Background: A growing body of literature suggests a relationship between human papillomavirus (HPV) infection and HIV. However, few studies have examined the relationship between site-specific and type-specific HPV infections and HIV among young men who have sex with men (YMSM). Given the high infectivity of HPV as well as its association with anal, penile and oropharyngeal cancer, more information on the relationship between HPV and HIV among YMSM is especially warranted.
Methods: Participants were enrolled in the P18 study, a prospective cohort study of health states among young gay, bisexual and other men who have sex with men. Beginning in October 2015, HPV DNA testing via nucleic acid hybridization assay was initiated at the 54-month visit; to date, n=108 YMSM have provided samples for oral HPV and n=99 for anal HPV testing.
Results: In this sample of YMSM (mean age=24 years old; 48.2% Hispanic/Latino, 32.4% Black, 9.3% White, 10.2% Asian/Pacific Islander or other race) HIV prevalence was 13.0%. For anal HPV, overall prevalence was 38.2%; by type, prevalence of high-risk strains was 24.5% and 17.3% for low-risk strains. For oral HPV, overall prevalence was 6.4%; by type, prevalence of high-risk strains was 3.6% and 1.8% for low-risk strains. Additionally, 11.8% of this sample tested positive for quadrivalent vaccine preventable strains (6,11,16,18) while 21.6% tested positive for the nonavalent vaccine preventable strains (6,11,16,18,31,33,45,52,58). Finally, the presence of anal HPV (any type) was associated with an HIV seropositive status (OR=5.63, 95% CI=1.44, 21.97; p=0.013) as was the presence of oral HPV (OR=12.13, 95% CI=2.37, 62.12; p=0.003).
Conclusions: Our findings provide evidence of high HPV prevalence in YMSM by site (anal/oral) and type (low/high risk strains) as well as for vaccine preventable strains. First, as anal, oral, and oropharyngeal cancers are significant sequellae of HPV infection, further investigation to examine vaccine uptake in YMSM is warranted. Second, the strong associations between HIV and both anal and oral HPV in this new generation of YMSM warrant further investigation to understand how site-specific HPV is associated with increased risk for HIV as well as to understand how HPV persistent is associated with HIV infection.