This poster was presented at the 10th Annual Canadian Conference on HIV/AIDS Research in Toronto in June 2001 and at the AIDS Impact conference in Brighton, England, in July 2001. An oral presentation of this abstract was also made by Dr. Peter Granger at the 3rd Canadian HIV/AIDS Skills Building Symposium in Montreal in July 2001.

Screening for and determinants of human papillomavirus (HPV) and anal canal cell dysplasia among men who have sex with men (MSM)

Peter Granger**, Steve Martindale*, Jacqueline M. O'Connell*, Magdalena A. Piaseczna*, Mary Lou Miller*, Darrel Cook***, Gil Kimel*, Arn J. Schilder*, Robert S. Hogg*.

* The Vanguard Project, BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
** Three Bridges Community Health Centre.
*** BC Centre for Disease Control, Vancouver, BC, Canada.

 

OBJECTIVES:

In a proposed prevalence and case/control study of gay and bisexual men (MSM) to be recruited from the existing Vanguard cohort, we plan to:

a) determine the prevalence of HPV and anal canal cell dysplasia among MSM in Vancouver;

b) identify the prevalence of potentially cancerous strains of HPV using HPV genotyping; and

c) identify socio-demographic and behavioural risk factors for HPV and anal canal cell dysplasia in this population.

BACKGROUND:

Human papillomaviruses (HPV) are among the most common sexually transmitted infections, and are implicated in anogenital diseases ranging from external genital warts to cervical and anal cancer. Little is known of the prevalence/incidence of HPV and anal canal cell changes among MSM in Canada.

METHODS:

Randomly selected participants in the Vanguard Project - an ongoing study of HIV rates and risk factors in young MSM in the Vancouver area - will be tested for anal HPV.

Three screening techniques will be used:

• anal pap smears to detect cell changes;
• HPV culture swabs; and
• HPV virus-typing to detect oncogenic strains of HPV.

Socio-demographic and behavioural data - including unprotected receptive anal intercourse - and self-reported history of anogenital warts, will be collected from self-administered questionnaires.

DISCUSSION:

Dysplastic and condylomatous lesions resulting from HPV infection can be detected and treated with some success. A strategy for early detection of anal HPV and anal canal cell changes, however, requires investigation of appropriate screening methods, sound knowledge of prevalence and incidence of HPV among MSM, socio-demographic and behavioural factors associated with infection, and knowledge of the impact of infection on population health.

With respect to the risk of developing anal cancer, there may be a substantial benefit of screening MSM - and especially HIV-positive MSM - using anal cytology.