HPV and Genital Warts among Peruvian Men Who Have Sex with Men and Transgender People: Knowledge, Attitudes and Treatment Experiences

Abstract

BackgroundSeveral studies have assessed the epidemiology of HPV infection among MSM, but no qualitative studies have specifically assessed how HPV and genital warts (GW) affect South American men who have sex with men (MSM) and male-to-female transgendered women (TG). This study explored the knowledge, attitudes and experiences of Peruvian MSM and TG regarding HPV and GW.MethodsWe performed a qualitative study consisting of fifteen in-depth interviews and three focus groups carried out in Lima, Peru with diverse MSM and TG groups, including sex workers. Resulting data were analyzed by applying a systematic comparative and descriptive content analysis.ResultsWhile knowledge of HPV was limited, awareness of GW was common, particularly among TG persons and sex workers. Still, few participants recognized that GW are sexually transmitted, and many had problems differentiating between GW and other STI/anogenital conditions. Stigmatizing experiences were common during sexual encounters with people who had visible GW. Shame, emotional and physical troubles, and embarrassing sexual experiences were reported by individuals with GW. Search for treatment was mediated by peers, but stigma and apparent health services’ inability to deal with GW limited the access to effective medical care.ConclusionsIn Peru, public health interventions should strengthen services for HPV/GW management and increase accurate knowledge of the transmission, treatment, and sequelae of HPV/GW in MSM and TG populations.

HPV and Anal Cancer Knowledge Among HIV-Infected and Non-Infected Men Who Have Sex with Men

“…As with other studies on knowledge of HPV and anal cancer, 16,17 participants in the present study were to a great extent uninformed and largely unaware of the link between HPV and anal cancer and the risk HPV and anal cancer presented to MSM. This is problematic for both clinicians and patients alike.…”

Attitudes Towards Human Papilloma Virus Vaccination in the Latin American Andean Region

“…Consistent with this, 77% of HIV negative MSM and TW have condom-less anal or oral sex [40]. EGW are traumatic for MSM, leading some to change from being the passive to the active partner, or to have sex in darkness [41]. Two-thirds of those with EGW would accept HPV vaccination for prophylaxis against HPV-attributable diseases [40].…”

“…HPV prevalence in Peruvian men who have sex with men (MSM) is 77.1%, of which 47.3% are high risk HPV [41]. Peruvian transgender women (TW) may have an anogenital HPV prevalence of 95.6%, with a 47.8% HR HPV type prevalence [42].…”

Factors Associated With Visible Anogenital Warts Among HIV-Uninfected Peruvian Men Who Have Sex With Men and Transwomen

“…29 The univariate analysis findings that engaging in transactional sex and self-identifying as a transwoman were significantly associated with a lower risk of anogenital warts could be related to greater awareness of anogenital warts in these groups. 30 Also, the finding that having more than 10 episodes of anal intercourse in the previous 3 months, compared with 3 or fewer episodes, was significantly associated with a 60% decrease in risk of having anogenital warts might be explained by more frequent condom use. Nyitray et al, 17 for example, found that MSM who never used condoms for anal intercourse were 6 times more likely to have anal canal HPV compared with MSM who always used condoms; however, that study did not consider the presence of visible anogenital warts.…”