Prevalence of Oral Human Papillomavirus Infection: Impact of Sex, Race/Ethnicity, and Vaccination Status

Background Prior studies have demonstrated differences in oral human papillomavirus (HPV) prevalence by sex and race/ethnicity. In this study, we examined the impact of vaccination on these disparities. Methods We examined participants aged 18–59 years in the National Health and Nutrition Examination Survey from 2011 to 2016 who reported their HPV vaccination status and submitted an adequate oral sample (N = 9437). Oral prevalence of HPV, grouped by any, low-risk, high-risk, 4 valent (4v) HPV, 9 valent (9v) HPV, and nonvaccine 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, nonvaccine, 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 with other groups. Significant differences were not observed by race/ethnicity among vaccinated males or females. Conclusions 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.