High prevalence of bacterial STI, anal HPV, cytological abnormalities and anal lesions among MSM in Togo, 2021: a baseline analysis of the ANRS I MIE 12,400/DepIST-H cohort.

BACKGROUND

Sexually transmitted infections (STI) are a prominent health issue in Africa, especially in key populations such as men who have sex with men (MSM). Here, we present the baseline results of a 2-year longitudinal cohort in Togo.

METHODS

A total of 200 MSM in Lomé, Togo, were included in the ANRS I MIE 12400/DepIST-H cohort, half living with HIV. High-risk HPV (hrHPV) detection was performed on anal smears. Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) were tested from urine, pharyngeal and anal swabs.

RESULTS

Overall, median age was 23 years, hrHPV prevalence was 75.9%, and was significantly higher in HIV-positive MSM (p = 0.008). The most common hrHPV types were HPV16 and HPV35 (18.7% each). Overall, 55.4% of participants had abnormal anal cytology, the most frequent lesions being low-grade squamous intraepithelial lesions, (22.3% of HIV-positive and 15.2% of HIV-negative MSM). The overall prevalence of GC and CT infections was 32.5% and 32.0%, respectively. Clinical anal lesions, mostly condyloma, were detected in 46.0% of participants (n = 86).

CONCLUSIONS

These findings emphasize the high prevalence of STIs among MSM and confirm the unusual distribution of HPV types in West Africa, with HPV35 being highly prevalent. A national strategy regarding STI screening and HPV vaccination in this key population is needed.

TRIAL REGISTRATION: NCT04910438 submitted on 2020-01-22.