Systematic Review of Racial Disparities in Human Papillomavirus–Associated Anal Dysplasia and Anal Cancer Among Men Who Have Sex With Men

Abstract

We systematically reviewed the literature on anal human papillomavirus (HPV) infection, dysplasia, and cancer among Black and White men who have sex with men (MSM) to determine if a racial disparity exists. We searched 4 databases for articles up to March 2014. Studies involving Black MSM are nearly absent from the literature. Of 25 eligible studies, 2 stratified by race and sexual behavior. Both reported an elevated rate of abnormal anal outcomes among Black MSM. White MSM had a 1.3 times lower prevalence of group-2 HPV (P < .01) and nearly 13% lower prevalence of anal dysplasia than did Black MSM. We were unable to determine factors driving the absence of Black MSM in this research and whether disparities in clinical care exist. Elevated rates of abnormal anal cytology among Black MSM in 2 studies indicate a need for future research in this population.

Does race impact survival for patients with anal squamous cell carcinoma?

“…Though the current study did not assess and compare incidence rates between the two groups, the racial disparities in certain demographic factors, in treatment, and in mortality between Black and White patients identified in our study draws attention to the lack of specific screening guidelines for anal SCC. Prior studies have identified young Black males as an at risk group for anal SCC, and have postulated that this may be related to changes in sexual practices over time . The current study found that Black patients with anal SCC were more likely to be younger than White patients, though it did not focus on disparities in age or sexual orientation.…”

Monitoring for Human Papillomavirus Vaccine Impact Among Gay, Bisexual, and Other Men Who Have Sex With Men—United States, 2012–2014

“…One analysis of racial differences in HPV incidence and clearance found that Asian/Pacific Islander men had a lower incidence of HPV than white or black men [37]. Additional data are needed on racial disparities in anal HPV and anal cancer prevalence among MSM [38]. …”

HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988–2017

“…HIV-positive MSM bear more STI burden than HIVnegative MSM. et al, 2014;Millett et al, 2006Millett et al, , 2007Purcell et al, 2012;Schafer et al, 2013;Walsh, Bertozzi-Villa, & Schneider, 2015;Yaphe et al, 2012 Substance Use (n = 11) Berg et al, 2011;Drumright et al, 2006;Haverkos & Drotman, 1995;Heath et al, 2012;Rajasingham et al, 2012;Romanelli & Smith, 2004;Vosburgh et al, 2012;Vu et al, 2015;Weidel et al, 2008;Woolf & Maisto, 2009;Wray et al, 2016 2 (18) 2 (18) 3 (27) 7 (64) 0 (0) 2 (18) 4.9 Moderate MSM who use substances Some evidence of consistent associations found between substance use and increased sexual risk behavior.…”

“…Childhood sexual abuse is also more prevalent among MSM than among heterosexual men (Schafer, Gupta, & Dillingham, 2013). Black MSM, compared with other MSM or other populations, are more likely to be HIV-positive and to report an STI (Millett et al, 2007;Millett, Peterson, Wolitski, & Stall, 2006;Walsh, Bertozzi-Villa, & Schneider, 2015). Greater numbers of HIV-positive MSM, compared with HIV-negative MSM, are affected by HCV, HPV, and syphilis (Abara et al, 2016;Ghisla et al, 2017;Jin et al, 2016;King et al, 2016;Machalek, Poynten, et al, 2012).…”