Prevalence of Oral HPV Infection in Unvaccinated Men and Women in the United States, 2009-2016

Abstract

To estimate changes in oral human papillomavirus (HPV) prevalence attributable to vaccination vs herd immunity, this national survey study uses National Health and Nutrition Examination Survey data to compare oral HPV prevalence for 4 types targeted by HPV vaccine and 33 nonvaccine types in unvaccinated US adults aged 18 to 59 years from 2009 to 2016.

Figure.. Prevalence Estimates and Ratios for Vaccine-Type and Nonvaccine-Type Oral HPV Infections Among Unvaccinated Men and Women Aged 18-59 Years, NHANES, 2009-2016

Human papillomavirus (HPV) prevalence data shown across 4 National Health and Nutrition Examination Survey (NHANES) cycles (2009-2010, 2011-2012, 2013-2014, and 2015-2016). HPV-16/-18/-6/-11 were considered vaccine types. Prevalence ratios were adjusted for age, race/ethnicity, education-level, marital status, smoking, and lifetime number of same- and opposite-sex oral sex partners. Prevalence trends across cycles were assessed using integer scores and quantified through odds ratios and 95% confidence intervals (CIs). Individuals with missing covariate values for education (n = 8), marital status (n = 5), or smoking (n = 895) were imputed the modal value. Individuals with missing lifetime (n = 1606) number of oral sex partners were imputed the sex-specific mean. All analyses accounted for the complex sample design, including the use of sample weights adjusted for unit nonresponse and the combination of 4 cycles. Weights were further poststratified to the age × sex × race distribution of the cycle-specific US population to account for nonparticipation in the sexual behavioral questionnaire or oral HPV components. Error bars indicate 95% CIs.