Impact of race, ethnicity, and human immunodeficiency virus status on anal high-risk HPV subtypes: Preliminary insights from a diverse urban population.
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INTRODUCTION: Racial differences have been identified in the distribution of cervical high-risk human papillomavirus (hrHPV) subtypes; however, there is limited understanding of hrHPV subtypes in anal specimens based on patient race/ethnicity. This knowledge gap limits possible vaccination and/or treatment efforts and may not provide optimal coverage in diverse populations. MATERIALS AND METHODS: This preliminary study evaluates anal hrHPV subtype distribution and cytological outcomes in a diverse population accessing care at a large, urban, publicly funded hospital over a 2-year period. The primary objectives were to analyze anal hrHPV subtypes and associated cytologic diagnoses, focusing on disparities among demographic groups, including racial and ethnic diversity, and among individuals living with human immunodeficiency virus (HIV). RESULTS: Ninety-two patients were identified with a predominance of male (87%) and gay-identifying (50%) individuals and a significant representation from Hispanic/Latinx (36%) and White (36%) backgrounds. A majority (88%) were living with HIV, and only a small fraction (7%) had received HPV vaccination. The most common hrHPV subtypes identified were non-16 and 18 hrHPV subtypes (46%). No significant differences were identified in distribution of HPV subtypes among different races/ethnicities or between sexual and gender minorities and heterosexual, cisgender-identifying individuals. However, individuals with HIV were more likely to have atypical cytologic diagnoses and non-16/18 HPV subtypes. CONCLUSIONS: The findings underscore the prevalence of non-16/18 hrHPV subtypes in a racially and ethnically diverse urban population, particularly among individuals living with HIV. The study highlights the need for expanded HPV subtype surveillance and vaccine development to ensure equitable prevention strategies across diverse populations.