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Anal human papillomavirus HPV testing was performed at the baseline and three annual follow-up visits. Results Between and , men were recruited and 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 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. You will be able to get a quick price and instant permission to reuse the content in many different ways. High-risk human papillomavirus HRHPV infection-related cancers, including squamous cell carcinomas of the cervix and anus, accounted for approximately 4.

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Several distinct populations experience anal cancer at markedly higher rates than the general population. These groups include people with high exposure to anal human papillomavirus HPV infection, such as gay and bisexual men GBM , 4 and individuals with immunodeficiency, including people living with HIV and solid organ transplant recipients. The role of other non-intercourse receptive anal sexual practices, such as rimming, fingering, fisting and receptive use of toys, in anal HRHPV transmission is less clear.

Signed informed consent was obtained from all participants. Detailed information on recent sexual exposures in the last 6 months was collected at each study visit through a computer-assisted self-interview. The questions also covered a range of non-intercourse receptive anal practices, including digital anal penetration fingering , receiving a hand into the anal canal fisting , receptive analingus rimming , receptive use of toys and insertion of recreational drugs into the anal canal shelving.

Participants who tested negative to any of the 13 HRHPV types at baseline and had at least one follow-up visit with a valid HPV test were included in the longitudinal analyses. For each type of HRHPV, person-years PY were calculated as the time from study entry to the date of the first positive test, or the last study visit for the participants who remained negative.

Risk factors for type-specific incident anal HRHPV were identified with univariable and multivariable Cox regression models using the Wei-Lin-Weissfeld method, 12 which allows incident anal HPV of multiple types at the same study visit to be included in the analysis. Demographic and HIV characteristics, all surveyed sexual practices and partner numbers in the prior 6 months were analysed for associations with incident HRHPV.

Data on missing report of sexual behaviour were treated as missing data, while those with an invalid HPV test result were excluded from the analysis. P values for trend were reported for ordinal variables, such as age group, the number of sex partners and frequencies of specific sexual behaviours. Multivariable Cox regression models using backward stepwise elimination were developed to determine risk factors independently associated with incident HRHPV.

All variables with a p value of less than 0. Age and HIV status were included a priori in the multivariable analyses. Non-intercourse receptive anal practices fingering, rimming, fisting and use of toys were stratified by RAI to assess whether associations between incident HRHPV and non-intercourse receptive anal practices were independent of RAI.

Non-intercourse receptive practices found to be significant on univariable analysis underwent stratified analysis individually and as a combined variable. Between and , men were recruited, and who had valid HPV results at baseline and at least one follow-up visit were included in the analysis. The median age at enrolment was 49 years IQR: 43— The majority identified as gay, homosexual , Among HIV-positive participants, the majority were receiving antiretroviral therapy A total of men developed incident HRHPV infection; men developed one incident infection; 86 had two incident infections; 37 had three incident infections; 12 had four incident infections; 5 had five incident infections; 2 had six infections; and 1 participant had eight incident infections throughout the study period.

The type-specific incidence ranged from 1.

After adjusting for these variables, no non-intercourse receptive anal practices remained independently associated with incident anal HRHPV.