Abstract
BACKGROUND: Sexually transmitted infections (STI) are a prominent health issue in Africa, especially in key populations such as men who have sex with men (MSM). Here, we present the baseline results of a 2-year longitudinal cohort in Togo. METHODS: A total of 200 MSM in Lomé, Togo, were included in the ANRS I MIE 12400/DepIST-H cohort, half living with HIV. High-risk HPV (hrHPV) detection was performed on anal smears. Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) were tested from urine, pharyngeal and anal swabs. RESULTS: Overall, median age was 23 years, hrHPV prevalence was 75.9%, and was significantly higher in HIV-positive MSM (p = 0.008). The most common hrHPV types were HPV16 and HPV35 (18.7% each). Overall, 55.4% of participants had abnormal anal cytology, the most frequent lesions being low-grade squamous intraepithelial lesions, (22.3% of HIV-positive and 15.2% of HIV-negative MSM). The overall prevalence of GC and CT infections was 32.5% and 32.0%, respectively. Clinical anal lesions, mostly condyloma, were detected in 46.0% of participants (n = 86). CONCLUSIONS: These findings emphasize the high prevalence of STIs among MSM and confirm the unusual distribution of HPV types in West Africa, with HPV35 being highly prevalent. A national strategy regarding STI screening and HPV vaccination in this key population is needed. TRIAL REGISTRATION: NCT04910438 submitted on 2020-01-22.