Heterogeneity in the Prevalence of High-Risk Human Papillomavirus Infection in Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Men Who Have Sex With Men in West Africa
Authors: Yaya Issifou , Boyer Véronique , Ehlan Phyllis Amivi , Coulibaly Alou , Agboyibor Mawuényégan Kouamivi , Traoré Issa , Kouamé Malan Jean-Baptiste , Maiga Alassane Kader , Kotchi Ochoh Rachelle , Nyasenu Yawo Tufa , Maradan Gwenaëlle , Rojas-Castro Daniela , Diallo Fodié , Anoma Camille , Dah Ter Tiero Elias , Mensah Ephrem , Dembélé Keita Bintou , Spire Bruno , Dagnra Claver Anoumou , Laurent Christian ,   CohMSM Study Group, Laurent Christian , Yaya Issifou , Ouedraogo Sayouba , Granouillac Bruno , Le Guicher Gwenvael , Serrano Laetitia , Peeters Martine , Couderc Clotilde , Spire Bruno , Sagaon-Teyssier Luis , Mora Marion , Maradan Gwenaëlle , Bourrelly Michel , Mimi Mohamed , Berenger Cyril , Boyer Sylvie , Castro Daniela Rojas , Riegel Lucas , Palvadeau Paméla , Keita Bintou Dembélé , Diallo Fodié , Coulibaly Alou , Maïga Alassane Kader , Camara Drissa , Diarra Mahamadou , Ouologuem Aly , Sangaré Naboh , Keita Abdoul Aziz , Cissé Oumar , Traoré Fodé , Ouary Bréhima Abdrahamane , Kanta Ibrahima , Anoma Camille , Kouamé Malan Jean-Baptiste , Kotchi Ochoh Rachelle , Aka Niamkey Thomas , Lokrou Kpassou Julien , Coulibaly Noufo Hamed , Koffi Jean Armel Ekessi , N’guessan Frédéric Dibi , Yoro Stéphane-Alain Babo , Cissé Adama , Dah Ter Tiero Elias , Traoré Issa , Rajaonarivelo Camille , Ouedraogo Fayçal Rodrique , Ouedraogo Joseph , Coulibaly Christian , Ouedraogo Mamadou , Ilboudo Ousseni , Traoré Abdoulazziz , Comsiambo Honoré , Mensah Ephrem , Agboyibor Richard Mawuényégan Kouamivi , Attisso Anani , Kokouba Anouwarsadat , Badjassim Aléda Mawuli , Agbomadji Kouakou Kokouvi Selom , Attiogbe Messan , Yaka Kossi Jeff , Ekon Agbégnigan Lorette , Bimba Julien , Dagnra Claver Anoumou Yaotsè , Ehlan Phyllis Amivi , Nyasenu Xavier Yawo Tufa , Tegueni Kokou Dominique 
Published: February 2021

Abstract

Background
Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d’Ivoire, Mali, and Togo.

Methods
A cross-sectional study was conducted in 2017–2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions.

Results
Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48–5.27) and study country (4.73, 2.66–8.43 for Mali; 3.12, 1.68–5.80 for Burkina Faso; 3.51, 1.92–6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively.

Conclusions
HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa.