Genital, Oral, and Anal Type-specific Human Papillomavirus Concordance within Individuals and between Partners

Studying human papillomavirus (HPV) genotype concordance between male and female partners and between multiple anatomic sites can help our understanding of HPV epidemiology.

Heterosexual couples ages 18+ formed within the past 6 months attended visits at 0, 2, 4, 6, 9, and 12 months. They answered questionnaires and provided genital, oral, and anal samples for HPV genotyping. We calculated observed/expected (O/E) concordance [with 95% confidence intervals (CI)] between anatomic sites of HPV genotype-specific infections across all visits and cumulatively (i.e., ever-positivity). We used mixed-effects logistic regression with random intercepts at the person level to estimate ORs for concordance and to assess predictors of genital HPV detection and partner concordance.

Within-individual O/E genital/anal concordance was 23.37 (CI, 15.55-38.05) for females and 14.79 (CI, 9.20-43.45) for males, whereas genital/genital O/E concordance between partners was 14.99 (CI, 12.47-18.41). Genital/genital concordance for ever-positivity within couples was substantial: O/E: 10.06 (CI, 8.55-12.12), with ORs of 70.75 (CI, 43.70-114.56) for females and 67.34 (CI, 41.96-108.06) for males. Significant predictors of genital ever-positivity were one's partner's ever-positivity, ORs of 66.2 (CI, 40.96-107.08) in females and 61.53 (CI, 38.19-99.14) in males, and age above the median in females and males, ORs of 1.66 (CI, 1.06-2.59) in females and 1.95 (CI, 1.30-2.91) in males. Concordance doubled (OR, 1.96; CI, 1.12-3.46) with occasions of intimacy above the median.

We observed substantial genital/anal concordance within individuals (particularly females) and genital/genital concordance between partners. Certain sociodemographic and behavioral factors influenced concordance.

Findings shed light on HPV natural history and transmissibility.