IRD, Inserm, University Montpellier, TransVIHMI, Montpellier, France.
Laboratoire de Biologie Moléculaire et d'Immunologie, Faculté des Sciences de la Santé, University Lomé, Lomé, Togo.
Clin Infect Dis. 2021 Dec 16;73(12):2184-2192. doi: 10.1093/cid/ciab157.
Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo.
A cross-sectional study was conducted in 2017-2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions.
Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48-5.27) and study country (4.73, 2.66-8.43 for Mali; 3.12, 1.68-5.80 for Burkina Faso; 3.51, 1.92-6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively.
HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa.
男男性行为者（MSM）是人乳头瘤病毒（HPV）感染的高危人群。我们评估了（i）HPV 感染的流行情况和相关因素，以及（ii）布基纳法索、科特迪瓦、马里和多哥 MSM 中可预防疫苗接种的 HPV 感染的流行情况。
2017-2018 年，我们对社区诊所随访的年龄在 18 岁及以上的 MSM 进行了横断面研究。使用 e-BRID 系统对口腔和肛门样本进行 HPV 感染检测。采用多变量逻辑回归分析 HR-HPV 感染的相关因素。
在 631 名参与者中，425 名 HIV 阴性，206 名 HIV 阳性。根据研究国家的不同，前者 HR-HPV 感染率为 9.2%至 34.8%，后者为 33.3%至 71.0%。多变量分析显示，HIV 感染（调整后的优势比（aOR）为 3.61，95%置信区间（CI）为 2.48-5.27）和研究国家（马里为 4.73，2.66-8.43；布基纳法索为 3.12，1.68-5.80；多哥为 3.51，1.92-6.42）与 HR-HPV 感染相关。其他相关因素包括低教育水平、自我定义的同性恋身份和无保护的肛交。在 HIV 阴性参与者中，可通过二价、四价和九价疫苗预防的感染的流行率分别为 5.9%、27.1%和 34.6%，在 HIV 阳性参与者中分别为 18.9%、43.7%和 54.9%。
在 HIV 阴性和 HIV 阳性的 MSM 中，研究国家之间的 HR-HPV 流行情况差异很大。疫苗可预防的 HPV 感染占主导地位。应向年轻的 MSM 提供疫苗接种，以减少该脆弱人群及其在西非的女性性伴侣中 HPV 感染的负担。
