Anogenital human papillomavirus (HPV) infection among men who have sex with men (MSM) is common, leading to morbidity including anal cancer. This study sought to elucidate incident anogenital HPV infection among teenage MSM.
We estimated incident type-specific HPV infection by HPV DNA from the anal canal and penis among 200 MSM aged 16 to 20 years in Melbourne, Australia. Men were seen at baseline, then month 3, 6 and 12. HPV infection refers to DNA of a specific type of HPV tested negative at baseline and positive at two or three follow-up visits.
Median age was 19 years. At baseline, men reported a median duration of 1.9 years since first receptive anal sex and a median of 4 receptive anal sex partners. The incidence rates for infection of any, any high risk, any low risk and any 4-valent vaccine preventable HPV at the anus were 54.7 (95% confidence interval (CI): 41.7-67.2), 26.6 (95% CI: 16.5-38.6), 35.7 (95% CI: 24.5-48.5) and 30.6 (95% CI: 19.9-42.7) per 100 person years, respectively. The incidence rate for infection of anal HPV 16 was 5.8 (95% CI: 1.6-14.2) per 100 person years. The incidence rates for infection of any, any high risk, any low risk and any 4-valent vaccine preventable HPV at the penis were 7.2 (95% CI: 2.0-17.3), 7.1 (95% CI: 2.0-17.0), 3.5 (95% CI: 0.4-12.1) and 5.3 (95% CI: 1.1-14.6) per 100 person years, respectively. The proportions of men with incident anal and penile warts were 2.2% (4/186, 95% CI: 0.6-5.4) and 0.5% (1/199, 95% CI: 0.0-2.8), respectively.
Incident anogenital HPV was high and occurred soon after first sexual experiences among teenage MSM. HPV vaccination needs to commence early for maximal prevention of HPV among MSM.