title: Sociodemographic and behavioral correlates of anogenital warts and human papillomavirus-related knowledge among men who have sex with men and transwomen in Lima, Peru.
abstract: BACKGROUND
  Human papilloma virus (HPV) is the most common sexually transmitted infection (STI) globally, with a high burden of anogenital warts (AGW) among men who have sex with men (MSM) and transwomen (TW).
  
  
  METHODS
  Six-hundred HIV negative MSM and TW (300 with AGW, 300 without) were recruited for a prospective cohort study to examine HPV outcomes and HPV vaccine knowledge. Participants completed a self-administered online questionnaire. Logistic regression was used to assess the association between sociodemographic and behavioral characteristics with HPV vaccine knowledge.
  
  
  RESULTS
  The average participant age was 25.5 years. Most (67%) were single and 41.2% self-reported STI symptoms. The average age of first anal intercourse was 17 years, with self-reported sexual role as active (36%), passive (36%), and both (27%). Three quarters (77%) of participants reported engaging in condomless anal or oral sex up to six months prior to the study. Less than half (48%) of participants had heard of HPV. Participants with AGW were more likely to report that condoms helped prevent HPV (p=0.01) and that the absence of genital warts does not mean the absence of HPV (p < 0.01).
  
  
  CONCLUSIONS
  Study participants had low levels of HPV knowledge but likely high HPV exposure due to condomless anal sex. The HPV knowledge gap may be explained in part by the stigma of sex work, underreporting of STIs, the high cost of the HPV vaccine in Peru, and misinformation about HPV vaccine. More work is needed to educate MSM and TW on HPV and the HPV vaccine.
authors.affiliation: From the *Program in Public Health, University of California, Irvine, Irvine, CA; †Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA; and ‡Epicentro Salud, Lima, Peru.
authors.forename: Brandon
authors.initials: B
authors.lastname: Brown
authors.forename: Emmi
authors.initials: E
authors.lastname: Monsour
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Jerome T
authors.initials: JT
authors.lastname: Galea
mesh_terms: D000328:Adult; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D010568:Peru / Q000453:epidemiology; D011446:Prospective Studies; D012725:Sexual Behavior / Q000523:psychology*; D063106:Transgender Persons / Q000523:psychology