Incidence and clearance of penile high-risk HPV infection and their determinants among HIV-negative men who have sex with men

BACKGROUND: Men who have sex with men (MSM) are at increased risk of anogenital HPV infections. We aimed to assess the incidence and clearance of penile high-risk HPV (hrHPV) infections and their determinants among HIV-negative MSM living in the Netherlands. METHODS: Between 2010 and 2015, HIV-negative MSM were semi-annually tested for penile HPV and completed detailed questionnaires on health and sexual behaviour. Self-collected penile swabs were tested for HPV DNA using SPF10-PCR DEIA/LiPA25 system. Type-specific hrHPV incidence (IR) and clearance rates (CR) were calculated for 12 hrHPV types (HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58 and -59). Determinants of incidence and clearance of HPV-16 and HPV-18, separately, and combined 7 hrHPV types covered by the nonavalent vaccine were assessed by Poisson regression, using generalized estimating equations for combined hrHPV types. RESULTS: We included 638 HIV-negative MSM, with a median age of 38 (interquartile range 33-43) years. HPV-16 had an IR of 4.9/1000 person-months of observation at risk (PMO) (95%-confidence interval (95%-CI) 3.8-6.3) and CR of 90.6/1000 PMO (95%-CI 60.7-135.1). The IR and CR of HPV-18 were 3.4/1000 PMO (95%-CI 2.5-4.5) and 119.2/1000 PMO (95%-CI 76.9-184.8), respectively. Age and condom use during insertive anal sex were not associated with hrHPV incidence, whereas, high number of recent sex partners was. CONCLUSIONS: The relatively high incidence and low clearance rate of penile HPV-16 and also HPV-18 among HIV-negative MSM correlates with their high prevalence and oncogenic potential. Incident HPV-infections were associated with recent sexual risk behavior