HPV infections among young MSM visiting sexual health centers in the Netherlands: Opportunities for targeted HPV vaccination

IntroductionIn 2009, girls-only HPV16/18 vaccination was introduced in the Netherlands which has achieved 46–61% uptake. Heterosexual men have benefitted from herd protection, but it is unknown whether men who have sex with men (MSM) also benefit from herd effects of the girls-only HPV16/18 vaccination program. Because MSM bear a high HPV-related disease burden, countries might consider targeted vaccination for MSM. To study possible herd effects and prior HPV exposure at a potential moment of vaccination, we assessed trends in the HPV prevalence and proportions (sero)negative for the various vaccine types among young MSM visiting sexual health centers (SHCs).MethodsWe used data from MSM included in PASSYON study years 2009–2017. In this biennial cross-sectional study among visitors of SHCs aged 16–24 years, MSM provided a penile and anal swab for HPV DNA testing (including vaccine types HPV6/11/16/18/31/33/45/52/58) and blood for HPV antibody testing (HPV16/18/31/33/45/52/58).ResultsIn total 575 MSM were included, with a median of 22 years of age and 15 lifetime sex partners and 3.5% HIV positive. Trends in penile or anal HPV prevalence during 2009–2017 were statistically non-significant for all vaccine types. Of the 455 MSM with a penile and anal swab, 360 (79%), 283 (62%) and 242 (53%) were HPV DNA negative at both anatomical sites for HPV16/18, HPV6/11/16/18 and HPV6/11/16/18/31/33/45/52/58 respectively. Among MSM who were HPV16/18 and HPV16/18/31/33/45/52/58 DNA negative and were tested for serology (n = 335 and 279 respectively), 82% and 71% were also seronegative for the respective types.DiscussionThere were no significant declines in the HPV prevalence among MSM up to eight years after introduction of girls-only HPV16/18 vaccination, indicating that MSM are unlikely to benefit largely from herd effects from girls-only vaccination. Most MSM were vaccine-type DNA negative and seronegative, suggesting that vaccination of young MSM visiting SHCs could still be beneficial.     

Anal human papillomavirus infections in young unvaccinated men who have sex with men attending a sexual health clinic for HPV vaccination in Melbourne,Australia

The Victorian Government introduced a time-limited quadrivalent human papillomavirus (HPV) vaccination catch-up program targeting gay and bisexual men who have sex with men (MSM) aged up to 26 years in 2017. As of 2017, men aged ≥20 years were not eligible for the school-based HPV vaccination program. This study examined the prevalence of anal HPV among 496 MSM aged 20–26 years before they received the first dose of the HPV vaccine at the Melbourne Sexual Health Centre, Australia. More than half (56.5%) had any high-risk HPV genotypes detected in the anus. Almost half (43.1%) had at least one quadrivalent HPV vaccine-preventable genotype (6, 11, 16 or 18) and one-fifth (21.0%) had HPV 16 detected in the anus. These findings suggest that a targeted catch-up HPV vaccination program for MSM is still beneficial to protect against high-risk HPV genotypes associated with anal cancer, as well as low-risk HPV genotypes.     

Anal human papillomavirus among men who have sex with men in three metropolitan cities in southern China: implications for HPV vaccination

IntroductionMen who have sex with men (MSM), especially those infected with human immunodeficiency virus (HIV), are at disproportionate risk for human papillomavirus (HPV) infection. Data about anal HPV prevalence among MSM in southern China are limited.MethodsMSM were recruited between January 1 and August 31, 2017 in three metropolitan cities: Guangzhou, Shenzhen and Wuxi. A self-completed tablet-based questionnaire was used to collect information about socio-demographic/sexual behavioral characteristics, history of sexually transmitted infections (STIs) and recreational drug use. An anal brush was used to collect exfoliated cells for HPV DNA testing and genotyping, and a blood sample was taken for HIV testing. Penile/anal warts were checked by a clinician.ResultsA total of 536 MSM were enrolled, including 39 HIV-positive and 497 HIV-negative individuals. Compared with HIV-negative MSM, prevalence of any HPV genotype (79.5% vs 46.7%), any high-risk genotype (64.1% vs 36.6%) and any nonavalent vaccine-preventable genotype (53.9% vs 31.6%) was significantly higher in HIV-positive MSM, with all P < 0.01. HIV infection (adjusted odds ratio [AOR], 4.28; 95% confidence interval [CI], 1.87–9.80), using recreational drugs (AOR, 1.87; 95% CI, 1.22–2.87), having ≥ 3 years of sexual experience (AOR, 1.52; 95% CI, 1.01–2.28), having ≥ 6 lifetime male partners (AOR, 1.92; 95% CI, 1.29–2.86), and engaging receptive anal intercourse (AOR, 2.30; 95% CI, 1.48–3.57) were associated with higher anal HPV prevalence. Any HPV prevalence increased with age, from 24.5% at < 20 years to 55.8% at ≥ 40 years.ConclusionsAnal HPV prevalence was high among MSM in southern China, significantly associated with HIV status and sexual experience. HPV prevalence increased with age among MSM. A targeted HPV vaccination program for teenage MSM might be necessary. Our findings will inform targeted HPV modelling among MSM in China.     

