Work

Prevalence and behavioral factors associated with penile and rectal HPV infection among men who have sex with men in Kenya

Year: 2026

Type: article

Abstract: Background: High-risk human papillomavirus (hrHPV) is a leading cause of anogenital cancers and disproportionately affects men who have sex with men (MSM), particularly in low- and middle-income countries. Few studies in sub-Saharan Africa have concurrently examined penile and rectal hrHPV infection and their site-specific behavioral and biological correlates. We assessed the prevalence, genotype distribution, and factors associated with penile and rectal hrHPV among MSM in Kisumu, Kenya. Methods: using GeneXpert, and HIV status was confirmed as per Kenyan national guidelines. hrHPV was analyzed separately by anatomical site. Log-binomial regression was used to estimate adjusted prevalence ratios (aPR) for associations with sociodemographic, behavioral, and biological factors. Results: Penile hrHPV prevalence was 24.7% (39/158) and rectal hrHPV prevalence was 12.5% (22/176); 6.7% of participants tested at both sites had dual-site infection. Most infections at both sites involved a single genotype group. HPV-18/45 was the most common genotype group at both sites. Penile hrHPV was more likely among participants with HIV (aPR=2.27, p=0.050) and those reporting insertive anal sex (aPR=5.26, p=0.062), and was less common among employed participants (aPR=0.25, p=0.048). Circumcision showed a protective trend (aPR=0.52, p=0.090). Rectal hrHPV was more common among participants with rectal chlamydia and/or gonorrhea infection (aPR=3.34, p=0.001), transgender or non-binary identity (aPR=2.28, p=0.036), and receptive anal intercourse (aPR=3.97, p=0.062). Although HIV was associated with rectal hrHPV in unadjusted analyses, this relationship was attenuated after accounting for rectal bacterial STI infection. Conclusions: hrHPV infection was common among MSM in Kisumu, Kenya, with distinct site-specific correlates. The strong association between rectal bacterial STIs and rectal hrHPV highlights the need for integrated HPV and STI screening. These findings support expansion of gender-neutral HPV vaccination and etiologic STI screening to reduce HPV-associated cancer risk among MSM in sub-Saharan Africa.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-026-14046-3