Anal HPV infection & disease: Common and preventable, but hard to treat

Human papillomavirus (HPV) is the most common sexually transmitted virus with approximately 80% of sexual active people getting infected at least once in their life. Some HPV types have carcinogenic potential and are therefore considered high-risk HPV types. This thesis reports on different aspects related to anal HPV infection and HPV-related disease in specific risk groups, being HIV-positive men who have sex with men and female sex workers. Incidence, prevalence, clearance, HPV antibody positivity and anal HPV viral load are studied for anal HPV infection. Also aspects of pre-stage anal cancer, called anal high-grade squamous intraepithelial lesions (HSIL) are studied in this thesis. These include the quality of screening for anal HSIL, risk factors and prediction of anal HSIL among HIV-positive men who have sex with men. Lastly, prevention of anal HPV infection and anal HPV-related diseases is discussed in studies on HPV vaccination intention among both men as well as female sex workers. In conclusion anal HPV infection and related disease is common and preventable, but hard to treat.