Acceptability of HPV vaccines and perceptions related to genital warts and penile/anal cancers among men who have sex with men in Hong Kong

Men who have sex with men (MSM) are at high risk of contracting HIV and developing genital warts and penile/anal cancers. HPV vaccines are efficacious in preventing such HPV-related diseases among males and WHO recommends its use to young MSM. In a cross-sectional survey, 542 MSM were interviewed. After being briefed about the vaccines’ efficacies and the market price, the prevalence of acceptability of HPV vaccination was 29.2%. Adjusted by significant background variables, perceived high/very high chances of contracting genital warts [adjusted odds ratio (AOR) = 2.04, 95%CI = 1.11–3.72] and penile/anal cancers (AOR = 1.89, 95%CI = 1.09–3.29) among local MSM, perceived moderately high mortality rate of penile/anal cancers (AOR = 1.78, 95%CI = 1.13–2.81), fear toward penile/anal cancers (moderate: AOR = 1.75, 95%CI = 1.07–2.86; high/very high: AOR = 1.82, 95%CI = 1.13–2.92) and disagreement with the statement “MSM in general are not willing to take HPV vaccines” (AOR = 1.82, 95%CI = 1.24–2.68) were associated with the conditional acceptability. Acceptability of this new measure is reasonably high and there are rooms for improvement. Implementation trials to promote HPV vaccination by changing cognitions such as HPV-related risk perceptions, norms and perceptions toward anal/penile cancer are greatly warranted.     

台州市男男性行为者HIV感染和新型毒品使用与人乳头瘤病毒感染相关分析

目的:分析台州市男男性行为者（MSM）中HIV阴性者和HIV感染者中新型毒品使用与肛管人乳头瘤病毒（HPV）感染的相关性。方法:采用横断面调查方法,分别于2016年8月至2017年10月在台州市4个区（县）CDC自愿咨询检测门诊采用方便抽样招募HIV阴性MSM、2016年8月至2019年6月招募台州市随访管理的HIV感...     

Human papillomavirus vaccination coverage among men who have sex with men—National HIV Behavioral Surveillance,United States, 2017

Men who have sex with men (MSM) are at high risk for infections and diseases caused by human papillomavirus (HPV), many of which are vaccine-preventable. In the United States, routine HPV vaccination has been recommended for adolescent males since 2011. This analysis evaluated self-reported receipt of ≥ 1 HPV vaccine dose by age group and HIV status among adult MSM using 2017 data from National HIV Behavioral Surveillance (NHBS) and compared the proportion vaccinated to prior years. Among 10,381 MSM aged ≥ 18 years, 17.9% of MSM overall and 28.4% of MSM living with HIV reported any HPV vaccination. Among 2,482 MSM aged 18–26 years, 32.8% overall and 51.3% living with HIV reported HPV vaccination. Since 2011, the proportion of MSM aged 18–26 years reporting HPV vaccination has increased over six-fold. As vaccinated adolescents age into young adults, coverage will continue to increase overall, including among MSM.     

