title: Anal human papillomavirus infection among Thai men who have sex with men with and without HIV infection: prevalence, incidence, and persistence.
abstract: BACKGROUND
  HIV-positive men who have sex with men (MSM) have a higher prevalence of anal human papillomavirus (HPV) infection and anal cancer incidence than HIV-negative MSM. High-risk HPV persistence is an important risk factor for the development of anal cancer.
  
  
  METHODS
  A total of 123 HIV-positive and 123 HIV-negative MSM were enrolled from the Thai Red Cross AIDS Research Centre in Bangkok, Thailand, and followed for 12 months. Anal sample collection for HPV genotyping was performed at every visit. HPV prevalence, incidence, clearance, and persistence were calculated. A logistic regression model was used to study factors associated with high-risk HPV persistence.
  
  
  RESULTS
  The prevalence of any anal HPV infection was 85% in HIV-positive and 58.5% in HIV-negative MSM (P < 0.0001). The prevalence of high-risk HPV infection was 57.5% in HIV-positive and 36.6% in HIV-negative MSM (P = 0.001). HPV 16 was the most common high-risk HPV type. HIV-positive MSM had a higher prevalence (22.5% vs. 9.8%, P = 0.008) and persistence (16.7% vs. 1.3%, P < 0.001) of HPV 16 than HIV-negative MSM and a trend for higher incidence (16.1 vs. 6.1 episodes/1000 person-months, incidence rate ratio 2.6, P = 0.058). HIV infection (odds ratio: 4.45, 95% confidence interval: 2.11 to 9.4, P < 0.001) and smoking in HIV-positive MSM (odds ratio: 2.3, 95% confidence interval: 1.17 to 4.5, P = 0.015) were independently associated with high-risk HPV persistence in multivariate models.
  
  
  CONCLUSIONS
  In addition to targeting HIV-positive MSM who are at higher risk for anal, high-risk HPV persistence, anal cancer prevention programs should also integrate behavioral interventions such as smoking cessation to modify risk for high-risk HPV persistence.
authors.affiliation: Thai Red Cross AIDS Research Centre, Bangkok, Thailand. nittaya.p@trcarc.org
authors.forename: Nittaya
authors.initials: N
authors.lastname: Phanuphak
authors.forename: Nipat
authors.initials: N
authors.lastname: Teeratakulpisarn
authors.forename: Tippawan
authors.initials: T
authors.lastname: Pankam
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kerr
authors.forename: Jiranuwat
authors.initials: J
authors.lastname: Barisri
authors.forename: Amornrat
authors.initials: A
authors.lastname: Deesua
authors.forename: Piyanee
authors.initials: P
authors.lastname: Rodbamrung
authors.forename: Piranun
authors.initials: P
authors.lastname: Hongchookiat
authors.forename: Nitiya
authors.initials: N
authors.lastname: Chomchey
authors.forename: Praphan
authors.initials: P
authors.lastname: Phanuphak
authors.forename: Annette H
authors.initials: AH
authors.lastname: Sohn
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D052162:Human papillomavirus 16; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult