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Human Immunodeficiency Virus Status Differentially Associated With Genital and Anal Human Papillomavirus Infection Among Chinese Men Who Have Sex With Men: A Cross-Sectional Survey

Qian, Han-Zhu MD, PhD*†; Hu, Yifei MD, PhD; Carlucci, James G. MD; Yin, Lu PhD*; Li, Xiangwei PhD; Giuliano, Anna R. PhD; Li, Dongliang MD**; Gao, Lei PhD; Shao, Yiming MD, PhD††; Vermund, Sten H. MD, PhD

doi: 10.1097/OLQ.0000000000000672
Original Studies

Background: Little is known about human papillomavirus (HPV) infection and genotypes when considering both anatomic site and human immunodeficiency virus (HIV) status among men who have sex with men (MSM) in low- and middle-income countries.

Methods: A cross-sectional study was conducted among MSM in Beijing, China. HIV serostatus was determined, and genital and anal HPV genotyping were performed from respective swabs.

Results: Of 1155 MSM, 817 (70.7%) had testing for genital (611; 52.9%) and/or anal (671; 58.1%) HPV. Preference for insertive anal sex (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.42–4.75) and syphilis (aOR, 1.50; 95% CI, 1.01–2.23) were associated with genital HPV. Inconsistent condom use during receptive anal sex (aOR, 1.82; 95% CI, 1.17–2.84), and HIV seropositivity (aOR, 2.90; 95% CI, 1.91–4.42) were associated with anal HPV. Among 465 (40.3%) MSM with specimens from both anatomic sites, anal HPV (68%) was more common than genital HPV (37.8%). Prevalence of anal HPV was higher among HIV-infected than uninfected MSM (P < 0.01). Some oncogenic HPV types were more commonly found at the anal site of HIV-infected MSM (P < 0.01).

Conclusions: Human papillomavirus is highly prevalent among Chinese MSM. Anal HPV was more common than genital HPV, and HIV seropositivity was associated with oncogenic HPV types at the anal site.

This cross-sectional study demonstrated that human papillomavirus (HPV) is highly prevalent among Chinese men who have sex with men. Anal HPV was more common than genital HPV, and human immunodeficiency virus was associated with oncogenic HPV types at the anal site.

From the *Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, †Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; ‡Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China; §Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN; ¶Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; ∥Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL; **Chaoyang Center for Disease Control and Prevention; and ††State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China

H.-Z.Q. is currently affiliated at U.S. Centers for Disease Control and Prevention, Atlanta, GA.

Conflict of Interest: None declared.

Financial supports: This work was supported by grants from U.S. National Institute of Health (Fogarty Center grant R24TW007988, NIAID Grants R01AI094562 and T32 HD060554-06A1) and Chinese State Key Laboratory for Infectious Disease Development Grant (2012SKLID103.

Previous Presentation: Part of the data was presented at the 20th Conference on Retroviruses and Opportunistic Infections (CROI 2013), March 5, 2013, Atlanta, Georgia, United States (oral poster Q-136).

Correspondence: Han-Zhu Qian, 2525 West End Avenue, Suite 725, Nashville, TN 37203. E-mail: lqz2@cdc.gov.

Received for publication December 12, 2016, and accepted May 17, 2017.

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