Association Between Use of Protection During Oral Sex and Oral HPV Prevalence

Objectives: To compare oral Human Papillomavirus (HPV) 16/18 prevalence by reported use of protection during oral sex.
Methods: Individuals with a history of oral sex were identified from National Health and Nutrition Assessment Survey from 2009-2014. NHANES is a series of ongoing cross-sectional surveys that examines approximately 5,000 persons very year across the US and is nationally representative dataset of the civilian, non-institutionalized US population. The survey involves household interview of the participants, followed by physical examination in a mobile examination center (MEC). Weighted logistic regression models computed associations between risk factors, including protection use and HPV 16/18 infection.
Results: 10,265 individuals representing 162,614,464 at the US level were identified. In bivariate analyses, age, sexual orientation, race, education, Poverty Income Ratio, marital status, smoking, alcohol and HIV status were significantly associated with the use of protection during oral sex, while gender, number of oral sex partners, smoking and drug use were associated with oral HPV 16/18 infection. After adjusting for these factors, use of protection was not associated with oral HPV 16/18 positivity (p=0.426). Independent predictors of HPV 16/18 infection were male gender (p=0.001), ≥11 oral sex partners (p<0.001) and current smoking (p=0.016).
Conclusions: Using protection during oral sex might not be protective against oral HPV 16/18 infection. Males, current smokers and those with a higher number of oral sex partners are at an elevated risk for oral HPV infection. These findings emphasize the need to promote HPV awareness and vaccination, as well as implement behavioral interventions.