Regional Differences in U.S. College Students' Oral and Sexual Health

Introduction: Human papillomavirus (HPV) is a cause of oropharyngeal cancers that is increasing among young people in the U.S. Due to the probable associations of oral sex with oral health and HPV infections, it is important to evaluate the sexual and oral health behavior of college students.

Methods: Data were obtained from the American College Health Association (ACHA-NCHA) surveys from 2011-2012.  The total of 56,011 survey responses were analyzed using SAS 9.3 (SAS Institute Inc. Cary, NC) and assessed with Chi-Square tests of independence.  Results: The rate of genital warts/HPV, as reported by students being diagnosed within past 12 months, varied by geographic region of the college campus (p<.0001). Frequencies for genital warts were 1.01% for Northeast (NE), 1.42% for Midwest (MW), 1.60% for South (S), and 1.31% for West (W) region. For the HPV vaccinations, relative frequencies were 49.44% (NE), 39.10% (NW), 40.49% (S), 39.64% (W) (p<.0001). Frequencies for oral sex experience were 65.94% (NE), 72.03% (MW), 69.41% (S), 71.16% (W) (p<.0001), and for condom/barrier use during oral sex were 2.36% (NE), 1.85% (MW), 1.55% (S), 2.04% (W). Frequencies for dental exam/cleaning within last 12 months were 77.73% (NE), 73.41% (MW), 72.04% (S) and 71.19% (W) (p<.0001).

Conclusions: Fewer students in Northeast region reported genital warts/HPV, more HPV vaccinations, fewer oral sex experiences, and more condom/barrier use during oral sex than students in other regions. Students in Northeast region may experience somewhat better health compared to other regions. National interdisciplinary programs are needed to promote sexual and oral health.