UC Irvine leads a bi-national team in a large cohort study to examine the impact of genital warts on HIV incidence among men who have sex with men (MSM) and transgender women (TGW) in Lima, Peru in a study titled “A prospective cohort study characterizing the role of anogenital warts in HIV acquisition among men who have sex with men: a study protocol”. The article was published in BMJ Open (http://bmjopen.bmj.com/content/4/9/e005687.abstract)

[Photo: Epicentro Salud study team meeting]

The HIV epidemic in Latin America is concentrated among MSM and TGW, with transmission predominantly occurring during unprotected anal intercourse. This mode of transmission is also responsible for other sexually transmitted infections (STIs) such as herpes simplex, chlamydia and gonorrhoea, human papillomavirus and syphilis. Still, studies assessing the prevalence of HIV and HPV among MSM have not addressed the role of genital warts and HPV-related diseases in the acquisition of HIV infection.

Community-based testing programs are a potentially important way to remove barriers including stigma for individuals to learn their STI status. Our prospective cohort study recruited 600 MSM/TGW at a gay men’s community health center in Lima, Peru named Epicentro Salud (http://epicentro.org.pe/). Half of participants have a history of anogenital warts (AGW), and the other half have no AGW history. All will be followed up for a two year period, with visits every six months and the main outcome measured being HIV status.

While several studies have noted a linkage between HPV infection and HIV, this is the first study that specifically examines the impact of genital warts on incident HIV infection. Furthermore, study results may facilitate the development of preventive intervention strategies to reduce the prevalence of AGW and thus prevent incident HIV infection, as HPV-related manifestations may be a good proxy for HIV risk. Study findings will be shared with the Peruvian Ministry of Health as well as other international and national public health organizations.

Manuscript authors include Brandon Brown from the GHREAT Initiative at the UC Irvine Program in Public Health, Ms. Mariam Davtyan from the UC Irvine Program in Public Health, Dr. Segundo Leon from the University of Cayetano Heredia School of Public Health in Peru, Dr. Jeffrey Klausner from UCLA Division of Infectious Diseases Department of Medicine, and research partners from Epicentro Salud in Lima, Peru including Mr. Hugo Sanchez, Mr. Gino Calvo, and Dr. Jerome Galea.