3 research outputs found
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Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men.
The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9-valent vaccine. Data were collected from 2012 to 2015 among men who have sex with men 18-26 years of age enrolled in a vaccine trial (N = 145). Penile/scrotal, perianal, anal, and oral samples were tested for 61 HPV types. Logistic regression was used to identify factors associated with types in the 9-valent vaccine. Participants' mean age was 23.0 years, 55.2% were African-American, and 26.2% were Hispanic; 93% had anal, 40% penile, and 6% oral HPV. Among those with anogenital infection, 18% had HPV16. Concordance was low between anogenital and oral sites. Factors independently associated with a 9-valent vaccine-type HPV were: race (African-American vs. White, OR=2.67, 95% CI=1.11-6.42), current smoking (yes vs. no, OR=2.37, 95% CI=1.03-5.48), and number of recent receptive anal sex partners (2+ vs. 0, OR=3.47, 95% CI=1.16-10.4). Most MSM were not infected with HPV16 or HPV18, suggesting that they may still benefit from HPV vaccination, but anogenital HPV was very common, highlighting the importance of vaccinating men before sexual initiation. CLINICAL TRIAL NUMBER: NCT01209325
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HIV-Infected Young Men Demonstrate Appropriate Risk Perceptions and Beliefs about Safer Sexual Behaviors after Human Papillomavirus Vaccination
The aim of this study was to identify risk perceptions after human papillomavirus (HPV) vaccination among HIV-infected young men who have sex with men. On average, participants appropriately perceived themselves to be at lower than neutral risk for HPV (mean subscale score 4.2/10), at higher than neutral risk for other sexually transmitted infections (7.0/10), and that safer sexual behaviors were still important (8.5/10). Higher perceived risk of HPV was associated with African-American race (p = .03); higher perceived risk of other sexually transmitted infections with White race (p = .01) and higher knowledge about HPV (p = .001); and higher perceived need for safer sexual behaviors with consistent condom use (p = .02). The study provides reassuring data that HIV-infected young men who have sex with men generally have appropriate risk perceptions and believe that safer sexual behaviors after vaccination are still important. These findings mirror the results of studies in HIV-infected young women and HIV-uninfected adolescents
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High prevalence of anal high-grade squamous intraepithelial lesions, and prevention through human papillomavirus vaccination, in young men who have sex with men living with HIV.
BackgroundMen who have sex with men (MSM) are at high risk for HPV-related anal cancer. Little is known about the prevalence of low-grade squamous intraepithelial lesions (LSIL) and the anal cancer precursor, high-grade squamous intraepithelial lesions (HSIL), among young MSM living with HIV (MSMLWH). HPV vaccination is recommended in this group but its safety, immunogenicity and protection against vaccine-type HPV infection and associated LSIL/HSIL have not been studied.Methods260 MSMLWH 18-26 years-old were screened at 17 U.S. sites for a clinical trial of the quadrivalent (HPV6/11/16/18) HPV (qHPV) vaccine. Those without HSIL were vaccinated at 0, 2, and 6 months. Cytology, high-resolution anoscopy with biopsies of lesions, serology, and HPV testing of the mouth/penis/scrotum/anus/perianus, were performed at screening/month 0, and months 7, 12 and 24.ResultsAmong 260 MSMLWH screened, the most common reason for exclusion was detection of HSIL, in 88/260 (34%). 144 MSMLWH were enrolled. 47% of enrollees were previously exposed to HPV 16. No incident qHPV type-associated anal LSIL/HSIL was detected among men naïve to that type, compared with 11.1, 2.2, 4.5, and 2.8 cases/100 person-years for HPV 6/11/16/18-associated LSIL/HSIL, respectively, among those previously exposed to that type. qHPV was immunogenic and safe with no vaccine-associated serious adverse events.Conclusions18-26 year-old MSMLWH naïve to qHPV vaccine types were protected against incident qHPV type-associated LSIL/HSIL. Given their high prevalence of HSIL there is an urgent need to vaccinate young MSMLWH prior to exposure to vaccine HPV types, before initiating sexual activity, and to perform catch-up vaccination