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Prevalence, Incidence and Risk Factors for HPV16 Seropositivity in Homosexual Men

Prevalence, Incidence and Risk Factors for HPV16 Seropositivity in Homosexual Men

HPV16 causes ~75% of HPV-associated anal cancer. Homosexual men are at greatly increased risk, but there are few data on the seroepidemiology of HPV16 in this population. We aim to determine the prevalence, incidence and risk factors for HPV16 seropositivity among community-based cohorts of homosexual Australian men.

1427 HIV negative men had sera collected annually from 2001 to 2007. 245 HIV positive men had sera collected annually between 2005 and 2007. Antibodies to HPV16 L1 were tested using multiplex type-specific Luminex serology. HPV16 seroprevalence, and seroincidence per 100 person-years (PY) in those initially HPV16 seronegative were calculated. Predictors of seroprevalent HPV16 were analysed by logistic regression and predictors of seroincident HPV16 by Cox regression for HIV negative participants.

A quarter (25.4%, 95% CI 23.1-27.9%) of HIV negative participants were HPV16 seropositive at baseline compared with nearly half of HIV positive participants (44.3%, 95% CI 37.4-51.5%). In contrast, HPV16 seroincidence was more than twice as high among HIV negative (3.1/100PY, 95% CI 2.5-3.8/100PY) as HIV positive men (1.3/100PY, 95% CI 0.3-5.2/100PY). In multivariate analyses, seroprevalent HPV16 was associated with more lifetime male partners (p=0.002), longer duration since first anal sex (p<0.001), preference for receptive role during anal sex (p=0.032), past infection with hepatitis B (p=0.035), positive HSV1 (p=0.034) and HSV2 (p=0.042) serology. In multivariate analyses, seroincident HPV16 was associated with younger age (p=0.004), reporting more recent male sexual partners (p=0.008) and unprotected anal intercourse with HIV positive or status unknown partners (p=0.021).

HPV16 seroprevalence was higher among HIV positive men, but HPV16 seroincidence was higher among HIV negatives. HPV16 seroincidence did not decline until after 34 years, suggesting that vaccination may be protective in many men under age 35. Both seroprevalence and seroincidence correlated well with markers of high risk sexual activity, particularly receptive anal sexual practices.

Speakers: Dr Mary Poynten

Australasian Sexual Health Conference 2011

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