Type-specific anal human papillomavirus prevalence among men, according to sexual preference and HIV status: A systematic literature review and meta-analysis


Background: Anal human papillomavirus (HPV) infection, most notably of HPV16, the central cause of anal cancer, is increased by anal sexual intercourse and worsened by HIV-positivity. Methods: We undertook a systematic review and meta-analysis of studies reporting type-specific anal HPV infection in men, according to sexual preference, HIV status and, when available, anal cytopathology. HPV prevalence was compared by prevalence ratios (PR). Results: 79 eligible studies were included, comprising 23,700 men: 1,805 HIV-negative men-who-have-sex-with-women (MSW), 924 HIV-positive MSW, 8,213 HIV-negative men-who-have-sex-with-men (MSM) and 12,758 HIV-positive MSM. In analyses irrespective of anal cytopathology, HPV16 prevalence was significantly higher in MSM than MSW, both among HIV-negative (14% versus 3%; PR 4.7, 95%CI 2.5-8.9) and HIV-positive men (30% versus 11%; PR=2.8, 95%CI 1.9-4.1). Likewise, HPV16 was significantly higher in HIV-positive than HIV-negative men, both among MSW (PR=3.5, 95%CI 1.6-7.7) and MSM (PR=2.1, 95%CI 1.8-2.5). Anal HPV16 prevalence was similar between HIV-positive MSW and HIV-negative MSM (PR=1.3, 95% CI 0.9-2.0). For MSM, anal HPV16 prevalence was significantly higher from studies with anal cytopathology, suggesting population sampling effects. Conclusion: Sexual preference and HIV infection are independent and similarly strong determinants of male anal HPV16 infection, confirming HIV-positive MSM as priorities for anal cancer prevention


Marra E, Lin C, Clifford GM




  • Epidemiology and Determinants of Health
    • Epidemiology
  • Population(s)
    • Men who have sex with men
    • Heterosexual men
    • General HIV+ population
    • General HIV- population
  • Co-infections
    • Other


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