of anal human papillomavirus (HPV) genotypes in male who have sex with men (MSM) living with HIV over a period of 5 years and determining risk factors for anal infection from high-risk (HR) HPV genotypes or included in vaccine Gardasil 9.

Setting: Time-trend, monocentric study on MSM living with HIV who underwent HPV test at anal site from 2015 to 2019.

Methods: Anal swabs were processed by multiplex real-time polymerase chain reaction to detect HPV genotypes. The Cochran-Armitage test was used to assess linear trend in HPV prevalence over time and logistic regression models to estimate risk factors.

Results: Of the 1352 MSM living with HIV, 168 (12%) were not infected by any HPV genotypes and only 6 were infected with a maximum of 6 genotypes; prevalence of HR-HPV genotypes or those included in the 9-valent vaccine remained stable over time. At multivariable analysis, the risk of carrying at least 1 genotype classified as HR or included in Gardasil 9 was associated with younger age [adjusted odds ratio (aOR) for younger than 30 years vs older than 45 years (95% confidence interval) 2.714 (1.484 to 4.961), P = 0.001, and 1.868 (1.141 to 3.060), P < 0.013, respectively] and a history of gonorrhea [aOR 2.118 (1.100 to 4.078), P = 0.025, and 1.785 (1.056 to 3.018), P = 0.031, respectively].

Conclusion: Our findings suggest that prevalence remained stable over time and that all MSM with HIV would benefit from Gardasil 9 immunization, particularly the youngest and those with a prior gonococcal infection.

MeSH terms

  • Adult
  • Anal Canal
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Homosexuality, Male
  • Humans
  • Male
  • Papillomaviridae / genetics
  • Papillomavirus Infections* / complications
  • Papillomavirus Infections* / epidemiology
  • Papillomavirus Infections* / prevention & control
  • Prevalence
  • Risk Factors
  • Sexual and Gender Minorities*
  • Vaccination