title: Epidemiology of anal HPV infection in high-risk men attending a sexually transmitted infection clinic in Puerto Rico.
abstract: OBJECTIVE
  Recent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico.
  
  
  METHODS
  We conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regression models were performed to determine factors associated with any, high-risk (HR), and multiple anal HPV infection.
  
  
  RESULTS
  The mean age of the study sample was 38.0±13.5 years. The most common HR types were 58, 51 and 31. Overall, HR anal HPV infection was found in 53.5% of the participants. Multiple HPV types in the anal canal were found in 47.6% of the sample. A third (29.8%) of participants reported being men who had sex with men (MSM). MSM had a significantly higher prevalence of any, HR and multiple HPV infection (p-value<0.05). Separate multivariate logistic regression analyses showed that being MSM was associated with any (OR = 4.5; [95%CI: 1.9-10.7]), HR (OR = 3.4; [95%CI: 1.1-10.3) and multiple anal HPV infection (OR = 3.6; [95%CI: 1.5-9.1). HIV was marginally associated with multiple anal HPV infection in multivariate analysis (OR = 3.3; 95%CI = 1.0-11.0).
  
  
  CONCLUSIONS
  Anal HPV is common among sexually active men attending this STI clinic, with higher likelihood of anal HPV infection among MSM.
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico ; Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Vivian
authors.initials: V
authors.lastname: Colón-López
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico ; Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Ortiz
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Lizbeth
authors.initials: L
authors.lastname: Del Toro-Mejías
authors.affiliation: Center for Research on Global Health, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Michael Craig
authors.initials: MC
authors.lastname: Clatts
authors.affiliation: University of California San Francisco, San Francisco, California, United States.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification / Q000235:genetics; D001003:Anal Canal / Q000821:virology*; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D055815:Young Adult