贝宁男男性行为者中高危型人乳头瘤病毒的流行情况及其决定因素：一项在预防 HIV 暴露前预防措施示范项目中嵌入的横断面研究。

Prevalence and determinants of high-risk human papilloma virus among men who have sex with men in Benin: a cross-sectional study embedded in a demonstration project on pre-exposure prophylaxis against HIV.

机构信息

Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada

Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Québec, Canada.

出版信息

BMJ Open. 2023 Nov 6;13(11):e074464. doi: 10.1136/bmjopen-2023-074464.

DOI:10.1136/bmjopen-2023-074464

PMID:37931972

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10632860/

Abstract

OBJECTIVES

This study aims to assess the prevalence and factors associated with anal high-risk human papilloma virus (HR-HPV).

DESIGN

A cross-sectional study conducted from 24 August 2020 to 24 November 2020.

SETTING

Primary care, Cotonou, Benin.

PARTICIPANTS

204 HIV-negative men who have sex with men initiating oral pre-exposure prophylaxis.

PRIMARY OUTCOME MEASURE

Anal HR-HPV genotypes using GeneXpert HPV assay. Fourteen HR-HPV were evaluated: HPV-16 and HPV-18/45 in 2 distinct channels and the 11 other genotypes as a pooled result (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68). The potential independent variables analysed included anal gonorrhoea and chlamydia infections, and sociodemographic and sexual behaviour factors. To assess the determinants of HR-HPV, univariate and multivariate Poisson regression models were performed by using SAS V.9.4.

RESULTS

Mean age±SD was 25.9±4.8 years. 131/204 men claimed insertive sex procured more pleasure. Thirty-two participants, accounting for 15.7% of the study sample, had gonorrhoea and/or chlamydia. The prevalence of any HR-HPV genotype was 36.3% (95% CI 30.0% to 43.0%). In total, 7.8% of men had HPV-16 and 7.4% had HPV-18/45. The prevalence for the pooled genotypes (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68) was 29.9%. Receptive anal sex during the last 6 months was strongly associated with prevalent HR-HPV infections. The adjusted proportion ratio (aPR) was 1.93 (95% CI 1.31 to 2.83). Gonorrhoea and chlamydia were also associated with the outcome of interest; p value for both infections was <0.05. The aPR comparing patients who perceived some risk of acquiring HIV to other men was 1.44 (95% CI 1.00 to 2.08).

CONCLUSIONS

In Benin, anal HR-HPV was common among HIV-negative men who have sex with men. Among this highly vulnerable population, there is a need for integrated preventive and management strategies targeting HPV and other sexually transmitted infections.

摘要

目的

本研究旨在评估肛门高危型人乳头瘤病毒（HR-HPV）的流行情况及相关因素。

设计

2020 年 8 月 24 日至 11 月 24 日进行的横断面研究。

地点

贝宁科托努的初级保健机构。

参与者

204 名开始口服暴露前预防的 HIV 阴性男男性行为者。

主要结局测量

使用 GeneXpert HPV 检测分析肛门 HR-HPV 基因型。评估了 14 种 HR-HPV：HPV-16 和 HPV-18/45 在 2 个不同的通道，以及其他 11 种基因型作为一个汇总结果（31、33、35、39、51、52、56、58、59、66 和 68）。分析的潜在自变量包括肛门淋病和衣原体感染以及社会人口学和性行为因素。为了评估 HR-HPV 的决定因素，使用 SAS V.9.4 进行了单变量和多变量泊松回归模型。

结果

平均年龄±标准差为 25.9±4.8 岁。204 名男性中有 131 名声称插入性性行为带来更多快感。32 名参与者（占研究样本的 15.7%）患有淋病和/或衣原体感染。任何 HR-HPV 基因型的患病率为 36.3%（95%CI 30.0%至 43.0%）。共有 7.8%的男性感染 HPV-16，7.4%的男性感染 HPV-18/45。（31、33、35、39、51、52、56、58、59、66 和 68）汇总基因型的患病率为 29.9%。在过去 6 个月内进行的肛门接受性性行为与 HR-HPV 感染密切相关。调整后的比例比（aPR）为 1.93（95%CI 1.31 至 2.83）。淋病和衣原体感染也与研究结果相关；两种感染的 p 值均<0.05。与其他男性相比，认为有感染 HIV 风险的患者的 aPR 为 1.44（95%CI 1.00 至 2.08）。