 I. To determine the sensitivity and specificity of HPV testing using different methods of detection, including HPV Hybrid Capture 2 HC2, HPV messenger ribonucleic acid mRNA assays APTIMA and OncoHealth HPV E6E7 oncoprotein assay and whether they improve the screening performance of routine anal cytology for the detection of anal high-grade squamous intraepithelial lesions HSIL when measured against the gold standard, biopsy-proven HSIL. 