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Prevalence of oral human papillomavirus infection: Impact of sex, race/ethnicity and vaccination status.

BACKGROUND
Prior studies have demonstrated differences by sex and race/ethnicity in oral HPV prevalence. This study examined the impact of vaccination on these disparities.


METHODS
We examined participants 18-59 years old in the National Health and Nutrition Examination Survey from 2011-16 who reported their HPV vaccination status and submitted an adequate oral sample (N=9,437). Oral prevalence of HPV, grouped by any, low risk, high risk, 4vHPV, 9vHPV, and non-vaccine types, was examined by sex, race/ethnicity and vaccination status. Binary logistic regression was used to estimate prevalence ratios by vaccination status. Multivariable logistic regression models controlled for age, sex, and race/ethnicity.


RESULTS
The prevalence of any type, non-vaccine type, low-risk, high-risk, 4vHPV, and 9vHPV types was higher among males than females, even among vaccinated participants. Examination of racial/ethnic differences demonstrated differences in all HPV groups among unvaccinated males and among low-risk types in females. In all but the 2 vaccine-type groups, the prevalence of oral HPV was notably higher among black males compared to other groups. Significant differences were not observed by race/ethnicity among vaccinated males or females.


CONCLUSION
Males tested positive for oral HPV more frequently than females, even among those vaccinated. This may have resulted from a lower frequency of males being vaccinated before initiating oral sex than females. Vaccination of males at the recommended age, therefore, may decrease differences in oral HPV by sex. Racial/ethnic differences were observed only in unvaccinated individuals, suggesting these disparities will decrease as more individuals are vaccinated.