Table 1_Sex differences in the prevalence of high-risk oral and anal human papillomavirus infections among heterosexually active populations in Ibadan, Nigeria.docx

PurposeTo determine sex differences in the prevalence of oral and anal high-risk HPV infections among heterosexually active males and females in Ibadan.
MethodsThis was a secondary analysis from the Sexual Behavior and HPV Infections in Nigerians in Ibadan (SHINI) study that involved sexually active males and females aged 18–45 years. After a face-to-face interview, samples were collected from the mouth, cervix, vulva, and anus by a sex-matched trained nurse. High-risk HPV (hrHPV) in oral or/and anal sites were primary outcome variables, profiled by AnyplexTM II HPV28 assay. The participants' demographic characteristics, sexual behaviors, and social lifestyle were included as explanatory variables. The chi-square or Fisher exact test was used to investigate the association between the presence of hrHPV and the participants' characteristics. Multivariable logistic regression was conducted to test the association between the sex of participants and each of the primary outcome after adjusting for potential confounders. Statistical significance was set at p < 0.05.
ResultsA total of 625 females including 310 females in general population (FGP) and 315 female sex workers (FSWs) and 316 males were recruited. Oral hrHPV prevalence was higher among FGP and FSWs than among males (10.5% vs. 14.9% vs. 3.6%, p < 0.001), as was anal hrHPV prevalence (39.3% vs. 60.8% vs. 6.7%, p < 0.001). More FGP (7.5%) and FSWs (13.0%) than males (0.9%) had hrHPV at both oral and anal sites (p < 0.001). Males had significantly lower odds of oral hrHPV [adjusted odds ratio (aOR) = 0.43, 95% CI: 0.15–1.24] than FSWs and FGP [aOR = 1.70, 95% CI: 0.62–4.63]. The odds of anal hrHPV was significantly lower among males [aOR = 0.05, 95% CI: 0.03–0.08] compared to FSWs and FGP [aOR = 0.42, 95% CI: 0.30–0.58].
ConclusionOral hrHPV, anal hrHPV, and hrHPV at both sites were more prevalent in females than in males in the heterosexually active population. These findings highlight the importance of developing targeted HPV prevention strategies that account for sex-specific risk factors and the potential biological underpinnings contributing to these disparities.

研究目的：旨在探究伊巴丹地区异性性行为活跃人群中，口腔与肛门高危型人乳头瘤病毒（high-risk HPV, hrHPV）感染率的性别差异。
研究方法：本研究为针对「伊巴丹尼日利亚人群性行为与HPV感染（Sexual Behavior and HPV Infections in Nigerians in Ibadan, SHINI）」研究的二次分析，纳入年龄18~45岁的性活跃男女受试者。经面对面访谈后，由性别匹配的经过专业培训的护士采集口腔、宫颈、外阴及肛门样本。以口腔或/和肛门部位的hrHPV感染作为主要结局指标，采用Anyplex™ II HPV28检测试剂盒进行分型检测。将受试者的人口学特征、性行为习惯与社会生活方式作为解释变量。采用卡方检验或Fisher确切概率法探究hrHPV感染与受试者特征间的关联；通过多变量logistic回归分析，在校正潜在混杂因素后，检验受试者性别与各主要结局指标间的关联，设定统计学显著性阈值为p<0.05。
研究结果：本研究共招募625名女性受试者（其中普通人群女性310名、女性性工作者315名）及316名男性受试者。普通人群女性与女性性工作者的口腔hrHPV感染率均高于男性（10.5% vs. 14.9% vs. 3.6%，p<0.001）；肛门hrHPV感染率亦呈现相同趋势（39.3% vs. 60.8% vs. 6.7%，p<0.001）。同时存在口腔与肛门部位hrHPV感染的受试者中，普通人群女性（7.5%）与女性性工作者（13.0%）占比亦显著高于男性（0.9%，p<0.001）。与女性性工作者及普通人群女性相比，男性的口腔hrHPV感染校正后比值比（adjusted odds ratio, aOR）为0.43（95%置信区间：0.15~1.24），感染风险显著更低；而男性的肛门hrHPV感染校正后比值比为0.05（95%置信区间：0.03~0.08），显著低于女性性工作者与普通人群女性（aOR=0.42，95%置信区间：0.30~0.58）。
研究结论：在异性性行为活跃人群中，女性的口腔hrHPV、肛门hrHPV以及同时存在口腔与肛门部位hrHPV感染的发生率均显著高于男性。本研究结果凸显了制定针对性HPV预防策略的必要性，需充分考虑性别特异性风险因素以及导致此类感染率差异的潜在生物学机制。