title: Prevalence of Anal High-Risk Human Papillomavirus Infections Among HIV-Positive and HIV-Negative Men Who Have Sex With Men in Nigeria.
abstract: BACKGROUND
  Prevalence estimates of anal high-risk human papillomavirus (HR-HPV) are needed in sub-Saharan Africa where HIV is endemic. This study evaluated anal HR-HPV in Nigeria among HIV-positive and HIV-negative men who have sex with men (MSM) for future immunization recommendations.
  
  
  METHODS
  We conducted a cross-sectional study to compare the prevalence of anal HR-HPV infections between 64 HIV-negative and 90 HIV-positive MSM. Multivariate Poisson regression analyses were used to examine demographic and behavioral risk factors associated with any HR-HPV infections.
  
  
  RESULTS
  The median age of the 154 participants was 25 years (interquartile range, 22-28 years; range, 16-38 years), and the median age at initiation of anal sex with another man was 16 years (interquartile range, 13-18 years; range, 7-29 years). The prevalence of anal HR-HPV was higher among HIV-positive than HIV-negative MSM (91.1% vs. 40.6%, P < 0.001). In the multivariate analysis, HIV infection (adjusted prevalence ratio [aPR], 2.02; 95% confidence interval [CI], 1.49-2.72), 10 years or more since anal sexual debut (aPR, 1.26; 95% CI, 1.07-1.49), and concurrent relationships with men (aPR, 1.32; 95% CI, 1.04-1.67) were associated with increased anal HR-HPV prevalence.
  
  
  CONCLUSIONS
  Anal HR-HPV infection is high for young Nigerian MSM, and rates are amplified in those coinfected with HIV. Providing universal coverage as well as catch-up immunization for young MSM may be an effective anal cancer prevention strategy in Nigeria.
authors.affiliation: From the *Institute of Human Virology and †Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD; ‡University of New Mexico Health Sciences Center, Albuquerque, NM; §University of Maryland School of Public Health, College Park, MD; ¶Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ∥Institute of Human Virology Nigeria, Federal Capital Territory, Nigeria.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Nowak
authors.forename: Patti E
authors.initials: PE
authors.lastname: Gravitt
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.forename: Wuese
authors.initials: W
authors.lastname: Dauda
authors.forename: Helen
authors.initials: H
authors.lastname: Omuh
authors.forename: William A
authors.initials: WA
authors.lastname: Blattner
authors.forename: Manhattan E
authors.initials: ME
authors.lastname: Charurat
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000821:virology; D001004:Anus Diseases / Q000150:complications / Q000453:epidemiology*; D001005:Anus Neoplasms; D060085:Coinfection; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006679:HIV Seropositivity; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult