Incidence, Persistence, and Clearance of Anal Human Papillomavirus Infections Among Adolescent and Young Men Who Have Sex With Men in China: An Observational Cohort Study.

BACKGROUND

High-risk adolescent and young men who have sex with men (MSM) populations in China experience a significant burden of human papillomavirus (HPV) infections, particularly involving HPV6, HPV11, HPV16, and HPV18. This prospective observational study investigated the prevalence, persistence, and clearance of HPV, highlighting the critical need for targeted interventions.

METHODS

Adolescent and young MSM across 4 Chinese provinces participated in the UniTest Study. Anal swab samples were collected at baseline and follow-up for HPV detection and genotyping. Sociodemographic and behavioral data were obtained through self-administered questionnaires. Incidence, persistence, and clearance rates were calculated, and potential determinants were analyzed using Poisson regression models.

RESULTS

The overall incidence of any HPV genotype was 42.1 per 1000 person-months (pm), with HPV16 (5.6/1000 pm), HPV6 (4.1/1000 pm), and HPV58 (3.2/1000 pm) being the most common incident genotypes. Persistent infections were observed in 28.0%, with HPV11 (4.5%), HPV6 (4.0%), and HPV16 (3.5%) as the top persistent genotypes. The clearance rate for any HPV genotype was 102.6 per 1000 pm. Participants who sought sex partners online had a higher likelihood of HPV incidence (risk ratio [RR] = 1.543, 95% confidence interval [CI] 1.043-2.282), while those with above-average academic performance had a lower likelihood of HPV incidence (RR = 1.551, 95% CI 1.058-2.274). Compared with Han, other ethnicities were associated with increased HPV clearance (RR = 5.757, 95% CI 1.067-31.067).

CONCLUSIONS

This study uncovers a substantial incidence of HPV infections among adolescent and young MSM in China, underscoring the imperative for focused health education and the swift implementation of customized HPV vaccination initiatives. Through the prioritization of preventive strategies and vaccination campaigns, it's possible to significantly diminish the impact of HPV infections and enhance sexual health outcomes within this at-risk group. Trial registration. Chinese Clinical Trial Registry, www.chictr.org.cn: ChiCTR1900020645.