British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
Sex Transm Dis. 2011 Oct;38(10):964-9. doi: 10.1097/OLQ.0b013e318222899d.
Inclusion of self-collected rectal swabs (SCRS) into existing community venue-based HIV surveillance systems for men who have sex with men (MSM) may provide a feasible method for monitoring human papillomavirus (HPV) vaccine-related outcomes in this population. We measured the prevalence of HPV and anal dysplasia through incorporating SCRS into ManCount, the Vancouver site of the M-Track HIV surveillance system.
Participating MSM were provided with a self-collection kit for collection on-site or at a follow-up venue. Swabs were subject to polymerase chain reaction amplification for HPV detection, and cytology slides were reviewed for anal dysplasia. Factors associated with participation were identified through multivariate logistic regression.
Of 766 men completing ManCount, 268 (35%) agreed to participate, self-collecting 252 specimens (247 on-site). Of 239 complete specimens, 33.5% did not have detectable β-globin; in the remainder (159 specimens) the prevalence of HPV infection was 62.3% (23.3% HPV type 16 or 18; 38.4% HPV type 6, 11, 16, or 18). In the 62.3% (149) of specimens adequate for cytology, the prevalence of anal dysplasia was 42.3% (HSIL 11.4%, LSIL 18.8%, ASC-US 6.7%, ASC-H 5.4%). Participation was associated with venue type, availability of on-site collection, and other characteristics.
SCRS can be feasibly integrated within existing community venue-based HIV surveillance systems for MSM, and may be a suitable method for monitoring the impact of HPV vaccination in this population. However, participation may be influenced by venue type and availability of on-site collection, and adequacy of SCRS specimens may be lower in community venues as compared with clinical settings.
将男性性行为者（MSM）自行采集的直肠拭子（SCRS）纳入现有的社区场所为基础的艾滋病毒监测系统，可能为监测该人群中人类乳头瘤病毒（HPV）疫苗相关结果提供一种可行的方法。我们通过将 SCRS 纳入 M-Track HIV 监测系统的温哥华站点 ManCount，来测量 HPV 和肛门发育不良的流行率。
为参加的 MSM 提供了一个自我采集套件，用于现场或在后续场所采集。拭子进行聚合酶链反应扩增以检测 HPV，并对细胞学幻灯片进行肛门发育不良检查。通过多变量逻辑回归确定与参与相关的因素。
在完成 ManCount 的 766 名男性中，有 268 名（35%）同意参与，自行采集了 252 个标本（247 个现场采集）。在 239 个完整标本中，33.5%未检测到β-球蛋白；在其余（159 个标本）中，HPV 感染的流行率为 62.3%（HPV 型 16 或 18 占 23.3%；HPV 型 6、11、16 或 18 占 38.4%）。在可进行细胞学检查的 62.3%（149 个）标本中，肛门发育不良的流行率为 42.3%（HSIL 占 11.4%，LSIL 占 18.8%，ASC-US 占 6.7%，ASC-H 占 5.4%）。参与与场所类型、现场采集的可用性以及其他特征有关。
SCRS 可以在现有的基于社区场所的 MSM 艾滋病毒监测系统中进行切实可行的整合，并且可能是监测 HPV 疫苗接种对该人群影响的合适方法。然而，参与可能受到场所类型和现场采集的可用性的影响，并且与临床环境相比，社区场所的 SCRS 标本可能不够充分。
