Abstract
BackgroundOropharyngeal cancers associated with oral human papillomavirus (oHPV) are becoming more common. Understanding factors associated with oHPV among African men, including those living in settings where broader contextual factors shape how HPV-associated cancers are prioritized, may help predict future cancer risk and inform screening interventions.MethodsFrom 2014 to 2018, a cross-sectional study of the prevalence of oHPV was conducted among men who have sex with men (MSM) in Abuja and Lagos, Nigeria. Participants completed HIV testing and behavioral questionnaires before providing oral gargle samples. Gargle samples were genotyped for oHPV and oral high-risk HPV (oHR-HPV16/18/31/33/35/39/45/51/52/56/58/59/68). Multivariable logistic regression estimated the adjusted odds ratio (aOR) and 95% confidence intervals (CIs).ResultsAmong 584 men, median age was 24 years (interquartile range: 22-28) and 69% were living with HIV. The prevalence of oHPV, oHR-HPV and HPV16 was 16.6% (95% CI: 13.7-19.9), 5.7% (95% CI: 3.9-7.8), and 1.2% (95% CI: 0.5-2.5), respectively. Living with HIV was positively associated with oHPV (aOR: 1.97, 95% CI: 1.14-3.41) and trended similarly for oHR-HPV (aOR: 2.30, 95% CI: 0.93-5.66). Oral HPV was associated with having insertive anal sex (aOR: 1.85, 95% CI: 1.06-3.24) as compared to both insertive and receptive. Oral HPV was associated with having sex with women over 5 years ago (aOR: 3.13, 95% CI: 1.28-7.67) but not in the past 5 years (aOR: 1.70, 95% CI: 0.91-3.18) as compared to no sex with women. Oral HR-HPV was independently associated with insertive anal sex (aOR: 2.59, 95% CI: 1.11-6.08).ConclusionsLiving with HIV was significantly associated with oHPV prevalence, though oHR-HPV prevalence was lower than expected. Longitudinal studies are needed to define risk pathways for oropharyngeal cancer, particularly in settings where social and structural contexts may affect access to appropriate care.