Grant: New Investigator Award - PA: HIV/AIDS Biomedical/Clinical Research

Cancer of the anus occurs at much higher rates in HIV-infected men who have sex with men (MSM). Both anal and cervical cancers are caused by a sexually transmitted virus called human papillomavirus (HPV), so these conditions may be passed on to sexual partners. Anal Pap smears can be used to screen for precancerous anal growths. If the pap is positive, then a high powered examination can be done to identify the precancerous growth which can then be removed using laser treatment. Our team has used HPV tests, anal Pap smears and high-power examinations of the anal canal to look for pre-cancerous changes in a large group of HIV-infected MSM. We found that the Pap smear was moderately accurate and that ¼ of our group had advanced pre-cancerous growths. These findings are important but more knowledge is needed before formal screening programs can be instituted. In the current project, we intend to evaluate how precancerous anal growths have changed over a 4 year period in the original group of HIV-infected men that we studied. The sexual partners will also be examined to see if they have the same kinds of HPV as the original subjects. These studies will help us determine: a) how often HIV-infected men to be re-checked in order to find advanced pre-cancer, b) how effective their previous treatments have been and c) whether their partners are at risk for similar conditions. These results will help design screening programs for anal cancer.