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Elmes J, Slhol R, Hess KL, et al. Receptive anal sex contributes substantially to heterosexually-acquired HIV infections among at-risk women in twenty US cities: results from a modelling analysis. Am J Reprod Immunol. 2020 Aug;84(2):e13263. doi:10.1111/aji.13263
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Results. In total, 6.2% were GC/CT positive (5.3% rectal, 1.7% urethral). We calculated adjusted (for education, race, age, relationship status, having health insurance, and income) odds ratios for factors associated with rectal and urethral GC/CT diagnoses. Age was inversely associated with urethral and rectal GC/CT. Compared to White men, Latinos had significantly greater odds of rectal GC/CT. Among men who reported anal sex, those reporting only insertive sex had lower odds of rectal GC/CT than men who reported both insertive and receptive. There was a positive association between rectal GC/CT and number of male partners (months), the number of anal receptive acts, receptive condomless anal sex (CAS) acts, and insertive CAS acts. Compared to those who had engaged in both insertive and receptive anal sex, those who engaged in only receptive anal sex had lower odds of urethral GC/CT. The number of male partners (months) was associated with increased odds of urethral GC/CT.
Younger age and shorter duration of viral suppression are risk factors for the development of high-grade pre-cancerous anal lesions in HIV-positive men who have sex with men (MSM), investigators from the Netherlands report in AIDS.
They designed the study to identify demographic and HIV-related risk factors associated with the development of pre-cancerous anal lesions to target men who would benefit from high-resolution anoscopy (HRA). However, the prevalence of such lesions was so high that they recommend that all MSM living with HIV should undergo HRA.
HIV-positive MSM have an increased risk of developing anal cancer. Many treatment centres have established clinics to detect pre-cancerous lesions. An HRA-guided biopsy is considered the gold standard for the diagnosis of these lesions. However, HRA is uncomfortable and costly. It would, therefore, be beneficial to identify the risk factors for pre-cancerous anal lesions so that HRA screening can be appropriately targeted.
Investigators at three clinics in Amsterdam, therefore, designed a study involving 1678 HIV-positive MSM who underwent HRA between 2008 and 2015 (HRA screening was offered to all HIV-positive MSM attedning these clinics). The researchers conducted a series of analyses to see if specific demographic and HIV-related factors were associated with an increased risk of lesions, including HSIL.
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