Dataset Information

Differences in oral sexual behaviors by gender, age, and race explain observed differences in prevalence of oral human papillomavirus infection.

ABSTRACT:

Purpose

This study explores whether gender, age and race differences in oral sexual behavior account for the demographic distribution of oral human papillomavirus infection (HPV) and HPV-positive oropharyngeal cancer (HPV-OSCC).

Methods

This analysis included 2,116 men and 2,140 women from NHANES (2009-10) who answered a behavioral questionnaire and provided an oral-rinse sample for HPV detection. Weighted prevalence estimates and prevalence ratios (PR) were calculated for sexual behaviors and oral HPV infection by gender, age-cohort (20-29, 30-44, 45-59, 60-69), and race, and contrasted with incidence rate ratios (IRR) of OSCC from SEER 2009. Multivariate logistic regression was used to evaluate predictors of oral sexual behavior and oral HPV16 infection.

Results

Differences in oral sexual behavior were observed by gender, age-cohort and race. Most men (85.4%) and women (83.2%) had ever performed oral sex, but men had more lifetime oral and vaginal sexual partners and higher oral HPV16 prevalence than women (each p<0.001). 60-69 year olds (yo) were less likely than 45-59 or 30-44 (yo) to have performed oral sex (72.7%, 84.8%, and 90.3%, p<0.001), although oral HPV16 prevalence was similar. Prevalence ratios (PR) of ever oral sex in men vs. women (PR = 1.03), and 45-59 vs. 30-44 year-old men (PR = 0.96) were modest relative to ratios for oral HPV16 infection (PRs = 1.3-6.8) and OSCC (IRR = 4.7-8.1). In multivariate analysis, gender, age-cohort, and race were significant predictors of oral sexual behavior. Oral sexual behavior was the primary predictor of oral HPV16 infection; once this behavior was adjusted for, age-cohort and race were no longer associated with oral HPV16.

Conclusion

There are differences in oral sexual behaviors when considering gender, age-cohort and race which explain observed epidemiologic differences in oral HPV16 infection across these groups.

SUBMITTER: D'Souza G

PROVIDER: S-EPMC3901667 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Differences in oral sexual behaviors by gender, age, and race explain observed differences in prevalence of oral human papillomavirus infection.

D'Souza Gypsyamber G Cullen Kevin K Bowie Janice J Thorpe Roland R Fakhry Carole C

PloS one 20140124 1

<h4>Purpose</h4>This study explores whether gender, age and race differences in oral sexual behavior account for the demographic distribution of oral human papillomavirus infection (HPV) and HPV-positive oropharyngeal cancer (HPV-OSCC).<h4>Methods</h4>This analysis included 2,116 men and 2,140 women from NHANES (2009-10) who answered a behavioral questionnaire and provided an oral-rinse sample for HPV detection. Weighted prevalence estimates and prevalence ratios (PR) were calculated for sexual ...[more]

PMID: 24475067

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Project description:Background:The burden of human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is disproportionately high among men, yet empirical evidence regarding the difference in prevalence of oral HPV infection between men and women is limited. Concordance of oral and genital HPV infection among men is unknown. Objective:To determine the prevalence of oral HPV infection, as well as the concordance of oral and genital HPV infection, among U.S. men and women. Design:Nationally representative survey. Setting:Civilian noninstitutionalized population. Participants:Adults aged 18 to 69 years from NHANES (National Health and Nutrition Examination Survey), 2011 to 2014. Measurements:Oral rinse, penile swab, and vaginal swab specimens were evaluated by polymerase chain reaction followed by type-specific hybridization. Results:The overall prevalence of oral HPV infection was 11.5% (95% CI, 9.8% to 13.1%) in men and 3.2% (CI, 2.7% to 3.8%) in women (equating to 11 million men and 3.2 million women nationwide). High-risk oral HPV infection was more prevalent among men (7.3% [CI, 6.0% to 8.6%]) than women (1.4% [CI, 1.0% to 1.8%]). Oral HPV 16 was 6 times more common in men (1.8% [CI, 1.3% to 2.2%]) than women (0.3% [CI, 0.1% to 0.5%]) (1.7 million men vs. 0.27 million women). Among men and women who reported having same-sex partners, the prevalence of high-risk HPV infection was 12.7% (CI, 7.0% to 18.4%) and 3.6% (CI, 1.4% to 5.9%), respectively. Among men who reported having 2 or more same-sex oral sex partners, the prevalence of high-risk HPV infection was 22.2% (CI, 9.6% to 34.8%). Oral HPV prevalence among men with concurrent genital HPV infection was 4-fold greater (19.3%) than among those without it (4.4%). Men had 5.4% (CI, 5.1% to 5.8%) greater predicted probability of high-risk oral HPV infection than women. The predicted probability of high-risk oral HPV infection was greatest among black participants, those who smoked more than 20 cigarettes daily, current marijuana users, and those who reported 16 or more lifetime vaginal or oral sex partners. Limitation:Sexual behaviors were self-reported. Conclusion:Oral HPV infection is common among U.S. men. This study's findings provide several policy implications to guide future OPSCC prevention efforts to combat this disease. Primary Funding Source:National Cancer Institute.

Dataset Information

Differences in oral sexual behaviors by gender, age, and race explain observed differences in prevalence of oral human papillomavirus infection.

Purpose

Methods

Results

Conclusion

Publications

Differences in oral sexual behaviors by gender, age, and race explain observed differences in prevalence of oral human papillomavirus infection.

Similar Datasets

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