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AIDS Patient Care STDS. 2019 Apr;33(4):149-156. doi: 10.1089/apc.2018.0276.

Human Papillomavirus Vaccination and Infection in Young Sexual Minority Men: The P18 Cohort Study.

Author information

1
1 Departments of Biostatistics and Epidemiology and Urban-Global Health, School of Public Health, Rutgers University, Piscataway, New Jersey.
2
2 Center for Health, Identity Behavior and Prevention Studies, Rutgers University, Newark, New Jersey.
3
3 Department of Medicine, RWJ School of Medicine, Rutgers University, Newark, New Jersey.
4
4 Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey.
5
5 School of Public Affairs and Administration, Rutgers University, Newark, New Jersey.
6
6 Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
7
7 Department of Epidemiology and Preventive Medicine, National and Kapodistrian University of Athens, Athens, Greece.
8
8 Department of Epidemiology, College of Global Public Health, New York University, New York, New York.
9
9 Department of Medicine, Langone School of Medicine, New York University, New York, New York.

Abstract

We examined the prevalence of infection with human papillomavirus (HPV) and HIV in a cohort of young gay, bisexual, and other men who have sex with men [sexual minority men (SMM)]. HPV vaccination uptake was assessed; HIV antibody testing was performed and genetic testing for oral and anal HPV infection was undertaken. We examined both HPV vaccination and infection in relation to key demographic and structural variables. Participants (n = 486) were on average 23 years old; 70% identified as a member of a racial/ethnic minority group, and 7% identified as transgender females. Only 18.1% of the participants indicated having received the full dosage of HPV vaccination and 45.1% were unvaccinated. Slightly over half the participants (58.6%) were infected with HPV, with 58.1% testing positive for anal infection and 8.8% for oral infection. HIV seropositivity was associated with infection to oral HPV [adjusted odds ratio (AOR) = 4.03] and vaccine-preventable HPV, whereas both neighborhood-level poverty (AOR = 1.68) and HIV infection (AOR = 31.13) were associated with anal infection to HPV (AOR = 1.68). Prevalence of HPV infection is high among unvaccinated young SMM, despite the availability and eligibility for vaccination. HPV infection adds further health burden to these populations and is particularly concerning for those who are HIV positive as HIV infection increases the risk of developing HPV-related cancers. These findings underscore a missed prevention opportunity for an at-risk and underserved population and suggest the need for active strategies to increase HPV vaccination uptake in young SMM before the onset of sexual behavior.

KEYWORDS:

HIV; HPV; cancer; emerging adulthood; gay and bisexual men; vaccination

PMID:
30932696
PMCID:
PMC6459271
[Available on 2020-04-01]
DOI:
10.1089/apc.2018.0276

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