Anogenital HPV Infection, Seroprevalence, and Risk Factors for HPV Seropositivity Among Sexually Active Men Enrolled in a Global HPV Vaccine Trial.

BACKGROUND In men, human papillomavirus (HPV)-related cancer incidence is rising, but data regarding male HPV infection and seroprevalence are available from only a few countries. METHODS This analysis of a global HPV vaccine trial evaluated baseline data from 1399 HIV-negative heterosexual men (HM) and men who have sex with men (MSM). Key objectives included assessment of HPV prevalence and risk factors for seropositivity to 9-valent HPV (9vHPV) vaccine types (6/11/16/18/31/33/45/52/58), and concordance between seropositivity and prevalent HPV type. RESULTS Overall, 455/3463 (13.1%) of HM and 228/602 (37.9%) of MSM were HPV DNA-positive for any 9vHPV vaccine type at baseline. Infection prevalence/seroprevalence (≥1 9vHPV vaccine types) was 13.2%/8.1% among 333 HM from Europe, and 37.9%/29.9% among 335 MSM from Europe/North America. Among men with baseline infection, MSM had higher seroprevalence for concordant HPV types (39.5% vs 10.8% in HM). Seropositivity risk (irrespective of baseline infection status) was higher among MSM vs HM (age-adjusted odds ratio=3.0, 95%CI=2.4-6.4). Among MSM, statistically significant seropositivity risk factors included younger age at sexual debut, higher number of receptive anal sex partners, and less frequent condom use. No factors assessed were associated with seropositivity in HM. CONCLUSIONS Higher proportions of MSM than HM were HPV DNA-positive and seropositive and concordance between HPV DNA positivity and seropositivity, a potential marker of true infection versus carriage, was higher in MSM. Most MSM and HM were seronegative for all 9vHPV vaccine types, suggesting the potential benefit of catch-up vaccination after sexual debut.