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Background: Men who have sex with men (MSM) have an increased risk of anogenital human papilomavirus (HPV) infection, which can lead to HPV-related anogenital lesions such as warts, anal intraepithelial neoplasia, and anal cancer. Some of these HPV types are preventable with vaccines. We aimed to describe the incidence of anal, penile, and oral HPV infection, and to estimate the site-specific transmission probability per partner, for teenage MSM., Methods: In our observational cohort study, we enrolled teenage MSM (aged 16-20 years) with low sexual exposure and a low prevalence of HPV in Melbourne (VIC, Australia). At baseline, 3, 6, and 12 months, we took a swab from the anal canal, and participants self-collected a swab from the penis and an oral rinse. Our primary outcome was definite and probable incident HPV infection of the anus, penis, or mouth at any time in the 12 months from baseline, assessed through the presence of HPV DNA. We defined definite incident HPV infection as the same HPV type detected more than once from the same site in men who had a negative HPV test at baseline. We defined probable incident HPV infection as only one positive test. We estimated the probability of HPV transmission per partner using HPV prevalence in MSM with a similar age to partners of men in our cohort. This study is registered at the Australian New Zealand Clinical Trials Registry and ClinicalTrials.gov, numbers ACTRN12611000857909 and NCT01422356., Findings: We enrolled 200 MSM aged 16-20 years (median 19 years [IRQ 18-20; range 16-20]) between Sept 20, 2010, and Aug 24, 2012. Over the 12 month follow-up period, we detected 48 definite (107 possible) HPV infections in the anus, ten definite (34 possible) HPV infections on the penis, and no definite (six possible) infections in the mouth. Definite incidence rate per 100 person-years for any anal HPV infection was 57 (95% CI 46-68), and for any anal HPV type in the quadrivalent vaccine was 33 (23-44). Definite incidence rate per 100 person-years for any penile HPV was 12 (6-21) and for any HPV type in the quadrivalent vaccine was 5 (1-12). Estimated probabilities of HPV transmission from the penis to the anus were significantly higher than were those from the anus to the penis (p<0·05 for all HPV types in the quadrivalent vaccine)., Interpretation: High incidence rates suggest that the vaccination coverage in MSM will need to be high. The transmission estimates will inform HPV modelling., Funding: Merck., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objectives: To report on sexual behaviors and sexually transmitted infections (STIs) among men who have sex with men (MSM) in their teens, when many MSM engage in their first sexual experiences., Methods: MSM aged 16 to 20 years were recruited via community and other sources. Men completed a questionnaire about their sexual behaviors and were screened for gonorrhea, chlamydia, syphilis, and HIV., Results: Two hundred men were included. The median age was 19 years. The median age at first insertive or receptive anal intercourse was 17 years. Half of men reported sex with mainly older men: these men were more likely to engage in receptive anal intercourse (48% vs. 25%, p < .001) than other men. Most men had engaged in insertive (87%) and receptive (85%) anal intercourse in the prior 12 months with 60% and 53% reporting inconsistent condom use with insertive and receptive anal intercourse partners, respectively. The median number of insertive anal intercourse partners was 3 and 1.5 (p < .001) among men reporting inconsistent and consistent condom use with insertive anal intercourse over the prior 12 months. The median number of receptive anal intercourse partners was 3 and 2 (p = .006) among men reporting inconsistent and consistent condom use with receptive anal intercourse over the prior 12 months. Pharyngeal gonorrhea, rectal gonorrhea, urethral chlamydia, rectal chlamydia, and syphilis were detected in 3.0%, 5.5%, 3.0%, 4%, and 2.0% of men, respectively. All men were HIV negative., Conclusion: Many of the teenage MSM in this study were at risk for STI. Preventative messages and STI screening interventions that are age appropriate need to be developed to reduce HIV and STI risk in this under-recognized group., (Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: Incidence of hepatitis B has not been well studied recently in men who have sex with men (MSM) despite increases in sexual risk practices and other sexually transmitted infections. Our aim was to determine the incidence of hepatitis B infection among MSM and level of immunity to hepatitis B attending a sexual health service over 10 years., Methods: A cross-sectional analysis of all MSM attending Melbourne Sexual Health Centre (MSHC) from 1 July 2002 and 30 June 2012, and a retrospective cohort study of MSM who had attended MSHC on multiple occasions who had hepatitis serology done more than once., Results: Of 10 031 MSM attending the clinic, 58.4% (95% CI 57.4% to 59.4%) (5655/9677) had hepatitis B surface antibody (HepBsAb), 10.6% (95% CI 10.0% to 11.4%) (840/7888) had core antibody (HepBcAb), and 3.7% (95% CI 3.0% to 4.5%) (95/2577) had surface antigen (HepBsAg). The proportion with HepBsAb decreased from 72% to 48% (p (trend)<0.001), with HepBcAb decreased from 12% to 8% (p (trend)=0.039) and with either HepBsAb or HepBcAb, decreased from 67% to 50% (p (trend)<0.001) from 2002 to 2012, but did not change for HepBsAg (p (trend)=0.08). Seven cases of hepatitis B occurred in 3540 person-years of observation, giving an incidence of 1.98 (95% CI 0.79 to 4.07) per 1000 person-years., Conclusions: The data suggest that the current level of immunity of about 50% has been sufficient to prevent any significant hepatitis B infection in the last 10 years. Continued high levels of vaccination are important for prevention.