Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Oral Dis. 2019 Mar;25(2):609-616. doi: 10.1111/odi.12997. Epub 2018 Nov 25.
The incidence of Human Papillomavirus (HPV) types 16 and 18 positive oropharyngeal squamous cell carcinomas is increasing. Oral HPV infection is acquired through oro-genital contact. We examined the association between barrier use during oro-genital sex and oral HPV 16/18 prevalence in HPV unvaccinated individuals.
A cross-sectional analysis of individuals aged 18-59 years with a history of oro-genital sex was conducted using National Health and Nutrition Assessment Survey (NHANES) from 2009 to 2014. Multivariable logistic regression models were adjusted for gender, total number of oro-genital sex partners, smoking status, and alcohol consumption. Using NHANES sample weights, analysis was weighted for national representation.
Sample of 4,357 individuals represented 68,680,333 individuals nationally. 6.6% reported always or usually using a barrier during oro-genital sex, and 1.3% were positive for oral HPV 16/18 infection. In the adjusted analysis, barrier users were less likely to be oral HPV 16/18 positive, as compared to those who did not report using a barrier (RR: 0.21; 95% CI: 0.04-0.97; p < 0.05).
Using barrier during oro-genital sex might help to reduce oral HPV 16/18 prevalence. Hence, the use of a barrier should be promoted not only during vaginal but also during oro-genital sex. This finding is particularly important among HPV unvaccinated individuals.
人乳头瘤病毒（HPV）16 型和 18 型阳性口咽鳞癌的发病率正在上升。口腔 HPV 感染是通过口-生殖器接触获得的。我们研究了在未接种 HPV 疫苗的个体中，口-生殖器性行为时使用屏障与口腔 HPV16/18 感染率之间的关系。
利用 2009 年至 2014 年全国健康和营养调查（NHANES）的数据，对有口-生殖器接触史的 18-59 岁个体进行横断面分析。多变量逻辑回归模型调整了性别、口-生殖器性伴侣总数、吸烟状况和饮酒状况。使用 NHANES 样本权重，对全国代表性进行了加权分析。
4357 名个体的样本代表了全国 68680333 人。6.6%的人报告在口-生殖器性行为中始终或通常使用屏障，1.3%的人口腔 HPV16/18 感染阳性。在调整分析中，与未报告使用屏障的个体相比，屏障使用者口腔 HPV16/18 阳性的可能性较低（RR：0.21；95%CI：0.04-0.97；p<0.05）。
在口-生殖器性行为中使用屏障可能有助于降低口腔 HPV16/18 的流行率。因此，不仅应在阴道性交中，而且应在口-生殖器性交中推广使用屏障。对于未接种 HPV 疫苗的个体，这一发现尤为重要。
