Brown Brandon, Davtyan Mariam, Leon Segundo R, Sanchez Hugo, Calvo Gino, Klausner Jeffrey D, Galea Jerome
Program in Public Health, Department of Population Health and Disease Prevention, University of California, Irvine, California, USA.
Unit of Health, Sexuality and Human Development, Cayetano Heredia University School of Public Health, Lima, Peru.
BMJ Open. 2014 Sep 16;4(9):e005687. doi: 10.1136/bmjopen-2014-005687.
The HIV epidemic in Latin America is concentrated among men who have sex with men (MSM) and transgender women (TGW) with transmission predominately occurring during unprotected anal intercourse. This mode of transmission is also responsible for other sexually transmitted infections (STIs) such as herpes simplex, chlamydia and gonorrhoea, human papillomavirus (HPV)/genital warts and syphilis. Studies assessing the prevalence of HIV and HPV among MSM have not addressed the role of genital warts and HPV-related diseases in the acquisition of HIV infection. Community-based testing programmes are a potentially important way to remove barriers including stigma for individuals to learn about their STI status.
The prospective cohort study will recruit 600 MSM/TGW at a community centre in Lima, Peru, named Epicentro. Half of the participants will have a history of or have current anogenital warts (AGW), and the other half will have no history of AGW. We will measure the prevalence and acquisition of STIs including syphilis, HPV, chlamydia and gonorrhoea and the HIV-incidence in the two groups. To the best of our knowledge, it will be the first study that specifically examines the impact of genital warts on incident HIV infection. This study will help to understand the relationship between AGW and HIV infection among MSM/TGW in Peru. Furthermore, it may facilitate the development of preventive intervention strategies to reduce the prevalence of AGW and prevent incident HIV infection. HPV-related manifestations may be a good proxy for HIV risk.
This study was approved by institutional review boards at the University of California, Los Angeles (UCLA) in the USA and Impacta in Peru. Study findings will be shared with the Peruvian Ministry of Health as well as other international and national public health organisations. Study results will be translated into Spanish for participants.
The Clinicaltrials.gov registration number is NCT01387412.
拉丁美洲的艾滋病毒疫情集中在男男性行为者（MSM）和变性女性（TGW）中，传播主要发生在无保护的肛交期间。这种传播方式也是其他性传播感染（STI）的原因，如单纯疱疹、衣原体和淋病、人乳头瘤病毒（HPV）/尖锐湿疣以及梅毒。评估男男性行为者中艾滋病毒和人乳头瘤病毒患病率的研究尚未探讨尖锐湿疣和HPV相关疾病在艾滋病毒感染获得中的作用。基于社区的检测项目是消除包括耻辱感在内的障碍、让个人了解其性传播感染状况的一种潜在重要方式。
这项前瞻性队列研究将在秘鲁利马一个名为Epicentro的社区中心招募600名男男性行为者/变性女性。一半参与者有或目前患有肛门生殖器疣（AGW）病史，另一半没有AGW病史。我们将测量两组中梅毒、人乳头瘤病毒、衣原体、淋病等性传播感染的患病率和感染情况以及艾滋病毒发病率。据我们所知，这将是第一项专门研究尖锐湿疣对艾滋病毒感染发生率影响的研究。本研究将有助于了解秘鲁男男性行为者/变性女性中AGW与艾滋病毒感染之间的关系。此外，它可能有助于制定预防干预策略，以降低AGW的患病率并预防艾滋病毒感染。HPV相关表现可能是艾滋病毒风险的一个良好指标。
本研究得到了美国加利福尼亚大学洛杉矶分校（UCLA）和秘鲁Impacta的机构审查委员会的批准。研究结果将与秘鲁卫生部以及其他国际和国家公共卫生组织分享。研究结果将翻译成西班牙语供参与者使用。
Clinicaltrials.gov注册号为NCT01387412。
