Oral Human Papillomavirus (HPV) Infection among Unvaccinated High-Risk Young Adults.

Gypsyamber D'Souza,Anne Griffioen,Emily Stammer,Alicia Wentz,Yingshi Guo,Renee Youngfellow,Weihong Xiao,Maura Gillison,Nicole Kluz

doi:10.3390/cancers6031691

Abstract

Oral HPV infection, the cause of most oropharyngeal cancer in the U.S., is not well studied among high-risk young adults. Men (n = 340) and women (n = 270) aged 18–25 years attending Baltimore County STD clinics were recruited if they declined HPV vaccination. Each participant had a 30-second oral rinse and gargle sample tested for 37 types of HPV DNA, and a risk-factor survey. Factors associated with prevalent infection were explored using log binomial regression. Men had higher prevalence of any oral HPV (15.3% vs. 7.8%, p = 0.004) and vaccine-type oral HPV (i.e., HPV16/18/6/11: 5.0% vs. 1.1%, p = 0.007) infection than women. In multivariate analysis, male gender (aPR = 1.93, 95% CI = 1.10–3.39), number of recent oral sex partners (p-trend = 0.013) and having ever performed oral sex on a woman (aPR = 1.73, 95% CI = 1.06–2.82) were associated with increased oral HPV prevalence. Performing oral sex on a woman may confer higher risk of oral HPV acquisition than performing oral sex on a man.

Highlights

While HPV vaccination is recommended for both girls and boys in the U.S, many young adults remain unvaccinated [1,2]
Oral HPV infection is associated with sexual behavior [7,9,10], and prevalence increases with number of oral sexual partners
We explored oral HPV infection among a group expected to be at high-risk for infection: young, sexually-active adults with no history of HPV vaccination who sought care at a sexually transmitted disease (STD) clinic

Summary

Introduction

While HPV vaccination is recommended for both girls and boys in the U.S, many young adults remain unvaccinated [1,2]. Oral HPV infection, which causes the majority of oropharyngeal cancer in the U.S, has not been well studied among high-risk young adults, this is one of the groups most likely to transmit STDs such as HPV [3]. Some studies have suggested that oral HPV prevalence remains higher among men than women, even after adjusting for oral sexual behavior [8,11], other studies, including a large systematic review, found no difference in oral HPV by gender [12]. Several studies included only men [4,13,14] or only women [15,16], preventing a comparison by gender

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Results

Conclusion