title: Sequential Acquisition of Anal Human Papillomavirus (HPV) Infection Following Genital Infection Among Men Who Have Sex With Women: The HPV Infection in Men (HIM) Study.
abstract: The purpose of this study was to assess the risk of sequential acquisition of anal human papillomavirus (HPV) infection following a type-specific genital HPV infection for the 9-valent vaccine HPV types and investigate factors associated with sequential infection among men who have sex with women (MSW).
  
  
  
  Genital and anal specimens were available for 1348 MSW participants, and HPV genotypes were detected using the Roche Linear Array assay. Sequential risk of anal HPV infection was assessed using hazard ratios (HRs) among men with prior genital infection, compared with men with no prior genital infection, in individual HPV type and grouped HPV analyses.
  
  
  
  In individual analyses, men with prior HPV 16 genital infections had a significantly higher risk of subsequent anal HPV 16 infections (HR, 4.63; 95% confidence interval [CI], 1.41-15.23). In grouped analyses, a significantly higher risk of sequential type-specific anal HPV infections was observed for any of the 9 types (adjusted HR, 2.80; 95% CI, 1.32-5.99), high-risk types (adjusted HR, 2.65; 95% CI, 1.26, 5.55), and low-risk types (adjusted HR, 5.89; 95% CI, 1.29, 27.01).
  
  
  
  MSW with prior genital HPV infections had a higher risk of a subsequent type-specific anal infection. The higher risk was not explained by sexual intercourse with female partners. Autoinoculation is a possible mechanism for the observed association.
authors.affiliation: Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute Department of Epidemiology and Biostatistics, University of South Florida, Tampa.
authors.forename: Shitaldas J
authors.initials: SJ
authors.lastname: Pamnani
authors.affiliation: Center for Infectious Diseases, University of Texas School of Public Health, Houston.
authors.forename: Alan G
authors.initials: AG
authors.lastname: Nyitray
authors.affiliation: Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute.
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.affiliation: Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute Department of Epidemiology and Biostatistics, University of South Florida, Tampa.
authors.forename: Dana E
authors.initials: DE
authors.lastname: Rollison
authors.affiliation: School of Medicine, University of São Paulo, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Instituto Nacional de Salud Publica, Cuernavaca, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Florida, Tampa.
authors.forename: Yangxin
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Florida, Tampa.
authors.forename: Amy
authors.initials: A
authors.lastname: Borenstein
authors.affiliation: Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute Department of Epidemiology and Biostatistics, University of South Florida, Tampa.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000821:virology*; D001004:Anus Diseases / Q000821:virology; D003075:Coitus; D020010:Heterosexuality; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000821:virology*; D012307:Risk Factors; D055815:Young Adult
keywords: HIM study; human papillomavirus (HPV); men; sequential genital and anal HPV infections