Incidence and clearance of penile high-risk HPV infection and their determinants among HIV-negative men who have sex with men.

Background Men who have sex with men (MSM) are at increased risk of anogenital HPV infections. We aimed to assess the incidence and clearance of penile high-risk HPV (hrHPV) infections and their determinants among HIV-negative MSM living in the Netherlands. Methods Between 2010 and 2015, HIV-negative MSM were semi-annually tested for penile HPV and completed detailed questionnaires on health and sexual behaviour. Self-collected penile swabs were tested for HPV DNA using SPF10-PCR DEIA/LiPA25 system. Type-specific hrHPV incidence (IR) and clearance rates (CR) were calculated for 12 hrHPV types (HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58 and -59). Determinants of incidence and clearance of HPV-16 and HPV-18, separately, and combined 7 hrHPV types covered by the nonavalent vaccine were assessed by Poisson regression, using generalized estimating equations for combined hrHPV types. Results We included 638 HIV-negative MSM, with a median age of 38 (interquartile range 33-43) years. HPV-16 had an IR of 4.9/1000 person-months of observation at risk (PMO) (95%-confidence interval (95%-CI) 3.8-6.3) and CR of 90.6/1000 PMO (95%-CI 60.7-135.1). The IR and CR of HPV-18 were 3.4/1000 PMO (95%-CI 2.5-4.5) and 119.2/1000 PMO (95%-CI 76.9-184.8), respectively. Age and condom use during insertive anal sex were not associated with hrHPV incidence, whereas, high number of recent sex partners was. Conclusions The relatively high incidence and low clearance rate of penile HPV-16 and also HPV-18 among HIV-negative MSM correlates with their high prevalence and oncogenic potential. Incident HPV-infections were associated with recent sexual risk behavior.