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Prevalence and risk factors of anogenital human papillomavirus infection in a community sample of men who have sex with men in Taiwan: baseline findings from a cohort study
  1. Carol Strong1,
  2. Huachun Zou2,3,4,
  3. Nai-Ying Ko1,5,6,
  4. Ya-Lun Liang1,
  5. Wen-Wei Ku7,
  6. Chia-Wen Lee8
  1. 1 Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan, Australia, Taiwan
  2. 2 School of Public Health, Sun Yat-sen University, Shenzhen, Australia, China
  3. 3 School of Public Health, Sun Yat-sen University, Guangzhou, Australia, China
  4. 4 Kirby Institute, University of New South Wales, Sydney, Australia, Australia
  5. 5 Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Australia, Taiwan
  6. 6 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Australia, Taiwan
  7. 7 Division of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Australia, Taiwan
  8. 8 Fengshan Lee Chia Wen Urologic Clinic, Kaohsiung, Australia, Taiwan
  1. Correspondence to Dr Carol Strong, Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan 70101, Taiwan; carol.chiajung{at}


Objectives Men who have sex with men (MSM) are a highly neglected population in the current recommendation of girls-only human papillomavirus (HPV) vaccination programmes in many countries. To better assess the cost effectiveness of HPV vaccination among men requires data on the prevalence of HPV infection in MSM using a community sample, which is still sparse in several regions. We examined the prevalence of and factors associated with anogenital HPV infection among MSM in Taiwan.

Methods MSM 20 years of age and older were recruited from the community and social media in Taiwan in 2015–2016 and screened for HPV infection to detect 37 genotypes. MSM were seen at baseline and were/will be seen at 6, 12, 24 and 36 months. Men completed a questionnaire regarding their sexual experiences. Multivariable regression analyses were conducted to identify associated behavioural risk factors using the baseline data.

Results A total of 253 MSM were recruited; 87 % were below 35 years of age. Diagnosis of HIV was reported in 4% of men; just over 20% had three or more anal sex partners in the past year. The prevalence of any tested HPV type was 29.4% at the anal site and 11% at the penile site. One quarter of MSM were infected with any of the 9-valent vaccine HPV types. Anal HPV detection was associated with having three or more receptive anal sex partners in the past year (adjusted odds ratio (aOR)=2.92, 95% CI 1.29 to 6.61) and having older sex partners (aOR=2.51, 95% CI 1.07 to 5.90).

Conclusions Our data provide the base to calculate the reproductive rate for HPV transmission in a low-risk community sample and cost-effectiveness to include men in HPV vaccination policies. Adding evidence from a community sample adds comprehensiveness for future estimates of disease transmission and vaccine effectiveness.

  • papillomavirus infections
  • risk factors
  • prevalence
  • homosexuality
  • male
  • sexual behavior
  • sexual and gender minorities

Statistics from


  • Handling editor Jackie A Cassell

  • CS and HZ contributed equally.

  • Presented at Part of the results was presented at the 31st International Papillomavirus Conference, Cape Town, South Africa (abstract number: HPV17-0463).

  • Contributors CS: study concept, data cleaning, design, analysis, writing and revisions. HZ, N-YK: study concept, design, analysis and manuscript review. Y-LL: data cleaning, analysis and manuscript review. W-WK, C-WL: study concept and manuscript review.

  • Funding This research was supported by the Taiwan Ministry of Science and Technology (MOST 105-2628-B-006-012-MY3 and MOST 104-2314-B-006-037).

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

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