Men who have sex with men who do not access sexual health clinics nor disclose sexual orientation are unlikely to receive the HPV vaccine in the UK

BackgroundMen who have sex with men (MSM) are recommended the Human Papillomavirus (HPV) vaccination due to their higher risk of genital warts and anal cancer.PurposeTo examine HPV vaccine acceptability amongst MSM in the UK.MethodsUsing advertisements via Facebook, MSM were recruited to an online survey measuring motivations for HPV vaccination. Logistic regression was performed to identify predictors of HPV vaccine acceptability.ResultsOut of 1508 MSM (median age = 22, range: 14–63 years) only 19% knew about HPV. Overall, 55% of MSM were willing to ask for the HPV vaccine and 89% would accept it if offered by a healthcare professional (HCP). Access to sexual health clinics (SHCs) [OR = 1.82, 95% CI 1.29–2.89], the disclosure of sexual orientation to a HCP [OR = 2.02, CI 1.39–3.14] and HIV-positive status [OR = 1.96, CI 1.09–3.53] positively predicted HPV vaccine acceptability. After receiving information about HPV, perceptions of HPV risk [OR = 1.31, CI 1.05–1.63], HPV infection severity [OR = 1.89, CI 1.16–3.01), HPV vaccination benefits [OR = 1.61, CI 1.14–3.01], HPV vaccine effectiveness [OR = 1.54, CI 1.14–2.08], and the lack of perceived barriers to HPV vaccination [OR = 4.46, CI 2.95–6.73] were also associated with acceptability.ConclusionsAlthough nearly half of MSM would not actively pursue HPV vaccination, the vast majority would accept the vaccine if recommended by HCPs. In order to achieve optimal uptake, vaccine promotion campaigns should focus on MSM who do not access SHCs and those unwilling to disclose their sexual orientation.     

男男性行为人群直肠冲洗行为状况及相关因素

  目的  了解男男性行为人群(men who have sex with men, MSM)直肠冲洗行为状况及相关因素,为制定针对性干预措施提供依据。  方法  2020年5月1日―2020年7月10日,在江苏省无锡市采用滚雪球抽样的方法,选取KTV、浴室、公园、酒吧等场所招募400名MSM研究对象,开展横断面调查。通过调查问卷收集研究对象的社会人口学信息、行为学信息、物质滥用史、性病史和直肠冲洗行为等内容,并采集调查对象静脉血进行HIV抗体检测。采用χ2检验和多因素Logistic回归分析模型分析MSM直肠冲洗行为的相关因素。  结果  共调查MSM400人,最近6个月发生性行为时进行直肠冲洗的占比51.3%,其中只在性行为前进行直肠冲洗的占比57.6%,只在性行为后进行直肠冲洗的占比14.6%,性行为前后均进行直肠冲洗的占比27.8%。多因素分析结果显示,月均收入>5 000元(OR=2.18, 95% CI: 1.36~3.51, P=0.001)、同性恋(OR=19.35, 95% CI: 4.01~93.38, P＜0.001)、双性恋(OR=10.31, 95% CI: 2.12~50.14, P=0.004)、最近6个月肛交时为被插入方(OR=8.96, 95% CI: 4.14~19.40, P＜0.001)、最近6个月肛交时为插入方和被插入方均有(OR=10.71, 95% CI: 4.80~23.89, P＜0.001)、物质滥用史(OR=3.20, 95% CI: 1.60~6.42, P=0.001)、性病史(OR=2.17, 95% CI: 1.30~3.63, P=0.003)、HIV检测阳性(OR=3.60, 95% CI: 1.14~11.36, P=0.029)是影响MSM直肠冲洗的相关因素。  结论  MSM发生性行为时进行直肠冲洗较普遍,且与HIV感染有关,迫切需要加强对该人群的健康教育和行为干预,以降低该人群感染HIV的风险。     

北京市男男性接触者HIV相关行为和STD感染状况

目的了解北京市男男性接触者(MSM)的基本情况,为预防艾滋病、性病传播提供依据。方法采用横断面调查设计,于2010年5月在自愿咨询检测(VCT)门诊对MSM进行现场问卷调查,收集相关信息。结果 304份有效问卷结果表明,38.82%的MSM与女性发生过性行为,近6个月内89.47%与男性发生过口交,67.43%与男性发生过主动肛交,59.21%与男性发生过被动肛交,每次都用安全套的比例分别为11.86%,5.88%、52.68%、51.67%。近1年内13.16%的MSM承认发生过群交,23.68%的MSM曾被诊断患过性病,12.83%的MSM认为自己感染人类免疫缺陷病毒(HIV)的风险很大。结论北京市MSM中艾滋病高危行为普遍存在,性传播疾病(STD)感染率高,极有可能造成HIV和STD的流行,制定针对该人群干预策略尤为重要。     

