Risk Factors for Human Papillomavirus-Associated Cancers Among People Living with HIV in Washington, District of Columbia

AIDS Res Hum Retroviruses. 2023 Apr;39(4):195-203. doi: 10.1089/AID.2022.0128. Epub 2023 Feb 14.

Abstract

District of Columbia (DC) has high rates of HIV infection and human papillomavirus (HPV)-associated cancers. People living with HIV (PLWH) are at risk for developing HPV-associated cancers. Previous studies identified factors that may further increase the risk of HPV-associated cancer among PLWH such as age, race/ethnicity, sex, risk factor for HIV transmission, stage of HIV infection, and age at HIV diagnosis. The extent to which PLWH in DC are affected by HPV-associated cancers has not previously been well described, and to our knowledge, the relationship between bacterial sexually transmitted infections (STIs) and subsequent development of HPV-associated cancer among PLWH in DC has not been explored. This was a retrospective case-control analysis of surveillance data on cancer, STIs, and HIV in Washington, DC from 1996 to 2015. There were 20,744 PLWH included in this study, of whom 335 (1.6%) had been diagnosed with an HPV-associated cancer. Among males living with HIV (MLWH), for every additional STI per 10 person-years, risk of developing an HPV-associated cancer increased by 11%. Exposure to STIs was not a significant risk factor for HPV-associated cancer among females. Ever being diagnosed with stage three HIV infection increased risk of HPV-associated cancers among males by 109% and females living with HIV by 111%. STI exposures were associated with HPV-associated cancers among MLWH in DC and ever being diagnosed with advanced HIV infection was associated with HPV-associated cancers among all PLWH. Clinicians treating MLWH should ensure their patients receive primary HPV infection prevention and HPV-associated cancer screenings.

Keywords: HIV; HPV-associated cancer; sexually transmitted infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • District of Columbia / epidemiology
  • Female
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Human Papillomavirus Viruses
  • Humans
  • Male
  • Neoplasms* / complications
  • Papillomavirus Infections* / complications
  • Papillomavirus Infections* / epidemiology
  • Retrospective Studies
  • Risk Factors