Oral Manifestations in Men who Have Sex with Men

1Peking University School and Hospital of Stomatology, Beijing, China, 2Beijing Youan Hospital, Capital Medical University, Beijing, China.1

Objectives: To examine the variation of oral manifestations in men who have sex with men (MSM) by age, type of intercourse, population characteristics and numbers of sex partners - factors associated with the rate of HIV infection.

Method: 682 MSM were enrolled in this study from HIV Voluntary Counseling and Visiting Center (VCT) in Beijing Youan Hospital. The sociodemographic and behavior interview, medical history, and oral examination were conducted in 507 MSM who consented. HIV sero-antibody was tested in 682 MSM. The control group included 149 individuals taking physical examination in First Hospital, Peking University, who were age and sex were matched.

Results: The prevalence of HIV-infection in MSM was 6.8% (33/682). Oral mucosal lesions appeared in 217 (42.8%) of the 507 MSM, which was significantly higher than those in control group (p=0.000). The prevalence of bloody vesicles in MSM was 11.4% (58/507), recurrent oral ulceration (ROU) 8.3% (42/507), fissured tongue 5.9% (30/507), leukoedema 5.5% (28/507), leukokeratosis 4.5% (23/507), hyperpigmentation 4.7% (24/507) and candidiasis 1.2% (6/507), chronic cheilitis 4.1% (21/507), geographic tongue 1.8% (9/507), angular stomatitis1.6% (8/507), oral candidiasis (OC) 1.2% (6/507). The prevalence of bloody vesicles in MSM was significantly higher than that in the control group (23.5%, 35/149) (p=0.000). In crosstabs analyses, the presence of oral mucosal lesions in MSM with oral sex (53.9%, 48/89) was significantly higher than those without (39.8%, 150/377, p=0.015), especially leukoedma and fissured tongue. The rates of oral bloody vesicles 27.3% (9/33) and OC 21.2% (7/33) in HIV sero-positive MSM were significantly higher than those in HIV sero-negative individuals (p=0.003).

Conclusion: Oral sex is a potential risk factor for oral mucosa lesions in MSM. Oral bloody vesicles may increase risk for HIV transmission.