Abstract
BACKGROUND: The global prevalence of and risk factors associated with same-type HPV infection across multiple anogenital sites among men has not been quantified. METHODS: Men aged 16-27 years participating in a multi-country 4-valent HPV vaccine trial (NCT00090285) were assessed at baseline for prevalent HPV infection at penile/scrotal and perineal/perianal sites (heterosexual men [HM] and men who have sex with men [MSM]) and additionally at intra-anal sites (MSM). Concordant infection with 9-valent HPV (9vHPV) vaccine types (6/11/16/18/31/33/45/52/58) was defined as same-type 9vHPV infection at 2 or 3 sites. RESULTS: 3363 HM and 595 MSM were included. Prevalence of concordant 9vHPV infection at 2 anogenital sites was 3.7% among HM and 9.1% among MSM, and 8.2% at 3 sites (including the intra-anal site) among MSM. HPV6 and HPV16 were most likely to occur at multiple anogenital sites in HM and MSM, with strong agreement observed between perineal/perianal and anal sites among MSM for HPV6 (Cohen's kappa, 0.78; 95% CI, .69-.87) and HPV16 (0.61; 95% CI, .50-.73). CONCLUSIONS: Concordant anogenital 9vHPV infection was more common among MSM than HM, which is consistent with evidence that MSM are at increased risk of HPV-related cancer across multiple anogenital sites. Clinical Trial Registration: ClinicalTrials.gov, NCT00090285.