河北省廊坊市男男性行为人群艾滋病/性传播疾病危险行为与感染率现况调查

目的 了解廊坊市区男男性行为(MSM)人群人口学和行为学特征及HIV与梅毒感染率.方法 2007年10-11月间在廊坊市、MSM场所和网络共招募MSM 118人,采用面对面访谈的方式完成问卷106份,调查收集了同性关系、异性关系、性接触方式以及HIV和梅毒的感染信息.结果 不同方式招募的MSM在年龄、婚姻状况和职业特征上存在差别(P＜0.05).约90.0%的人认同自己的同性性取向,82.1%的人保持着与男性的性接触,50.4%的人和女性保持着性关系.该人群性接触方式的比例由高到低依次为肛交(87.7%)、口交(58.5%)、吻肛(32.1%)、拳交(15.1%)和群交(8.5%).17.0%的人表示曾经发生过性交出血的情况.在HIV防范意识方面,仅有31.1%的人意识到自己有感染HIV的风险,23.6%的人曾经做过HIV检测.参加检测的84名MSM中HIV感染率为4.8%,梅毒抗体携带率为22.6%.结论 MSM人群艾滋病/性传播疾病防治意识较为薄弱,HIV和梅毒的感染率较高,亟需通过多种方式在该人群中开展针对性干预工作.     

乌鲁木齐市HIV阴性男男性行为者肛门HPV新发感染和感染清除研究

目的 了解乌鲁木齐市HIV阴性MSM肛门HPV新发感染和感染清除特征。方法 采用队列研究,通过乌鲁木齐市NGO组织于2016年4月11日至2021年11月30日以雪球抽样方式招募MSM 1269名,随访方式为每6个月1次,采集肛周脱落细胞进行HPV基因型检测,使用精确Poisson分布计算新发感染密度和感染清除密度,Cox比例风险模型分析新发感染、自然清除的影响因素。结果 将随访次数≥1 次的858名MSM纳入本次分析,中位年龄29.00（25.00,36.00） 月,中位随访时间26.28（10.57,48.82） 月,随访次数2.96（1.00,6.00）次。仅高危型、仅低危型和混合型新发感染密度分别是9.39/1000人月（95%CI:7.89~11.09）、4.45/1000人月（95%CI:3.52~5.54）、12.36/1000人月（95%CI:10.36~14.63）,清除密度分别为108.78/1000人月（95%CI:94.37~124.78）、96.76/1000人月（95%CI:78.19~118.41）和86.87/1000人月（95%CI:77.12~97.50）。HPV 6型和16型有相对更高的新发感染率和更低的清除率。HPV感染6个月清除率在30%~40%左右,90%左右的MSM在24个月会清除HPV。多变量分析中,接受性肛交（αHR=1.514,95%CI:1.025~2.811）、无业或失业（αHR=1.746,95%CI:1.085~2.811）增加仅高危型新发感染风险;≤24岁（αHR=2.227,95%CI:1.087~4.563）增加仅低危型新发感染风险;同性性伴数越多（αHR=1.051,95%CI:1.008~1.096）增加混合型新发感染风险;未在浴池寻找性伴（αHR=2.267,95%CI:1.036~4.961）更容易清除仅低危型;本科及以上（αHR=1.785,95%CI:1.234~2.582）、未发生商业性行为（αHR=1.967,95%CI:1.191~3.248）有利于HPV16/18型感染清除。结论 乌鲁木齐市MSM肛门HPV新发感染率较高,其中HPV 6型和16型较高的新发感染率和低清除率需要关注,虽然HPV感染24个月内自然清除率在90%左右,但仍存在一定比例的再发感染,有必要在年轻男性中接种HPV疫苗。     

HPV vaccine uptake in men who have sex with men in Scotland

Human papillomavirus (HPV) vaccines are currently utilised globally in national immunisation programmes. In July 2017, a national HPV vaccine programme for men who have sex with men (MSM) was initiated across Scotland with vaccine being offered in the sexual health clinic setting. During the first year of this targeted vaccination programme, there were 5905 individuals who received at least one dose of HPV vaccine, representing 63.7% of eligible MSM attendees in this period. Vaccine uptake was relatively stable across all age groups (range 49.8–55.5%). The vaccination programme appears to have dovetailed well with pre-existing sexual health services and appears to be popular with MSM attending the service. The MSM HPV vaccine programme is a robust adjunct to the national girls programme but gender-neutral immunisation will reduce stigma and inequality in HPV-driven disease.     

