title: Feasibility of incorporating self-collected rectal swabs into a community venue-based survey to measure the prevalence of HPV infection in men who have sex with men.
abstract: BACKGROUND
  Inclusion of self-collected rectal swabs (SCRS) into existing community venue-based HIV surveillance systems for men who have sex with men (MSM) may provide a feasible method for monitoring human papillomavirus (HPV) vaccine-related outcomes in this population. We measured the prevalence of HPV and anal dysplasia through incorporating SCRS into ManCount, the Vancouver site of the M-Track HIV surveillance system.
  
  
  METHODS
  Participating MSM were provided with a self-collection kit for collection on-site or at a follow-up venue. Swabs were subject to polymerase chain reaction amplification for HPV detection, and cytology slides were reviewed for anal dysplasia. Factors associated with participation were identified through multivariate logistic regression.
  
  
  RESULTS
  Of 766 men completing ManCount, 268 (35%) agreed to participate, self-collecting 252 specimens (247 on-site). Of 239 complete specimens, 33.5% did not have detectable β-globin; in the remainder (159 specimens) the prevalence of HPV infection was 62.3% (23.3% HPV type 16 or 18; 38.4% HPV type 6, 11, 16, or 18). In the 62.3% (149) of specimens adequate for cytology, the prevalence of anal dysplasia was 42.3% (HSIL 11.4%, LSIL 18.8%, ASC-US 6.7%, ASC-H 5.4%). Participation was associated with venue type, availability of on-site collection, and other characteristics.
  
  
  CONCLUSIONS
  SCRS can be feasibly integrated within existing community venue-based HIV surveillance systems for MSM, and may be a suitable method for monitoring the impact of HPV vaccination in this population. However, participation may be influenced by venue type and availability of on-site collection, and adequacy of SCRS specimens may be lower in community venues as compared with clinical settings.
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada. mark.gilbert@bccdc.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
authors.forename: Michael
authors.initials: M
authors.lastname: Kwag
authors.forename: Wendy
authors.initials: W
authors.lastname: Mei
authors.forename: Claudia
authors.initials: C
authors.lastname: Rank
authors.forename: Rhonda
authors.initials: R
authors.lastname: Kropp
authors.forename: Alberto
authors.initials: A
authors.lastname: Severini
authors.forename: Dirk
authors.initials: D
authors.lastname: van Niekerk
authors.forename: Chen
authors.initials: C
authors.lastname: Zhou
authors.forename: Natasha
authors.initials: N
authors.lastname: Press
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D001003:Anal Canal / Q000473:pathology / Q000821:virology*; D001004:Anus Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D001955:British Columbia / Q000453:epidemiology; D016001:Confidence Intervals; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006679:HIV Seropositivity; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012007:Rectum / Q000473:pathology / Q000821:virology*; D018571:Sentinel Surveillance; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014611:Vaccination; D055815:Young Adult