title: Comparison of age-specific patterns of sexual behaviour and anal HPV prevalence in homosexual men with patterns in women.
abstract: OBJECTIVE
  Anal human papillomavirus (HPV) is highly prevalent in men who have sex with men (MSM) of all ages, whereas cervical HPV declines with age. We explore the hypothesis that different sexual behavioural patterns are the basis of this difference in age distribution.
  
  
  METHODS
  Published data on age-specific HPV prevalence for women (cervical HPV) were extracted from a large meta-analysis and for MSM (anal HPV) from the EXPLORE study of HIV-negative MSM. Age-specific data on recent sexual activity were extracted from two behavioural surveys: the second Australian Study of Health and Relationships survey and the 2013 Gay Community Periodic Survey.
  
  
  RESULTS
  At least 50% of MSM at all ages reported more than one sexual partner in the past 6 months. In comparison, 33% of women aged 16-19 years reported more than one partner over the past year. This decreased to 19% and 6% in women aged 20-29 and 30-39 years, respectively, and to fewer than 5% of women in older age groups. Prevalent anal HPV was detected in over 50% of MSM in each age group. Prevalence did not decline with age. In contrast, there was a steady decrease in cervical HPV prevalence with age. Cervical HPV prevalence fell from 23% among North American women aged <25 years to 3% in women aged ≥65 years.
  
  
  CONCLUSIONS
  In contrast to the decreasing prevalence with age among heterosexual women, the high prevalence and lack of decline in prevalent anal HPV among older MSM are likely to be related to continuing high rates of newly acquired HPV infection from ongoing sexual exposure through new partners.
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Isobel Mary
authors: IM
authors: Poynten
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors: Dorothy
authors: D
authors: Machalek
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia Royal Prince Alfred Hospital Sexual Health, Sydney, New South Wales, Australia.
authors: David
authors: D
authors: Templeton
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Fengyi
authors: F
authors: Jin
authors: Western Sydney Sexual Health Centre, University of Sydney, Sydney, New South Wales, Australia.
authors: Richard
authors: R
authors: Hillman
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Iryna
authors: I
authors: Zablotzska
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Garrett
authors: G
authors: Prestage
authors: Centre for Social Research in Health, UNSW Australia, Sydney, New South Wales, Australia.
authors: Martin
authors: M
authors: Holt
authors: Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia.
authors: Andrew
authors: A
authors: Grulich
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001003:Anal Canal / Q000821:virology; D001004:Anus Diseases / Q000453:epidemiology / Q000821:virology*; D001315:Australia / Q000453:epidemiology; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012737:Sex Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D002577:Uterine Cervical Diseases / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult
keywords: ANOGENITAL CANCER; BEHAVIOURAL SCIENCE; GAY MEN; HPV