How very young men who have sex with men view vaccination against human papillomavirus

Background

HPV vaccination of men who have sex with men (MSM) prior to the commencement of sexual activity would have the maximum impact on preventing HPV and anal cancer in this population. However, knowledge and attitudes towards HPV vaccination among very young MSM have not been previously studied.

Methods

Two hundred MSM aged 16 to 20 were recruited via community and other sources. Participants were asked about their knowledge and attitudes towards HPV and HPV vaccination.

Results

Most (80%, 95% confidence interval (CI) 72.2–87.2%) men were not willing to purchase the vaccine because of its cost (AUD$450). However, if the vaccine was offered to MSM free of charge, 86% (95% CI: 80–90%) reported they would be willing to disclose their sexuality to a health care provider in order to obtain the vaccine. Over half (54%, 95%: 47–61%) of men would only be willing to disclose their sexuality to receive the HPV vaccine after their first experience of anal intercourse. The age at first insertive anal intercourse and the age at first receptive anal intercourse were 0.21 (IQR: −2.5 to 3.2) and 0.17 (IQR: −2.9 to 2.7) years earlier than the age that men would be willing to disclose their sexuality to receive the HPV vaccine, respectively. Willingness to receive the vaccine at a younger age was associated with younger age at first insertive anal intercourse.

Conclusion

Overall, very young MSM expressed high acceptance of HPV vaccination. Early, opportunistic vaccination of very young MSM may be feasible in settings where very young MSM have not been vaccinated through universal programs targeting school aged males. However, given HPV infections occur early on, the effectiveness of this approach will be less than vaccination targeting school aged boys.     

2010年镇江市男男性行为者队列基线调查

目的了解江苏省镇江市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用分类滚雪球抽样的方法于2010年2—9月,在镇江市范围内招募MSM进行问卷调查,了解其社会人口学及艾滋病高危行为特征,并采集血样进行人类免疫缺陷病毒(HIV)抗体、梅毒抗体、丙型肝炎病毒(HCV)抗体的检测。结果共调查456名MSM,77.0%最近6个月发生过同性口交性行为,其中61.0%有多个同性口交性伴;87.1%最近6个月发生过同性肛交性行为,其中55.3%有多个同性肛交性伴,14.9%最近1周发生过多次同性肛交性行为;11.3%最近6个月与同性发生过商业性行为,34.9%与异性发生过性行为;最近6个月与同性发生口交性行为时坚持使用安全套的比例为16.0%,肛交时坚持使用安全套的比例是40.3%,与同性发生商业性行为时坚持使用安全套的比例是40.0%,与异性发生性行为时坚持使用安全套的比例为26.4%。456名调查者均采集血样进行了血清学检测,初筛HIV阳性人数40人,确证HIV阳性人数35人,阳性率为7.3%(95%CI 5.40%～10.51%);确证梅毒抗体阳性人数为48人,阳性率为10.5%(95%CI7.86%～13.71%);确证HCV抗体阳性人数为2人,阳性率为0.4%(95%CI0.05%～1.58%);确证HIV抗体与梅毒抗体合并阳性人数为4人,合并阳性率为0.9%(95%CI 0.24%～2.23%)。在多因素logistic回归模型中,月收入为1 000～3 000元(OR=0.40,95%CI 0.18～0.87)与HIV感染的关系具有统计学意义。结论镇江市MSM中无保护性性行为较为普遍,HIV和梅毒感染率较高,应在该人群中加强包括艾滋病宣传和安全套推广在内的艾滋病干预措施,控制艾滋病等性传播疾病的流行。     

