Sexual Positioning Practices and Anal Human Papillomavirus Infection among Young Men Who Have Sex with Men and Transgender Women - Chicago, Illinois, 2016-2018

Ethan Morgan, Elissa Meites, Lauri E. Markowitz, Casey D. Xavier Hall, Troy D. Querec, Elizabeth R. Unger, Richard A. Crosby, Michael E. Newcomb, Brian Mustanski

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; men who have sex with men (MSM) have higher prevalence of infection and related disease compared with other men. We assessed whether differences in HPV acquisition exist among MSM according to their sexual positioning practices, as well as self-reported receipt of HPV vaccination. Methods We enrolled young MSM and transgender women aged 18 to 26 years in Chicago, IL (N = 666). Participants self-reported their history of HPV vaccination and submitted self-collected anal swab specimens for type-specific HPV detection using an L1-consensus PCR assay. Multivariable logistic regression analyses were used to assess relationships between sexual positioning practices and detection of any HPV or quadrivalent HPV vaccine (4vHPV) types by vaccination status, defined as self-reported receipt of ≥1 HPV vaccine dose versus none. Results Among 666 participants, 400 (60.1%) had any anal HPV, and 146 (21.9%) had a 4vHPV type. Among vaccinated participants, 18, 36, and 177 reported exclusively insertive, exclusively receptive, or both sexual positioning practices, respectively. Compared with participants reporting exclusively insertive anal sex, odds of any HPV were significantly higher among participants engaging exclusively in receptive anal sex (adjusted odds ratio [aOR], 5.90; 95% confidence interval [CI], 2.52-13.78), as well as those engaging in both (aOR, 3.32; 95% CI, 1.71-6.44). Vaccinated participants, compared with unvaccinated participants, had lower odds of 4vHPV-type HPV regardless of sexual positioning practices (aOR, 0.56; 95% CI, 0.34-0.92). Conclusions Adult men and transgender women who practice anal receptive sex have high prevalence of infection with any HPV. Routine vaccination of all adolescents is expected to reduce HPV-related disease incidence among adult MSM and transgender women as vaccinated cohorts age.

Original languageEnglish
Pages (from-to)709-713
Number of pages5
JournalSexually Transmitted Diseases
Issue number10
StatePublished - Oct 1 2021

Bibliographical note

Funding Information:
Sources of Funding: The VIM study was funded by the Centers for Disease Control and Prevention (U48DP005014). The RADAR study was supported by a grant from the National Institute on Drug Abuse at the National Institutes of Health (F32DA046313, PI: Morgan; U01DA036939, PI: Mustanski).

Publisher Copyright:
© Lippincott Williams & Wilkins.

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases


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