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Nowak Rebecca; Gravitt, Patti; He, Xin; Ketende, Sosthenes; Anom, Wuese; Omuh, Helen; Blattner, William; Charurat, Manhattan
JAIDS Journal of Acquired Immune Deficiency Syndromes: January 2016
doi: 10.1097/01.qai.0000479736.51946.de
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Introduction: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 (IQR): 22–28, range: 16–38] and the median age at initiation of anal sex with another man was 16 years (IQR: 13–18, range: 7–29). 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% CI: 1.49 to 2.72], 10 years or more since anal sexual debut (aPR: 1.26, 95% CI: 1.07 to 1.49), and concurrent relationships with men (aPR: 1.31, 95% CI: 1.04 to 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 co-infected with HIV. Providing universal coverage as well as catch-up immunization for young men may be a more effective prevention strategy in Nigeria.

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