Human papillomavirus incidence and transmission by vaccination status among heterosexual couples
- PMID: 40107087
- DOI: 10.1016/j.jcv.2025.105779
Human papillomavirus incidence and transmission by vaccination status among heterosexual couples
Abstract
Background: Understanding human papillomavirus (HPV) transmission dynamics within couples is necessary for optimal vaccine catch-up strategies. We used data from the Transmission Reduction and Prevention with HPV Vaccination (TRAP-HPV) study to estimate sex-specific incidence and transmission rates.
Methods: The TRAP-HPV study enrolled (2014-2022) new (≤6 months) heterosexual couples aged 18+ in Montreal, Canada. The study employed a 2 × 2 factorial design. Participants (n = 308) were randomized into four groups: neither partner vaccinated against HPV, only the male partner vaccinated against HPV, only the female partner vaccinated against HPV, or both partners vaccinated against HPV. Genital samples, collected at 0, 2, 4, 6, 9, and 12 months, were genotyped for 36 HPV types. We performed time-to-event analyses for vaccine-targeted HPVs (6/11/16/18/31/33/45/52/58) and HPVs phylogenetically related (35/39/44/59/67/68/70) and unrelated (26/34/40/42/51/53/54/56/61/62/66/69/71/72/73/81/82/83/84/89) to vaccine-targeted types, using type-specific HPV infections as the unit of analysis.
Results: Participants had a mean age of 25.5 years (SD 6.0), and a median of 6 (IQR: 2-15) lifetime sexual partners. Among males, incidence rates (in events/1000 months) were 0.99 (95 % CI: 0.17-3.07) and 1.67 (95 % CI: 0.75-3.51) in the two groups with vaccinated males versus 2.42 (95 % CI: 0.97-7.63) and 3.35 (95 % CI: 1.95-6.30) in the groups with unvaccinated males. Results were similar for the three HPV groups.
Conclusions: There was no consistent pattern of protection against incident HPV detection in females and no indication that recent vaccination was associated with lower transmission in discordant couples or with protection for one's partner. Findings should not be generalized to younger populations.
Keywords: HPV; Human papillomavirus; Incidence; Sexually transmitted infections; Transmission; Vaccination.
Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Eduardo L. Franco reports financial support was provided by Canadian Institutes of Health Research. Eduardo L. Franco reports financial support was provided by Merck Canada Inc. Francois Coutlee reports financial support was provided by Quebec Health Research Fund. Eduardo L. Franco reports a relationship with Merck Canada Inc that includes: consulting or advisory and funding grants. Eduardo L. Franco reports a relationship with Roche that includes: consulting or advisory, funding grants, and non-financial support. Eduardo L. Franco reports a relationship with GSK that includes: consulting or advisory. Francois Coutlee reports a relationship with Merck Sharp & Dohme Corp that includes: funding grants and non-financial support. Francois Coutlee reports a relationship with Becton Dickinson and Company that includes: funding grants and non-financial support. Francois Coutlee reports a relationship with Roche that includes: funding grants, non-financial support, and speaking and lecture fees. Francois Coutlee reports a relationship with Merck that includes: speaking and lecture fees. Eduardo L. Franco has patent related to the discovery “DNA methylation markers for early detection of cervical cancer” pending to Moshe Szyf, David Cheishvili, Mariam El-Zein, and Eduardo L. Franco. Mariam El-Zein has patent related to the discovery “DNA methylation markers for early detection of cervical cancer” pending to Moshe Szyf, David Cheishvili, Mariam El-Zein, and Eduardo L. Franco.
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