Penile human papilloma virus (HPV) in high risk populations with and without HIV: Epidemiological insights from Argentina

Abstract

Background: Human papillomavirus (HPV) is a common sexually transmitted infection, with higher prevalence among men who have sex with men (MSM) and people who self-identify as transgender women (PSTGW). High-risk genotypes (hrHPV) carry oncogenic potential. This study assessed hrHPV prevalence in penile samples from MSM and PSTGW in Buenos Aires, Argentina. Methods: A cross-sectional analysis of baseline data from a longitudinal study was conducted. Participants aged ≥18 were recruited from an HIV prevention center. Penile samples, collected via standardized sandpaper exfoliation, were analyzed using the AmpFire HPV Genotyping Assay for 15 genotypes. Logistic regression models identified factors associated with HPV. Results: Among 298 samples from 300 participants (256 MSM, 44 PSTGW), HIV prevalence was 27%. Penile hrHPV prevalence was 31%, with no significant difference between MSM and PSTGW (p = 0.465). Frequent genotypes included HPV-33, HPV-53 and HPV-16 (6.3%, 5.3%, and 4.6% respectively). People with HIV (PWH) showed higher hrHPV prevalence than HIV negative individuals (41% vs 27%, p = 0.023), more infections with ≥3 genotypes (15% vs 4%, p < 0.001), and higher nonavalent vaccine genotype detection (30% vs 15%, p = 0.005). Multivariate analysis associated hrHPV infection with being PWH (aOR = 1.99), >5 sexual partners in the past month (aOR = 1.77), and lifetime sex work (aOR = 2.68). Conclusions: Penile hrHPV was highly prevalent among MSM and PSTGW, particularly among PWH and those with a history of sex work. Low vaccination rate and high prevalence of vaccine-preventable genotypes underscore the need to expand HPV vaccination in these populations.