person being vaccinated

HPV-SAVE Study Team: Screening and Vaccine Evaluation in men who have sex with men

Research Team: Salit, Irving E. (co-Principal Investigator); Rosenes, Ron (co-Principal Investigator); Brunetta, Jason; Burchell, Ann; Grennan, Jonathan; Kaul, Rupert; Macpherson, Paul; McEwen, Owen; Raboud, Janet; Rachlis, Anita; Severini, Alberto; Tan, Darrell Hoi San; Tinmouth, Jill  

What is this research about?

Human Papilloma Virus (HPV) is a common sexually transmitted infection. Previous research by this research team has shown that men who have sex with men in Ontario frequently carry HPV in the anal canal. Several types of HPV cause cancer including anal cancer and cervical cancer. Anal cancer is much more common among men who have sex with men, and in particular among HIV-positive men than in the general population; in fact, rates exceed rates of cervical cancer among women before cervical screening began. Effective antiretroviral treatments have reduced the incidence of many AIDS-defining cancers, but rates of anal cancer continue to increase among HIV-positive men who have sex with men.

Men with certain types of HPV typically develop anal dysplasia (abnormal growths in the lining of the anus). These growths are not yet cancerous, however a proportion of them will become cancer if left unchecked. This research aims to gather evidence to better prevent and treat anal dysplasia and cancer. This five-year project has several objectives:

  1. To learn more about how HIV-positive men who have sex with men understand HPV and anal cancer and their willingness to be vaccinated for HPV or screened for anal cancer
  2. To develop and evaluate an education brochure specifically for these at-risk men and evaluate its effect on the willingness of HIV-positive men to take part in anal screening
  3. To gather evidence about the best ways to screen for anal cancers and dysplasia. Anoscopy is an effective, but invasive, way to look for cancer and dysplasia. This research aims to determine the best ways to determine who should be referred to anoscopy, and how initial screening tools should be used.
  4. To compare the outcomes of removing the dysplasia (using ablative therapies) versus ongoing careful monitoring when an HIV-positive man has been diagnosed with high-grade dysplasia
  5. To further understand how anal HPV infection affects the lining of the anus and a man’s susceptibility to HIV infection through anal sex.

OHTN Support: This project is supported by a $1.5 million team grant awarded through the CIHR Advancing Boys’ and Men’s Health Research initiative in 2015. Though this initiative, CIHR worked with other research funders, including OHTN, to address disparities that affect men’s health. OHTN and CIHR contribute equally to this award, with OHTN contributing $150,000 each year for five years (2015-2019).

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