Incidence, persistence, and factors associated with HPV infection among male adolescents with and without perinatally acquired HIV infection.

BACKGROUND Infection with high-risk human papillomavirus (HR-HPV) has been shown to be more prevalent and persistent in female adolescents with HIV. However, data among male adolescents with perinatally acquired HIV (PHIV) are limited. SETTING We investigated the incidence and persistence of HR-HPV in anogenital compartments and associated factors among PHIV in comparison to HIV-uninfected (HU) male adolescents in Thailand. METHODS PHIV and HU males aged 12-24 years were enrolled. At baseline and three subsequent annual visits, specimens from the scrotum, penis, and anal area were obtained for HPV and other testing. RESULTS From June 2013 to October 2017, 49 PHIV and 47 HU male adolescents with a median age of 18 (interquartile range [IQR] 17-20) years were enrolled. PHIV had higher incidence of any HR-HPV infection than HU adolescents (33.05 [95%CI, 20.82-52.46] vs. 15.73 [95%CI, 8.18-30.22] per 100 person-years, p=0.04). The persistence of any HR-HPV genotypes (detected at >2 annual visits) was not different by group (PHIV 27% vs. HU 23%, p=0.75). Having ≥3 sex partners in past 6 months (adjusted prevalence ratio [aPR] 2.39, 95%CI 1.14- 5.05; p=0.02) and co-infection with other sexually transmitted infections (STIs; syphilis, chlamydia, and/or gonorrhea) were associated with persistent HR-HPV infection (aPR 6.21, 95%CI 2.87-13.41; p <0.001). CONCLUSIONS Thai PHIV male adolescents had a higher incidence of HR-HPV infection than those without HIV. Having multiple sex partners and co-infection with STIs were associated with persistent HR-HPV infection. These data demonstrate the need to prioritize PHIV male adolescents in routine and catch-up HPV vaccination programs.