This abstract was presented as a poster at the 11th Annual Canadian Conference on HIV/AIDS Research in Winnipeg in April 2002, and will be presented as a poster at the XIV International AIDS Conference to be held in Barcelona, Spain, in July 2002.

The relationship between sociodemographic background, sexual behaviour, and HIV on self-reported anogenital warts among young men who have sex with men

Elissa Press, Keith Chan, Steve Martindale, Mary Lou Miller, Peter Granger, Robert Hogg

The Vanguard Project, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC.

OBJECTIVES:

To determine the self-reported prevalence of anogenital warts, a sexually transmitted disease (STD), in a cohort of men who have sex with men (MSM), and to identify the relationship between sociodemographic background, sexual behaviour, and HIV status on anogenital infection. Anal warts are associated with human papillomavirus (HPV) which has been linked to the development of anal cancer. Although risk factors are currently uncharacterized in Canada, high-risk sexual practices and other STDs are implicated in HPV pathogenesis.

METHOD:

Men aged 15 to 30 years, who had not previously tested HIV+, were enrolled in a prospective cohort in Greater Vancouver. Eligible participants completed baseline questionnaires and at least one follow-up questionnaire between 05/95 and 09/01. Using Chi-Square analysis, data from the two most recent questionnaires were used to identify characteristics and risk factors of men with self-reported anogenital warts.

RESULTS:

Few participants (27/168) reported ever having received an anal Pap smear. No significant differences were found between HIV+ and HIV- men in testing for or reporting anal warts. Men reporting anogenital warts were more likely to be Caucasian (83% vs. 73%, p=0.04), have gonorrhea (26.5% vs. 10.6%, p=0.001) and herpes (14.7% vs. 3.5%, p=0.001), have had 20 or more male sexual partners in their lifetime (82.5% vs. 67.2%, p=0.003), and have had protected or unprotected casual anal insertive intercourse with a known HIV infected partner (61.2% vs. 45.8%, p=0.005). They were also more likely to report the use of nitrate inhalants (43% vs. 31%, p=0.026), ecstasy (43.7% vs. 31.4%, p=0.02), ketamine (27.7% vs. 13.1%, p=0.001), and gamma-hydroxybuturate (22.6% vs. 14.5%, p=0.049), although these drugs may in fact be markers for higher sexual activity.

CONCLUSIONS:

To reduce HPV rates, prevention efforts designed for young MSM should incorporate issues relating to substance use, and encourage treatment of other STDs.