Incidence of HIV among Indian men who have sex with men

描述(由申请人提供)：最近的几篇文章表明，人类乳头瘤病毒(HPV)和/或HPV相关疾病可能在获得艾滋病毒感染方面发挥作用，类似于其他性传播感染(STI)。这一点至关重要，因为HPV感染可能是印度男男性行为者(MSM)中最常见的性传播感染，MSM也是一个感染艾滋病毒风险非常高的群体。如果HPV的作用得到确认，HPV疫苗接种可能有助于艾滋病毒预防工作，因为现在已经有有效的HPV疫苗可用。我们正在完成的一项研究的初步数据显示，印度HIV血清阳性的MSM有非常高的生殖道HPV感染流行率，但对印度HIV血清阴性的MSM中HPV或HPV相关疾病的流行或发病率一无所知。此外，艾滋病毒感染的发病率在这一组中还没有确定。我们的目标是获得所需的关键数据，以设计一项关于HPV感染在HIV感染中的作用的明确的前瞻性研究。我们的具体目标是：1)确定印度高危男男性接触者中艾滋病毒的一年发病率；2)测试采用受访者驱动抽样(RDS)招募300名高危HIV血清阴性男男性接触者样本的可行性和可接受性；3)产生关于HPV感染和HPV相关疾病、HPV以外的性传播疾病、性危险行为和其他潜在混杂因素的流行和发病率的初步描述性数据。男性将每隔6个月进行一年多的跟踪调查，总共进行3次访问。在每次访问中，每个站点的150名男男性接触者将接受一份问卷调查。HPV DNA样本将从肛门、阴茎和口腔中收集。将采集血液进行艾滋病毒检测。将进行肛门细胞学和高分辨率肛门镜检查，并对可见的肛门病变进行活检。阴茎和口腔检查以及活组织检查也将进行。HPV DNA检测将在CMC Vellore进行。培训和质量保证将在加州大学旧金山分校进行。我们的结果对印度的男性和女性都很重要，因为许多印度男男性同性恋者都有女性的性伴侣，并可能成为女性的桥梁人口。这些数据将对印度MSM的癌症预防工作非常重要，因为HPV相关癌症可能是可以预防的。有关HPV的数据将有助于开发最佳的下一代疫苗。这项研究建立在加州大学旧金山分校、CMC Vellore、HumSafar Trust和艾滋病恶性联盟之间日益增长的合作基础上。它将导致印度的能力建设和对HPV相关疾病的更多研究。

DESCRIPTION (provided by applicant): Several recent publications indicate that human papillomavirus (HPV) and/or HPV-related disease may play a role in acquisition of HIV infection, similar to other sexually transmitted infections (STIs). This is critically important because HPV infection may be the most common STI among Indian men who have sex with men (MSM), a group also at very high risk of HIV. If a role for HPV is confirmed, HPV vaccination may contribute to HIV prevention efforts, since effective HPV vaccines are now available. Preliminary data from a study we are now completing show that Indian HIV-seropositive MSM have a very high prevalence of anogenital HPV infection but nothing is known of the prevalence or incidence of HPV or HPV-related disease in Indian HIV- seronegative MSM. Moreover, the incidence of HIV infection is not established in this group. Our goal is to obtain critical data needed to design a definitive prospective study on the role of HPV infection in HIV acquisition. Our specific aims are: 1) To determine the one-year incidence of HIV among high-risk MSM in India; 2) To test the feasibility and acceptability of recruiting a sample of 300 high-risk HIV-seronegative MSM using respondent-driven sampling (RDS) and 3) To produce preliminary descriptive data on the prevalence and incidence of HPV infection and HPV-associated disease, STIs other than HPV, sexual risk behaviors and data on other potential confounders. Men will be followed over one year at 6-month intervals for a total of 3 visits. At each visit 150 MSM at each site will be administered a questionnaire. HPV DNA samples will be collected from the anus, penis and mouth. Blood will be obtained for HIV testing. Anal cytology and high resolution anoscopy will be performed with biopsy of visible anal lesions. Penile and oral exams and biopsies will also be performed. HPV DNA testing will be performed at CMC Vellore. Training and quality assurance will be performed at the UCSF. Our results will be important for both men and women in India, since many Indian MSM have female sexual partners, and may serve as a bridge population to women. The data will be important for cancer prevention efforts in Indian MSM since HPV-related cancers may be preventable. Data on HPV will be useful for development of optimal next-generation vaccines. This study builds upon a growing collaboration between UCSF, CMC Vellore, Humsafar Trust and the AIDS Malignancy Consortium. It will lead to capacity-building and additional studies of HPV-associated diseases in India.