| dc.description.abstract | Background: Men who have Sex with Men (MSM) populations exist in virtually all cultures and
communities. Men who have sex with Men have a heavy burden of HIV and associated
conditions including anal squamous cell carcinoma and its precursor lesions. High risk HPV
infection associated causally with both invasive squamous carcinoma and its precursor lesions
has been identified in 70% of all MSM irrespective ofHIV status.
Highly Active anti-Retroviral Therapy (HAART) does not significantly alter the pathogenesis of
ASIL, HPV infections or SCC. As more and more HIV positive MSM continue to live longer
due to HAART, the prevalence of ASIL, HPV infections and SCC is expected to rise. It is
expected that screening with the aim of detecting early precursor lesions and treating them before
they become invasive cancer will reduce the prevalence, morbidity and mortality associated with
invasive squamous cell carcinoma Screenfug-~ing pap smears is expected to achieve similar
success to that of cervical pap smears.
Objective: To determine the prevalence of anal intraepithelial neoplasia in HIV positive Men
who have Sex with Men (MSM) attending comprehensive care clinics in Nairobi.
Design and methods: A cross sectional-descriptive study was done. A total of ninety four HIV
positive MSM who met the inclusion criteria were recruited using respondent-driven sampling,
and completed a questionnaire, detailing their socio-demographic data, sexual practice and
medical history. Conventional smears were prepared for anal cytology and stained with Pap
stain. Slides were reviewed by the principal investigator and two cytopathologists. In case of any
discrepancy, an independent cytopathologist reviewed ~ slides.
Setting: KNH CCC, Casino STC clinic and Kenyatta National Hospital Cytology Laboratory. Results: Ninety four eligible participants who gave consent were included in the study. Forty,
(44%) showed normal anal cytology, 51 (56%) had abnormal anal cytology as follows: ASC-US,
16(17.6%), LSIL, 29 (31.8%) and HSIL 6 (6.6%), while 3 (3.2%) had unsatisfactory smears.
candida was the most frequent organism accounting for 77%. 1 butschlii cysts were observed in
11% of smear, while coccobacilli were in 6% of smears.
Conclusion: The prevalence of AIN is high, among HIV positive MSM in Kenya, similar to that
reported in western countries.
Recommendation: Routine screening for high- risk MSM is recommended, and screening and
treatment for candidiasis, an opportunistic infection in HIV positive person should be done. | en |
