HPV and Anal Intraepithelial Neoplasia among Men who have Sex with Men at a Private Clinic in Chicago, IL

Background: Men who have sex with men (MSM) are at greatly increased risk of HPV-associated anal cancer, and HIV-positive MSM are at even greater risk. Anal Intraepithelial Neoplasia (AIN) is the potential precursor lesion of anal cancer, with AIN 3 indicating carcinoma in situ. This study examined AIN and STI in a private clinic setting among white MSM, a population underrepresented in the literature.  

Methods: From 2008 to 2011, health outcomes data was collected for 243 patients from patients receiving an anal Pap smear at a private clinic. This cross-sectional study examined those medical records for STI and HIV correlates of AIN, including HPV. Descriptive statistics and univariate analysis were conducted using Epi Info 7.   

Results: Among the sample population, 63% tested positive for high-risk HPV, 43% tested positive for AIN, 37% of patients indicated they were HIV-positive, 26% of patients had anal warts, and 9% tested positive for STIs. Among patients with AIN, a significant number were HPV-positive (p<0.001). Univariate analysis determined HPV was 2.5 times more likely present among MSM with AIN (OR=2.5, 95% CI: 1.43 to 4.33).

Discussion: Although the significant correlation between HPV and AIN has been established in the literature, it is interesting to note the correlation in a private clinic setting with primarily white MSM. Clinicians should be aware of the risk of HPV, AIN, and potential anal cancer even among a non-minority population with access to healthcare. Future studies should examine these correlations in other populations and in larger samples.