Background: Men who have sex with men (MSM) are at risk for HIV acquisition, and may beneficiate of pre-exposure prophylaxis (PrEP). Descriptive, quantitative, cross-sectional survey was conducting in 2018 estimating the prevalence of anal and oral high risk Human papillomavirus (HR-HPV) infection and associated risk factors among young adult MSM taking PrEP in healthcare facilities in Orléans, France.
Methods: Anal and oral samples were collected from prospectively included MSM seeking PrEP at consultation services in a French hospital to be screened by multiplex real-time PCR (Anyplex? II HPV 28, Seegene, South Korea) for HPV DNA. Face-to-face standardized interview was used to collect socio-demographic and behavioral characteristics.
Results: A total of 61 MSM (mean age, 36.1 years) taking PrEP were enrolled. The anal HPV and HR-HPV prevalence were 93.4% (95% CI: 87.2-99.6) and 81.9% (95% CI: 72.3-91.6), respectively. Oral HPV and HR-HPV prevalence were 33.9% (95% CI: 21.5-46.3) and 19.6% (95% CI: 9.2-30.1), respectively. HR-HPV-33 targeted by prophylactic Gardasil-9® vaccine was the most detected genotype, both in anal and oral specimens. More than two-thirds (68.8%) of the study MSM carried at least one HPV genotype targeted by Gardasil-9® vaccine in their anal specimens; all oral HPV-positive specimens carried at least one HPV genotype covered by this vaccine. Condomless receptive anal intercourse and past history of anal gonorrhea were the main factors strongly associated with increased risk for anal HPV infection (aOR: 10.4, 95% CI: 1.2-90.5%) and multiple anal HR-HPV (aOR: 5.77, 95% CI: 1.7-19.3%), respectively. Conversely, having had < 10 different male partners in the last 12 months was associated with decreased risk for anal infection with both multiple HPV (aOR: 0.19, 95% CI: 0.05-0.83%) and HR-HPV (aOR: 0.17, 95% CI: 0.04-0.8%). No associated risk factor could be evidenced for carrying oral HPV.
Conclusions: French MSM using PrEP are at high risk for both anal and oral carriage of HR-HPV infections and therefore for HPV-related cancers. There is an urgent need to strengthen existing HIV and other sexually transmitted infections prevention strategies and interventions towards HIV-negative French MSM taking PrEP.