RT Journal Article SR Electronic T1 Sexual behaviours associated with incident high-risk anal human papillomavirus among gay and bisexual men JF Sexually Transmitted Infections JO Sex Transm Infect FD BMJ Publishing Group Ltd SP 101 OP 107 DO 10.1136/sextrans-2020-054851 VO 98 IS 2 A1 Ian K J Wong A1 Isobel Mary Poynten A1 Alyssa Cornall A1 David J Templeton A1 Monica Molano A1 Suzanne M Garland A1 Christopher K Fairley A1 Carmella Law A1 Richard J Hillman A1 Mark N Polizzotto A1 Andrew E Grulich A1 Fengyi Jin A1 , YR 2022 UL http://sti.bmj.com/content/98/2/101.abstract AB Objective High-risk human papillomavirus (HRHPV) causes anal cancer, which disproportionately affects gay and bisexual men (GBM). We examined sexual behaviours associated with incident anal HRHPV in an observational cohort study of GBM in Sydney, Australia.Methods GBM aged 35 years and above were enrolled in the Study of the Prevention of Anal Cancer. Detailed information on sexual practices in the last 6 months, including receptive anal intercourse (RAI) and non-intercourse receptive anal practices, was collected. Anal human papillomavirus (HPV) testing was performed at the baseline and three annual follow-up visits. Risk factors for incident HRHPV were determined by Cox regression using the Wei-Lin-Weissfeld method.Results Between 2010 and 2015, 617 men were recruited and 525 who had valid HPV results at baseline and at least one follow-up visit were included in the analysis. The median age was 49 years (IQR 43–56) and 188 (35.8%) were HIV-positive. On univariable analysis, incident anal HRHPV was associated with being HIV-positive (p<0.001), having a higher number of recent RAI partners regardless of condom use (p<0.001 for both), preference for the receptive position during anal intercourse (p=0.014) and other non-intercourse receptive anal sexual practices, including rimming, fingering and receptive use of sex toys (p<0.05 for all). In multivariable analyses, being HIV-positive (HR 1.46, 95% CI 1.09 to 1.85, p=0.009) and reporting condom-protected RAI with a higher number of sexual partners (p<0.001) remained significantly associated with incident HRHPV. When stratified by recent RAI, non-intercourse receptive anal practices were not associated with incident HRHPV in men who reported no recent RAI.Conclusion GBM living with HIV and those who reported RAI were at increased of incident anal HRHPV. Given the substantial risk of anal cancer and the difficulty in mitigating the risk of acquiring anal HRHPV, HPV vaccination should be considered among sexually active older GBM.Trial registration number ANZCTR365383.Data are available upon reasonable request. Sharing of study data for research collaboration will be reviewed on a case-by-case basis by the study chief investigators. Requests can be made to the project leader, IMP, who is a coauthor in the submission.