title: Predictors of high-risk and low-risk oral HPV infection in the United States.
abstract: Determine predictors of high-risk and low-risk oral HPV infection in the United States.
  
  
  
  Retrospective analyses of National Health and Nutrition Examination Survey cross-sectional data of U.S. population from 2009 to 2012.
  
  
  
  Database queried for subjects aged 18 to 69 with oral rinse human papillomavirus (HPV) DNA data. Logistic regression identified factors associated with high-risk and low-risk infection. Covariates included age, gender, ethnicity, income-to-poverty (IP) ratio, sexual orientation, human immunodeficiency virus infection, other sexually transmitted infections, lifetime sexual partners, and lifetime oral sex partners.
  
  
  
  In total, 9,256 subjects were identified with mean age of 42.1 years. Oral HPV infection was present in 8.1% (N = 747); 55.7% were high-risk and 55.3% were low-risk types, including 11% with both. Oral infection had a negative association with female gender (odds ratio [OR] 0.3, P < 0.001), IP ratio ≥ 3 (OR 0.7, P = 0.02), and one lifetime oral sex partner (OR 0.7, P = 0.03). Increasing oral sex behavior (6-21+ lifetime partners) was positively associated with oral HPV (OR 1.4-3.0, P = 0.03). Low-risk infection had negative associations with female gender (OR 0.4, P < 0.001) and non-Hispanic white ethnicity (OR 0.6, P = 0.02), IP ratio ≥ 3 (OR 0.6, P = 0.01), and positive association with > 20 sexual partners (all sex OR 1.7, P = 0.04; oral sex OR 1.9, P = 0.02). Predictors of high-risk HPV infection included male gender and increasing oral sex partners.
  
  
  
  Increasing oral sex partners is positively associated with oral HPV infection; female sex and higher socioeconomic class are negatively associated. The risk-factor profiles for high-risk and low-risk HPV types are distinct, with similar trends related to sexual behaviors.
  
  
  
  4. Laryngoscope, 126:1365-1372, 2016.
authors.affiliation: Division of Head and Neck Surgery, University of California, San Diego, San Diego, California, U.S.A.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Orosco
authors.affiliation: School of Medicine, University of California, San Diego, San Diego, California, U.S.A.
authors.forename: Suraj
authors.initials: S
authors.lastname: Kedarisetty
authors.affiliation: Division of Head and Neck Surgery, University of California, San Diego, San Diego, California, U.S.A.
authors.forename: Avram S
authors.initials: AS
authors.lastname: Hecht
authors.affiliation: Department of Surgery, University of California, San Diego, San Diego, California, U.S.A.
authors.forename: David C
authors.initials: DC
authors.lastname: Chang
authors.affiliation: Division of Head and Neck Surgery, University of California, San Diego, San Diego, California, U.S.A.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Coffey
authors.affiliation: Division of Head and Neck Surgery, University of California, San Diego, San Diego, California, U.S.A.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Weissbrod
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Human papillomavirus (HPV); NHANES; oral; oral sex; oropharynx; smoking