MSM have a higher risk of repeated and persistent HPV infection and associated diseases, such as genital warts and anal cancer, at all ages and regardless of HIV status or other immunocompromising conditions.6,8 Patterns of HPV infection and disease in MSM are markedly different from those of heterosexual men and women. Men have stable incidence and prevalence throughout life. HPV infection incidence among men is highest in young adulthood, shortly after sexual debut, and then declines.9,10 MSM are also less likely to benefit from herd protection attained from HPV vaccination of females.