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

Abbey B. Berenson, Jacqueline M. Hirth, Mihyun Chang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1230-1236
Number of pages7
JournalClinical Infectious Diseases
Issue number7
StatePublished - Apr 1 2022


  • HPV vaccination
  • oral HPV
  • racial disparities
  • sex differences

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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