重庆市男男性接触者艾滋病病毒感染率及其影响因素

目的 了解重庆市男男性接触人群(MSM)艾滋病病毒(HIV)感染率及其影响因素.方法 2007年7-9月在重庆市渝中区、九龙坡区和沙坪坝区通过滚雪球方式招募1044名MSM进行面对面的问卷调查,以HIV感染状况为应变量,人口学特征、艾滋病防治知识知晓水平、性行为状况、接受干预服务、梅毒感染状况等为自变量进行逐步向前法的logistic回归分析与HIV感染相关的因素.结果 调查的1044名MSM中,艾滋病防治知识知晓率高(89.5%),近6个月与男性发生无保护性的肛交比例为63.8%;梅毒感染率为8.5%(89/1044),HIV感染率为12.5%(131/1044).多因素回归分析发现,年龄较大(OR=1.69,95%CI:1.13～2.52)、文化程度在初中以下(OR=1.89,95%CI:1.17～3.05)、首次性行为年龄在18岁以下(OR=3.11,95%CI:1.20～8.02)、近6个月男性性伴数在10个以上(OR=2.24,95%CI:1.24～4.02)、近6个月与女性有性行为史(OR=2.40,95%CI:1.64～3.51)和梅毒感染(OR=4.52,95%CI:2.77～7.38)是HIV感染的独立危险因素.结论 MSM人群无保护性性行为发生率、梅毒和HIV感染率均高.     

磷酸可待因滥用与MSM人群HIV感染及相关高危行为的关联性

目的 了解男男性行为(men who have sex with men,MSM)人群磷酸可待因的滥用情况,分析滥用磷酸可待因与(human immunodeficiency virus,HIV)感染及相关高危行为的关系。 方法 采用访谈式问卷收集2012年6月－2013年6月,中国7城市MSM人群的社会人口学、性行为、磷酸可待因及其他药物滥用行为等信息。采集静脉血检测HIV抗体。 结果 4 492名MSM调查对象中,84名(1.87%)自报近半年内有磷酸可待因滥用经历。滥用者近半年内发生同性商业性行为(AOR=3.431,95%CI:2.104~5.593)、肛门出血(AOR=2.052,95%CI:1.243~3.387)、安全套破裂(AOR=2.735,95%CI:1.578~4.741)、群体性行为(AOR=4.573,95%CI:2.454~8.521)、吸食rush(AOR=2.759,95%CI:1.763~3.387)和存在部分特定性病症状(AOR=4.926,95%CI:2.880~8.426)的风险均显著更高。吸食过rush(AOR=1.509,95%CI:1.219~1.869)、肛门出血(AOR=1.595,95%CI:1.246~2.041)和存在部分特定性病症状(AOR=1.689,95%CI:1.192~2.392)与HIV感染呈正相关。未发现滥用磷酸可待因与HIV感染之间的显著关联性(OR=1.289,95%CI:0.588~2.825)。 结论 尽管MSM群体中磷酸可待因滥用还不普遍,但相关滥用者容易发生与HIV感染相关的各类高危行为,间接增加其HIV感染风险。卫生部门需进一步加强关注和监测MSM群体的磷酸可待因滥用情况,控制该人群HIV的流行和扩散。     

Assessing knowledge of human papillomavirus among men who have sex with men (MSM) using targeted dating applications

BackgroundThe incidence of HPV-related oropharyngeal and anal cancer has been increasing significantly over the past 30 years, especially among males. This study sought to better understand the level of knowledge of HPV-related disease in the LGBTQ+ community, and serve as a method to increase awareness for HPV vaccination as a safe and effective method for cancer prevention.MethodsSCRUFF and Jack’d are geosocial networking and dating mobile applications for men who have sex with men (MSM). All users of the applications who were located in the US at the time of the study were invited to participate in a survey on HPV knowledge, the HPV vaccine, and vaccination status. The Pearson test was used to identify possible associations.ResultsHalf of the HPV vaccine-eligible respondents reported having received at least one dose of the HPV vaccine, while only 37.9% of the individuals aged 9–26 reported being vaccinated against HPV. Among the unvaccinated, 63.3% reported being interested in future vaccination, or learning more about it. No significant differences were noted regarding vaccination status nor HPV knowledge between respondents from rural vs urban locations. Respondents from the South were the least knowledgeable about cancer and genital warts caused by HPV (79.4%, p < 0.01), and had the lowest rate of vaccination compared to other regions (18.5%, p < 0.01). More than half of respondents reported being either somewhat comfortable (15.8%) or very comfortable (42.2%) with receiving the HPV vaccine from a dentist.ConclusionsThe findings of this study identify demographic groups and geographical areas where preventive campaigns for HPV would be most needed. The findings highlight dental providers as an underutilized source of HPV education and vaccine recommendation. The study reveals opportunities to close gaps in care and knowledge, and points to future directions for research and development of effective interventions.     

