Risk Factors for Oral Human Papillomavirus in Adults Infected and Not Infected With Human Immunodeficiency Virus

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Abstract
Background and Objectives: To investigate in a cross-sectional study the determinants of oral human papillomavirus infection in 287 individuals who are sexually active. Goal: To assess prevalence as well as risk factors for oral human papillomavirus infection. Study Design: One hundred seventy-eight human immunodeficiency virus-seropositive (158 men and 20 women) and 109 human immunodeficiency virus-negative (73 men and 36 women) individuals were recruited consecutively from sexually transmitted disease-human immunodeficiency virus clinics and gastrointestinal endoscopy clinics. Oral brushings were tested with the L1 consensus polymerase chain reaction assay for human papillomavirus detection. Results: Human papillomavirus DNA was detected in 32 (11.2%) of 287 individuals. Associated with oral human papillomavirus infection on univariate analyses were human immunodeficiency virus infection (odds ratio, 6.9; 95% confidence interval, 2.0–23.2), homosexuality (odds ratio, 3.7; 95% confidence interval, 1.5–9.4), unprotected oral sex (odds ratio, 5.5; 95% confidence interval, 1.6–18.4), syphilis (odds ratio, 2.5; 95% confidence interval, 1.1–6.3), gonorrhea (odds ratio, 4.2; 95% confidence interval, 1.9–9.1),Chlamydia trachomatis(odds ratio, 4.4; 95% confidence interval, 1.8–10.6), and genital herpes (odds ratio, 2.9; 95% confidence interval, 1.3–6.5). Human immunodeficiency virus infection andC. trachomatiswere independently predictive of human papillomavirus infection in multivariate stepwise logistic regression. Conclusions: This study suggests that sexual activity plays an important role in the transmission of human papillomavirus in the oral cavity.
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