title: Trends and Determinants of Human Papillomavirus Concordance Among Human Immunodeficiency Virus-Positive and -Negative Heterosexual Couples in Rakai, Uganda.
abstract: Limited data are available on human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)-negative or HIV-positive couples followed longitudinally.
  
  
  
  Genital HPV was assessed in 725 concordant HIV-negative couples and 209 HIV-positive couples enrolled in a male circumcision trial in Rakai, Uganda, using the Roche Linear Array assay, which detects 37 HPV genotypes. Human papillomavirus prevalence and determinants of genotype-specific concordance were assessed at annual visits. Cumulative detection of HPV genotypes over 2 years was also assessed.
  
  
  
  At enrollment, HPV infection was detected in 54% of HIV-negative women, 56% of HIV-negative men, and 93% of HIV-positive men and women. For HIV-negative couples, genotypic concordance was 30% at baseline (n = 219/725) and declined significantly with age (adjusted prevelance risk ratio [adjPRR] = 0.53; 95% confidence interval [CI] = 0.28-0.93 comparing women aged >40 years to those aged 15-19 years) and male circumcision (adjPRR = 0.60; 95% CI = 0.47-0.77) and increased among couples with recent intercourse (adjPRR = 1.26; 95% CI = 1.04-1.53). These associations were not seen in HIV-positive couples. Among couples with HPV results at all visits, ≥1 of the same genotypes were detected in both partners in 60% of HIV-negative couples and 96% of HIV-positive couples over 2 years.
  
  
  
  Human papillomavirus genotype-specific concordance is more common in HIV-positive couples, and irrespective of HIV status, the majority of couples exhibit HPV concordance over 2 years.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Grabowski
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.|Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington D.C. USA.
authors.forename: Patti E
authors.initials: PE
authors.lastname: Gravitt
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.|Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.|School of Public Health, Makerere University, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.affiliation: Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Redd
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Xiangrong
authors.initials: X
authors.lastname: Kong
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.|Rakai Health Sciences Program, Entebbe, Uganda.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Wawer
authors.affiliation: Rakai Health Sciences Program, Entebbe, Uganda.|Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.|Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.|Rakai Health Sciences Program, Entebbe, Uganda.|Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Aaron A R
authors.initials: AAR
authors.lastname: Tobian
mesh_terms: D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006678:HIV / Q000302:isolation & purification; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D020010:Heterosexuality; D006801:Humans; D016014:Linear Models; D008297:Male; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: HIV; Human papillomavirus (HPV); Uganda; concordance; male circumcision; sexually transmitted infections