A comparison of HIV seropositive and seronegative young adult heroin- and cocaine-using men who have sex with men in New York City, 2000–2003

The purpose of this analysis was to determine the prevalence and correlates of HIV infection among a street-recruited sample of heroin-and cocaine-using men who have sex with men (MSM). Injection (injecting ≦3 years) and non-injection drug users (heroin, crack, and/or cocaine use<10 years) between 18 and 40 years of age were simultaneously street-recruited into two cohort studies in New York City, 2000–2003, by using identical recruitment techniques. Baseline data collected among young adult men who either identified as gay/bisexual or reported ever having sex with a man were used for this analysis. Nonparametric statistics guided interpretation. Of 95 heroin/ cocaine-using MSM, 25.3% tested HIV seropositive with 75% reporting a previous HIV diagnosis. The majority was black (46%) or Hispanic (44%), and the median age was 28 years (range 18–40). HIV-seropositive MSM were more likely than seronegatives to be older and to have an HIV-seropositive partner but less likely to report current homelessness, illegal income, heterosexual identity, multiple sex partners, female partners, and sex for money/drug partners than seronegatives. These data indicate high HIV prevalence among street-recruited, drug-using MSM compared with other injection drug use (IDU) subgroups and drug-using MSM; however, lower risk behaviors were found among HIV seropositives compared with seronegatives. Large-scale studies among illicit drug-using MSM from more marginalized neighborhoods are warranted.     

贵阳市男男性行为者包皮环切术接受意愿调查

目的探索包皮环切术作为艾滋病预防干预措施在贵州省贵阳市男男性行为人群(MSM)中的可接受性及影响因素。方法对贵阳市招募的符合条件的302名男男性行为行者进行包皮环切术(MC)接受意愿及其影响因素问卷调查。结果本次调查的MSM性取向为同性恋的占57.3%(173/302),发生首次性行为的平均年龄是21.7岁,首次性行为的性伴61.6%(186/302)是男性;最近6个月男性性伴数平均是4.2人,94.4%(285/302)的MSM与男性有过肛交性行为,且与男性发生性行为时只有31.4%(89/302)的MSM每次都使用了安全套,17.9%(54/302)的MSM有与女性发生性行为史,只有35.1%(19/54)的人每次都使用了安全套;包皮环切术接受率为48.01%(145/302);多因素非条件logistic回归分析结果表明,认为包皮环切术能预防艾滋病性病传播、自认为包皮过长及包茎现象、认为MC提高性生活质量和相信MC质量好是包皮环切术接受意愿的主要影响因素。结论包皮环切术对性功能和预防疾病方面的影响与该手术的接受意愿有一定的关系。     

北京市男男性行为者行为因素和心理状态与HIV感染关系的研究

目的 了解北京市男男性行为者(MSM)中HIV感染情况及其影响因素.方法 于2008年3-6月,在北京市招募MSM进行问卷调查,了解其社会人口学和行为学特征,并采集血样进行HIV抗体、梅毒抗体、HBsAg和HCV抗体检测.采用X~2检验和logistic回归模型对HIV感染的影响因素进行分析.结果共有550名符合纳入标准的MSM参加本次调查,HIV感染率为4.5%(25/550).多因素logistic回归分析显示,近1个月与临时男性性伴无保护性肛交(X~2=11.381,P=0.001)、近3个月同性性行为后直肠冲洗(X~2=5.326,P=0.021)、近1个月感到悲伤(X~2=8.809,P=0.003)与MSM感染HIV的关系有统计学意义.结论 在加强安全性行为预防干预的同时需采取适当的心理干预措施,以控制HIV在该人群中的传播.