Penile human papillomavirus prevalence in circumcised sexual minority men with and without HIV

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OBJECTIVE: Understanding the burden of penile human papillomavirus (HPV) among high-risk groups is essential to inform tailored prevention strategies to reduce HPV-related morbidity. We estimated the prevalence of penile HPV and its association with HIV among circumcised sexual minority men (SMM). DESIGN: A cross-sectional study from a community-based cohort of SMM with and without HIV in Nigeria. METHODS: Penile swabs were genotyped with a next-generation sequencing assay for any and high-risk HPV (HPV16/18/31/33/35/39/45/51/52/56/58/59/68). HIV status was ascertained using rapid diagnostic tests. Multivariable logistic regression models estimated the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between HIV and any and high-risk penile HPV. RESULTS: Among 498 participants, median age was 24 (interquartile range: 22-28) years and 70.5% ( n = 351) were living with HIV. The prevalence of any ( n = 362) and high-risk ( n = 239) penile HPV was 72.7% [95% confidence interval (95% CI): 68.6-76.4] and 48.0% (95% CI: 43.6-52.4), respectively. The most common high-risk HPV types were 16, 51, 45, and 18, while the most common low-risk types were 6 and 11. HIV was significantly associated with increased odds of any penile HPV (aOR 1.93, 95% CI: 1.20-3.12). Similar to any HPV, the association of HIV with high-risk penile HPV trended in the positive direction (aOR 1.45, 95% CI: 0.96-2.27), but it was not statistically significant. CONCLUSION: Penile HPV and HIV were highly prevalent among circumcised SMM in Nigeria. The most prevalent strains were vaccine-preventable, highlighting the need to prioritize HPV vaccination for boys as an additional strategy to prevent HPV-related morbidities.

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