Genital, Oral, and Anal Type-specific Human Papillomavirus Concordance within Individuals and between Partners

Abstract

Background: Studying human papillomavirus (HPV) genotype concordance between male and female partners and between multiple anatomic sites can help our understanding of HPV epidemiology.

Methods: Heterosexual couples ages 18+ formed within the past 6 months attended visits at 0, 2, 4, 6, 9, and 12 months. They answered questionnaires and provided genital, oral, and anal samples for HPV genotyping. We calculated observed/expected (O/E) concordance [with 95% confidence intervals (CI)] between anatomic sites of HPV genotype-specific infections across all visits and cumulatively (i.e., ever-positivity). We used mixed-effects logistic regression with random intercepts at the person level to estimate ORs for concordance and to assess predictors of genital HPV detection and partner concordance.

Results: Within-individual O/E genital/anal concordance was 23.37 (CI, 15.55-38.05) for females and 14.79 (CI, 9.20-43.45) for males, whereas genital/genital O/E concordance between partners was 14.99 (CI, 12.47-18.41). Genital/genital concordance for ever-positivity within couples was substantial: O/E: 10.06 (CI, 8.55-12.12), with ORs of 70.75 (CI, 43.70-114.56) for females and 67.34 (CI, 41.96-108.06) for males. Significant predictors of genital ever-positivity were one's partner's ever-positivity, ORs of 66.2 (CI, 40.96-107.08) in females and 61.53 (CI, 38.19-99.14) in males, and age above the median in females and males, ORs of 1.66 (CI, 1.06-2.59) in females and 1.95 (CI, 1.30-2.91) in males. Concordance doubled (OR, 1.96; CI, 1.12-3.46) with occasions of intimacy above the median.

Conclusions: We observed substantial genital/anal concordance within individuals (particularly females) and genital/genital concordance between partners. Certain sociodemographic and behavioral factors influenced concordance.

Impact: Findings shed light on HPV natural history and transmissibility.