Is oral sex or smoking associated with prevalent oral HPV infections in college women?

Background: The prevalence of human papillomavirus (HPV)-related cancers of the head and neck is increasing, but little is known about the epidemiology of oral HPV in young women. The study objectives were to determine the prevalence of oral HPV infections and associated risk factors in a sample of college women. Methods: 1030 women attending a large southeastern university provided an oral rinse/gargle specimen and completed a computer-based questionnaire in 2011 (mean age 21.9 years; 51% white, 15% black; 14% Hispanic, 10% Asian, and 10% other race/ethnicity). Oral specimens were tested for 37 HPV genotypes using a commercial assay. Results: Of 1011 women with valid results, 10 had oral HPV (1.0%), representing HPV types 16, 51, 59, 62, 73, and 84. At least 1 HPV vaccination was reported by 467 (45.4%); neither of those with oral HPV type 16 had been vaccinated. The prevalence of oral HPV infections differed in those who had ever smoked (8/456, 1.75%) and those who had not (2/555, 0.36%), p=0.05; and also appeared to differ in persons who had ever engaged in oral sexual behavior (10/802, 1.27%) compared to those who had not (0/209, 0.00%), p=0.13. Conclusion: Oral HPV infections were uncommon in college women, and oral HPV screening in this population appears to be unwarranted. Risk factors for oral HPV were common and were similar to those in other populations. Oral HPV infections could be latent (not shedding or detectable), could be acquired later in life, or could truly be rare in young women.