scholarly journals Sexual behaviours associated with incident high-risk anal human papillomavirus among gay and bisexual men

2021 ◽  
pp. sextrans-2020-054851
Author(s):  
Ian K J Wong ◽  
Isobel Mary Poynten ◽  
Alyssa Cornall ◽  
David J Templeton ◽  
Monica Molano ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Anal Cancer ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Sexual Behaviours ◽  
And Bisexual

ObjectiveHigh-risk human papillomavirus (HRHPV) causes anal cancer, which disproportionately affects gay and bisexual men (GBM). We examined sexual behaviours associated with incident anal HRHPV in an observational cohort study of GBM in Sydney, Australia.MethodsGBM aged 35 years and above were enrolled in the Study of the Prevention of Anal Cancer. Detailed information on sexual practices in the last 6 months, including receptive anal intercourse (RAI) and non-intercourse receptive anal practices, was collected. Anal human papillomavirus (HPV) testing was performed at the baseline and three annual follow-up visits. Risk factors for incident HRHPV were determined by Cox regression using the Wei-Lin-Weissfeld method.ResultsBetween 2010 and 2015, 617 men were recruited and 525 who had valid HPV results at baseline and at least one follow-up visit were included in the analysis. The median age was 49 years (IQR 43–56) and 188 (35.8%) were HIV-positive. On univariable analysis, incident anal HRHPV was associated with being HIV-positive (p<0.001), having a higher number of recent RAI partners regardless of condom use (p<0.001 for both), preference for the receptive position during anal intercourse (p=0.014) and other non-intercourse receptive anal sexual practices, including rimming, fingering and receptive use of sex toys (p<0.05 for all). In multivariable analyses, being HIV-positive (HR 1.46, 95% CI 1.09 to 1.85, p=0.009) and reporting condom-protected RAI with a higher number of sexual partners (p<0.001) remained significantly associated with incident HRHPV. When stratified by recent RAI, non-intercourse receptive anal practices were not associated with incident HRHPV in men who reported no recent RAI.ConclusionGBM living with HIV and those who reported RAI were at increased of incident anal HRHPV. Given the substantial risk of anal cancer and the difficulty in mitigating the risk of acquiring anal HRHPV, HPV vaccination should be considered among sexually active older GBM.Trial registration numberANZCTR365383.

HIV, immune dysfunction and the natural history of anal high-risk human papillomavirus infection in gay and bisexual men

2020 ◽  
Author(s):  
I Mary Poynten ◽  
Fengyi Jin ◽  
Suzanne M Garland ◽  
Richard J Hillman ◽  
Monica Molano ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Natural History ◽  
Anal Cancer ◽  
Gay And Bisexual Men ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Clearance Rates ◽  
History Of ◽  
And Bisexual

Abstract Objectives Incidence of anal cancer is highest in gay and bisexual men (GBM). A better understanding of the natural history of anal high-risk human papillomavirus (HRHPV) infection is needed for anal cancer prevention. Methods The Study of the Prevention of Anal Cancer was a 3-year study of Australian GBM, aged 35 years or older. We examined incidence, clearance and risk factors for 13 HRHPV types tested for at baseline and 3 annual visits. Results In 525 men with ≥ 2 visits, 348 (66.3%) acquired ≥ 1 incident HRHPV infection. HPV16 incidence rates were similar, but non-16 HRHPV incidence was higher in HIV-positive (51.8/100 person years, PY) than HIV-negative men (36.5/100 PY, p &lt; 0.001). Annual clearance rates of HPV16 (13.21/100 PY, 95% CI 10.53-16.56) were lower than for other HRHPV types. HRHPV clearance rates were not associated with HIV overall but were significantly lower in those with a lower nadir CD4 (&lt;200 cells/µl) for HPV16 (p=0.015) and other HRHPV types (p=0.007). Conclusion The higher incidence of non-16 HRHPV types, coupled with the lower clearance of non-16 HRHPV types in those with past impaired immune function, is consistent with the greater role of non-16 HRHPV in anal cancer in HIV-positive people.

Predictors of Unprotected Anal Intercourse Among HIV-Positive Latino Gay and Bisexual Men

2004 ◽  
Vol 8 (4) ◽  
pp. 379-389 ◽  
Author(s):  
Paul J. Poppen ◽  
Carol A. Reisen ◽  
Mar�a Cecilia Zea ◽  
Fernanda T. Bianchi ◽  
John J. Echeverry
Keyword(s):  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Hiv Positive ◽  
Bisexual Men ◽  
And Bisexual

scholarly journals The Disparities in Mental Health Between Gay and Bisexual Men Following Positive HIV Diagnosis in China: A One-Year Follow-Up Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3414
Author(s):  
Rui Luo ◽  
Vincent M.B. Silenzio ◽  
Yunxiang Huang ◽  
Xi Chen ◽  
Dan Luo
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Gay And Bisexual Men ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Depression And Anxiety ◽  
Follow Up Study ◽  
And Bisexual ◽  
One Year

This study aimed to determine the change in mental health (depression and anxiety) among HIV-positive gay and bisexual men (GBM) one year after diagnosis and the disparities in trajectories of mental health between them. The potential factors contributing to the disparities were also investigated. This was a one-year follow-up study focusing on the mental health of newly diagnosed HIV-positive individuals. Participants rated their depression, anxiety, stress, and social support levels at baseline and one year later. Information on the utilization of mental healthcare and the initiation of antiretroviral therapy (ART) after diagnosis was collected at one-year follow-up. A total of 171 and 87 HIV-positive gay and bisexual men, respectively, completed two-time points surveys in this study. The depressive and anxiety symptoms experienced by HIV-positive GBM improvement one year after diagnosis. These improvements tended to be smaller in gay participants. Other factors including mental health care utilization and ART status during the one-year follow-up period, changes in social stress scores and objective social support scores were also associated with the changes in depression and anxiety, and all these factors, except for change in objective support, were found to be statistically different between HIV-positive GBM. Special attention should be given to the mental health of HIV-positive gay men. Promoting HIV-positive gay men to assess to mental health services and ART may be important for these populations to improve mental health. Enhancing social support and reducing stress levels may also be necessary for the vulnerable HIV-positive sexual minority groups.

