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      Prevalence of and Risk Factors for Anal Human Papillomavirus Infection in a Sample of Young, Predominantly Black Men Who Have Sex With Men, Houston, Texas

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          Abstract

          <p class="first" id="d1468955e177">Approximately two thirds of a sample of predominantly black men who have sex with men harbored human papillomavirus (HPV) genotypes in the anal canal that most commonly cause malignant and nonmalignant disease. It is important to increase the currently low HPV vaccine coverage in this population. </p><div class="section"> <a class="named-anchor" id="s1"> <!-- named anchor --> </a> <h5 class="section-title" id="d1468955e183">Background</h5> <p id="d1468955e185">Young men who have sex with men (MSM) are at increased risk for human papillomavirus (HPV)–associated disease as a result of HPV infection. Our objective was to characterize the prevalence of high-risk anal HPV infection and factors associated with prevalence in a group of young, primarily black MSM in Houston, Texas. </p> </div><div class="section"> <a class="named-anchor" id="s2"> <!-- named anchor --> </a> <h5 class="section-title" id="d1468955e188">Methods</h5> <p id="d1468955e190">MSM aged 18–29 years were recruited using a respondent-driven sampling method to study HIV and sexually transmitted disease transmission and risk. All engaged in peer-recruitment chains and self-collected anal exfoliated cells. Prevalence ratios assessed factors associated with high-risk HPV and HPV types in the 9-valent vaccine. </p> </div><div class="section"> <a class="named-anchor" id="s3"> <!-- named anchor --> </a> <h5 class="section-title" id="d1468955e193">Results</h5> <p id="d1468955e195">Black race was reported by 87% of men. Slightly over one half (53%) were human immunodeficiency virus (HIV) positive. Approximately 75% of men had at least 1 high-risk HPV type, and 39% of HIV-positive men harbored HPV-16. Analysis that controlled for potential confounders revealed that only HIV infection was associated with high-risk HPV infection. </p> </div><div class="section"> <a class="named-anchor" id="s4"> <!-- named anchor --> </a> <h5 class="section-title" id="d1468955e198">Conclusion</h5> <p id="d1468955e200">Black MSM would benefit from increased HPV vaccination efforts, owing to high rates of HPV infection, increased HPV disease, and low vaccination series completion rates in this population. </p> </div>

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          Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America.

          Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34 189 HIV-infected (55% MSM, 19% other men, 26% women) and 114 260 HIV-uninfected individuals (90% men). Among men, the unadjusted anal cancer incidence rates per 100 000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7-151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5-61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100 000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8-6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5-2.2). In comparison with the period 2000-2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI, .3-.9) in 1996-1999 and 0.9 (95% CI, .6-1.2) in 2004-2007. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued.
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            Approaches for estimating prevalence ratios.

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              Improved Inference for Respondent-Driven Sampling Data With Application to HIV Prevalence Estimation

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                Author and article information

                Journal
                The Journal of Infectious Diseases
                Oxford University Press (OUP)
                0022-1899
                1537-6613
                March 01 2018
                February 14 2018
                December 05 2017
                March 01 2018
                February 14 2018
                December 05 2017
                : 217
                : 5
                : 777-784
                Affiliations
                [1 ]Center for Infectious Diseases, Department of Epidemiology, Human Genetics, and Environmental Sciences, Tampa, Florida
                [2 ]Center for Health Promotion and Prevention Research, Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Tampa, Florida
                [3 ]Center for Infection Research in Cancer (CIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
                [4 ]Department of Medicine, University of Chicago, Illinois
                Article
                10.1093/infdis/jix617
                5853382
                29216355
                ac150f38-2a39-40ca-9a5b-1a26641cc63d
                © 2017
                History

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