Genotypic distribution of penile and anal high-risk human papillomavirus among men who have sex with men in Rwanda

Abstract

INTRODUCTION: Men who have sex with men (MSM) experience a disproportionately high burden of high-risk human papillomavirus (hr-HPV) infection, particularly at anal and penile sites, increasing their risk of HPV-associated cancers. In Rwanda, data on the prevalence and genotype distribution of hr-HPV among MSM remain limited. The objective was to determine the prevalence and genotypic distribution of anal and penile hr-HPV infections among MSM in Rwanda, assess the frequency of multiple hr-HPV genotype co-infections, and compare genotype distribution between HIV-infected and HIV-uninfected MSM.

METHODS: A cross-sectional laboratory-based study was conducted among 120 MSM residing in Kigali, Rwanda. Anal and penile swab samples were collected and tested for hr-HPV using a real-time isothermal amplification genotyping assay capable of detecting 14 oncogenic HPV genotypes and HPV-53. Sociodemographic and clinical information, including HIV status, was obtained through a structured questionnaire. Data were analysed using STATA version 15.

RESULTS: The prevalence of hr-HPV was 28.3% in anal samples and 39.2% in penile samples. HPV- 16 was the most frequently detected genotype at both sites, followed by HPV-53, HPV-31, HPV-51, and HPV-59. Multiple genotype infections were common among participants. HIV-positive MSM had a significantly higher prevalence of penile hr-HPV infection (65.0%) than HIV-negative MSM (34.0%) (p < 0.05).

CONCLUSION: MSM in Rwanda bear a substantial burden of anal and penile hr-HPV infection, characterized by the predominance of oncogenic genotypes and higher prevalence among individuals living with HIV. These findings highlight the need for targeted HPV prevention and control strategies, including expanded vaccination, integrated HPV screening, and strengthened HIV care services for this vulnerable population.