Prevalence and Risk Factors for HPV Seropositivity and Anogenital DNA-Positivity among Men Who Have Sex With Men: A Repeated Cross-Sectional Study

Abstract

Objectives: To assess associations of potential risk factors with HPV seropositivity among men who have sex with men (MSM), and compare these to risk factors for anal and penile HPV DNA-positivity in the same study population.Methods: Seropositivity and anal and penile HPV DNA-positivity were determined for 7 high-risk HPV genotypes for MSM aged 16-24 years participating in PASSYON 2009-2021. Logistic regression models were conducted to assess risk factors for seropositivity, anal and penile HPV DNA-positivity.Results: 1,019 MSM were included. HPV-16 and -18 were most common for serology, and anal and penile HPV DNA-positivity. Although no clear similarities were observed for most risk factors for HPV seropositivity and anal or penile DNA-positivity, receptive anal intercourse (RAI) was the strongest associated risk factor for both seropositivity (RAI ever aOR 3.50, 95%CI 1.56-7.88; RAI previous 6 mos. aOR 2.17, 95%CI 1.44-3.26) and anal DNA-positivity (RAI previous 6 mos. aOR 1.67, 95%CI 1.09-2.56).Conclusions: Our study is suggestive of site-specific immune response after HPV infection; RAI might lead to anal HPV infections and consequently to seroconversion. Finally, as the two genotypes that are most oncogenic and preventable by all HPV vaccines were most common, our results underline the importance of gender-neutral vaccination.