The Natural History of Anal High-grade Squamous Intraepithelial Lesions in Gay and Bisexual Men

2020 ◽  
Author(s):  
I Mary Poynten ◽  
Fengyi Jin ◽  
Jennifer M Roberts ◽  
David J Templeton ◽  
Carmella Law ◽  
...  
Keyword(s):  
Natural History ◽  
Gay And Bisexual Men ◽  
Hiv Positive ◽  
High Grade ◽  
Bisexual Men ◽  
Squamous Intraepithelial Lesions ◽  
History Of ◽  
And Bisexual ◽  
Intraepithelial Lesions

Abstract Background Gay and bisexual men (GBM) are disproportionately affected by anal cancer. Prevention is hindered by incomplete understanding of the natural history of its precursor, anal high-grade squamous intraepithelial lesions (HSIL). Methods The Study of the Prevention of Anal Cancer, conducted between 2010 and 2018, enrolled human immunodeficiency virus (HIV)-positive and HIV-negative GBM aged ≥35 years. Anal cytology and high-resolution anoscopy (HRA) were performed at baseline and 3 annual visits. A composite HSIL diagnosis (cytology ± histology) was used. Cytological high-grade squamous intraepithelial lesions (cHSIL) incidence and clearance rates were calculated with 95% confidence intervals (CIs). Predictors were calculated using Cox regression with hazard ratios (HRs) and 95% CIs. Results Among 617 men, 220 (35.7%) were HIV-positive, median age 49 years. And 124 incident cHSIL cases occurred over 1097.3 person-years (PY) follow-up (11.3, 95% CI 9.5–13.5 per 100 PY). Significant bivariate predictors of higher incidence included age &lt;45 years (HR 1.64, 95% CI 1.11–2.41), HIV positivity (HR 1.43, 95% CI .99–2.06), prior SIL diagnosis (P-trend &lt; .001) and human papillomavirus (HPV)16 (HR 3.39, 2.38–4.84). Over 695.3 PY follow-up, 153 HSIL cleared (clearance 22.0, 95% CI 18.8–25.8 per 100 PY). Predictors were age &lt; 45 years (HR 1.52, 1.08–2.16), anal intraepithelial neoplasia (AIN)2 rather than AIN3 (HR 1.79, 1.29–2.49), smaller lesions (HR 1.62, 1.11–2.36) and no persistent HPV16 (HR 1.72, 1.23–2.41). There was 1 progression to cancer (incidence 0.224, 95% CI .006–1.25 per 100 PY). Conclusion These data strongly suggest that not all anal HSIL detected in screening requires treatment. Men with persistent HPV16 were less likely to clear HSIL and are more likely to benefit from effective HSIL treatments.

Perceptions and deflections: associations between attitudes towards people with hepatitis C and testing for hepatitis C among Australian gay and bisexual men

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 268 ◽  
Author(s):  
Loren Brener ◽  
Jeanne Ellard ◽  
Dean Murphy ◽  
Denton Callander
Keyword(s):  
Hepatitis C ◽  
Online Survey ◽  
Sexual Transmission ◽  
Gay And Bisexual Men ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Bisexual Men ◽  
Health Seeking ◽  
And Bisexual ◽  
Hcv Testing

Background Research indicates that the incidence of hepatitis C (HCV) among HIV-positive men who have sex with men (MSM) is increasing. Although injecting drug use remains the predominant means of transmission of HCV in the developed world, there is evidence of sexual transmission of HCV among MSM. Stigma associated with HCV has been shown to negatively impact HCV testing and health-seeking behaviour. There is little research that addresses attitudes towards HCV testing among this population. Methods: The current exploratory study focussed on HCV knowledge, HCV testing, sexual practices, perceptions of HCV risk and attitudes towards people with HCV among Australian MSM. The sample consisted of 590 men who completed an online survey. Results: The findings suggest that attitudinal factors related to HCV were associated with HCV testing behaviour. The more negatively respondents felt about people with HCV, the less likely they were to have ever had an HCV test. Behavioural risk factors related to sexual practices (i.e. is condom use and sexual risk activities) were not associated with HCV testing. Testing for HCV was associated with HIV-positive status, more knowledge about HCV and a greater likelihood of ever having injected drugs. Conclusions: The attitudes of MSM towards those who inject drugs are negative, mirroring that of society more generally. Furthermore, these attitudes, coupled with a lack of knowledge of the risk of sexual transmission of HCV among gay men, especially those who are HIV-positive, may act to prevent routine HCV testing among some MSM at potential risk of acquiring HCV.

Awareness and knowledge of anal cancer in a community-recruited sample of HIV-negative and HIV-positive gay and bisexual men

Sexual Health ◽  
2019 ◽  
Author(s):  
Lance Feeney ◽  
Mary Poynten ◽  
Fengyi (Jeff) Jin ◽  
Craig Cooper ◽  
David J. Templeton ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Gay And Bisexual Men ◽  
Hiv Positive ◽  
Bisexual Men ◽  
And Bisexual ◽  
Hiv Negative
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