960. Prevalence and Sexual Risk Factors Associated with Anal Human Papilloma Virus (HPV) Disease in an HIV Clinic Population
Session: Poster Abstract Session: Sexually Transmitted Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Background: There is limited research in rural areas regarding the prevalence and risk for HPV Anal disease in individuals infected with HIV; therefore, we determined the prevalence of HPV anal disease in this population and assessed potential associations with sexual practices.

Methods: A prospective convenience cohort sample using anal cytology via anal swab was used to determine prevalence of HPV anal disease in men and women attending a HIV clinic for care. Patients were invited to participate if they were older than 18 years of age and not currently pregnant. Detailed assessments of demographic information, sexual history, social history and medical history were obtained via survey.

Results: Sixty-five eligible men and women were enrolled. The mean age was 41 years (range 21 to 78 years).  Sixty-three percent were white, 25% black and 12% Hispanic.  Fifty-five percent of individuals reported sexual debut as 17 years or younger. Median reported lifetime sexual partners was 27.  Of the 13 women sampled, 54% participated in anal sex. A total of 31 subjects had anal disease of any kind (48%).  The most commonly observed abnormality was LSIL, noted in 15 subjects (23%). Fifteen patients had cytology samples deemed unsatisfactory (23%). Men (p=0.01) and those having anal sex (p=0.04) were more likely to have anal disease. Sex toy use, enema use prior to sex and lubricant use were not associated with anal disease.

Conclusion: In our population of HIV patients, we found that anal disease attributable to HPV was common. An alarming number of patients had unsatisfactory cytology sampling; a change from cotton to Dacron swabs improved sampling. A large percentage of patients declined to be sampled at time of visit; many cited preparation prior to testing. The overall prevalence of HPV anal disease in our clinic was quite large and would lead us to screen patients regularly.

Nicole Leedy, MD, Timothy Crawford, PhD and Alice Thornton, MD, University of Kentucky, Lexington, KY


N. Leedy, None

T. Crawford, None

A. Thornton, None

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