Human papillomavirus infections among couples in new sexual relationships

Abstract

Background: No studies have examined human papillomavirus (HPV) infections among couples early in their sexual relationships when transmission is most likely. Our objective was to describe the distribution of HPV infections among recently formed couples, using the partnership as the unit of analysis.

Methods: Women aged 18-24 years attending a university or junior college in Montreal enrolled in a longitudinal study with their new male partners. Self-collected vaginal swabs and clinician-collected swabs from the penis and scrotum were tested for 36 HPV genotypes. Participants self-reported sexual behavior in computerized questionnaires. We analyzed patterns of genital HPV infection in 263 couples using data obtained at enrollment.

Results: Couples had engaged in vaginal sex for a median of 3.9 months. HPV was detected in 64% (169/263) of couples. In 41% (109/263), both partners harbored the same HPV type-nearly 4 times more than expected if HPV status of partners were uncorrelated. There were 583 type-specific HPV infections among 169 couples for whom at least one partner was infected. Of these, 42% were of the same type for both partners (95% confidence interval = 36%-47%). This rose from 25% among those engaging in vaginal sex for less than 2 months to 68% among those at 5 to 6 months.

Conclusions: Although HPV is common, detection of the same type in persons initiating a sex relationship would be rare given type-specific prevalence rates. The high degree of concordance we found suggests a high probability of transmission.

FIGURE 1.

Observed proportion of couples concordant on one or more HPV types compared with the expected distribution of the proportion of concordant couples assuming independence in HPV type distribution between partners (details are provided in the text).

FIGURE 2.

Distribution of 10 most common and vaccine-preventable HPV types among recently formed couples (n = 263). M+F+ indicates male positive, female positive; M−F+, male negative, female positive; M+F−, male positive, female negative.

FIGURE 3.

Patterns of HPV type concordance and discordance in 419 infections among 126 monogamous couples in whom at least one partner had detectable infection. A, By months engaging in vaginal sex; B, By total number of vaginal sex encounters.