title: Factors associated with visible anogenital warts among HIV-uninfected Peruvian men who have sex with men and transwomen: a cross-sectional study.
abstract: BACKGROUND
  Visible, anogenital warts may be associated with risk factors for HIV infection. This cross-sectional study examined the factors associated with visible anogenital warts among HIV-uninfected Peruvian men who have sex with men (MSM) and transwomen.
  
  
  METHODS
  Six hundred HIV-uninfected MSM and transwomen were recruited from a community-based setting in metropolitan Lima, Peru, through outreach activities. Participants were tested for syphilis, completed a behavioral questionnaire, and were examined for visible anogenital warts. Logistic regression was used to assess the independent association between sample characteristics, HIV-related risk factors, and visible anogenital warts.
  
  
  RESULTS
  A tertiary education versus a primary/secondary (adjusted odds ratio [AOR], 1.79; 95% confidence interval [CI], 1.07-2.99), a first experience of anal intercourse at age 20 years or older versus younger ages (AOR, 2.80; 95% CI, 1.45-5.38), and self-reporting of current sexually transmitted infection symptoms (AOR, 2.38; 95% CI, 1.61-3.52) were significant correlates of visible anogenital warts, whereas syphilis infection, transactional sex, receptive anal intercourse, and self-identifying as a transwoman were not.
  
  
  CONCLUSIONS
  Although not associated with key risk factors for HIV infection in Peruvian MSM and transwomen, the presence of visible anogenital warts should prompt clinicians to consider the possibility of unreported same-sex sexual behaviors and other risk sexually transmitted infection/HIV risk factors.
authors.affiliation: From the *Epicentro Salud, Lima, Peru; †Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, CA; ‡Faculty of Population Health, Centre for Sexual Health and HIV Research, University College London, London, UK; §Unit of Health, Sexuality and Human Development, Universidad Peruana, Cayetano Heredia University School of Public, Health, Lima, Peru; ¶Division of Infectious Diseases, Department of Medicine, University of California, Los Angeles, CA; and ∥Program in Public Health, University of California, Irvine, CA.
authors.forename: Jerome T
authors.initials: JT
authors.lastname: Galea
authors.forename: Janni J
authors.initials: JJ
authors.lastname: Kinsler
authors.forename: Daniel Berrio
authors.initials: DB
authors.lastname: Galan
authors.forename: Gino
authors.initials: G
authors.lastname: Calvo
authors.forename: Hugo
authors.initials: H
authors.lastname: Sánchez
authors.forename: Segundo R
authors.initials: SR
authors.lastname: Leon
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Brandon
authors.initials: B
authors.lastname: Brown
mesh_terms: D001004:Anus Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D018023:HIV Seronegativity; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology; D063106:Transgender Persons