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Original research
Social networks, high-risk anal HPV and coinfection with HIV in young sexual minority men
  1. Kayo Fujimoto1,
  2. Alan G Nyitray2,
  3. Jacky Kuo1,
  4. Jing Zhao3,
  5. Lu-Yu Hwang1,
  6. Elizabeth Chiao4,
  7. Anna R Giuliano5,
  8. John A Schneider6,
  9. Aditya Khanna7
  1. 1 School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  2. 2 Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  3. 3 Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
  4. 4 Department of Epidemiology, MD Anderson Cancer Center, Houston, Texas, USA
  5. 5 Center for Immunization and Infection Research in Cancer (CIIRC), Moffitt Cancer Center, Tampa, Florida, USA
  6. 6 Department of Medicine and Health Studies, University of Chicago, Chicago, Illinois, USA
  7. 7 Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island, USA
  1. Correspondence to Professor Kayo Fujimoto, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA; kayo.fujimoto{at}uth.tmc.edu

Abstract

Objectives Young sexual minority men (SMM) exhibit a high prevalence and incidence of high-risk genotypes of human papillomavirus (hrHPV) anal infections and a confluence of a high prevalence of HIV and rectal STIs. Social determinants of health (SDOHs) are linked to social network contexts that generate and maintain racial disparities in HIV and STIs. A network perspective was provided to advance our knowledge of drivers of genotype-specific hrHPV infection and coinfection with HIV. The study also examined whether socially connected men are infected with the same high-risk HPV genotypes and, if so, whether this tendency is conditioned on coinfection with HIV.

Methods Our sample included 136 young SMM of predominantly black race and their network members of other races and ethnicities, aged 18–29 years, who resided in Houston, Texas, USA. These participants were recruited during 2014–2016 at the baseline recruitment period by network-based peer referral, where anal exfoliated cells and named social and sexual partners were collected. Exponential random graph models were estimated to assess similarity in genotype-specific hrHPV anal infection in social connections and coinfection with HIV in consideration of the effects of similarity in sociodemographic, sexual behavioural characteristics, SDOHs and syphilis infection.

Results Pairs of men socially connected to each other tend to be infected with the same hrHPV genotypes of HPV-16, HPV-45 and HPV-51 or HPV-16 and/or HPV-18. The tendency of social connections between pairs of men who were infected with either HPV-16 or HPV-18 were conditioned on HIV infection.

Conclusions Networked patterns of hrHPV infection could be amenable to network-based HPV prevention interventions that engage young SMM of predominantly racial minority groups who are out of HIV care and vulnerable to high-risk HPV acquisition.

  • molecular HPV epidemiology
  • HIV
  • young men who have sex with men
  • social determinants of health
  • racial disparity
  • syphilis

Data availability statement

Data are available on reasonable request. Data can be obtained by the corresponding author on reasonable request, after the approval of UTHealth Committee for the Protection of Human Subjects.

https://doi.org/10.1136/sextrans-2021-055283

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    Data availability statement

    Data are available on reasonable request. Data can be obtained by the corresponding author on reasonable request, after the approval of UTHealth Committee for the Protection of Human Subjects.

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    Footnotes

    • Handling editor Eric P F Chow

    • KF and AK contributed equally.

    • Contributors KF initiated the project, framed the paper, designed the social network models and co-led the writing of the article with AK. AK specified the initial social network models and analysed the data, reported the preliminary results and co-led the writing of the paper. AGN and JAS designed data collection, framed the paper, interpreted the results and contributed to the implications of the results. JK specified, conducted and revised the social network models and reported the finalised results. ARG conducted HPV sequencing, genotyping and interpreted the results. EYC interpreted the results and contributed to the implications and discussion. L-YH and JZ collected, processed and managed the specimens and data. All authors substantially contributed to the study, engaged in the writing and approved the final version. The corresponding author accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding This work was supported by the National Institute of Mental Health of the National Institutes of Health (Grant No. 1R01MH100021); the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (Grant No. R21AI139480); The Brown University Center for Addiction and Disease Risk Exacerbation (P20 GM130414); the Providence/Boston Centre for AIDS Research (Grant No. P30AI042853); a Research Training Award for Cancer Prevention Post-Graduate Training Programme in Integrative Epidemiology from the Cancer Prevention & Research Institute of Texas (Grant No. RP160097); Sally W Vernon, PhD, Distinguished Professorship in Social Determinants of Health. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health and the above funding institutions.

    • Disclaimer The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Cancer Prevention & Research Institute of Texas.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.