Abstract 971: Biological sex disparities in oral HPV infection and vaccination rates in people with HIV in Puerto Rico: a public health concern
Authors: Jurelis Torres-Reyes, Juliana M. Serrano-Rodríguez, Gabriel Borgez-Vélez, Jeannette L. Salgado-Montilla, María Sánchez-Vázquez, Magaly Martínez-Ferrer, Ana P. Ortiz-Martínez, Josué Pérez-Santiago
Journal: Cancer Research (2025)

Abstract Background: Human papillomavirus (HPV) is the most common sexually transmitted infection, with estimates for the probability of infection with the virus exceeding 80% for women and 90% for males across their lifetime. People with HIV (PWH) are at a higher risk of acquiring oral HPV infection, despite antiretroviral therapy, making them more susceptible to Oropharyngeal cancer (OPC). Puerto Rico (PR) has a significant burden and disparity of HPV and HIV-related malignancies, and socio-economic disadvantages, which limit access to HPV vaccine. While HPV vaccination rates in the US is 46% in young adults, HPV vaccination rates in PR are limited, particularly in PWH. Here, we described the prevalence of oral HPV infection among PWH in PR and investigated socio-behavioral factors associated with HPV infection. Methods: We evaluated 135 sexually active PWH with a median age of 48 years old. Oral rinse samples were collected and analyzed for HPV and genotyped using the DNA ELISA kit HPV SPF10 and RHA kit HPV SPF10-LiPA25. An administered questionnaire collected sociodemographic characteristics and lifestyle variables. Statistical analyses were performed in R-statistical software. Results: There was a 32% prevalence of oral HPV infection, of which 61% were high-risk genotypes, with HPV-18 being the most abundant (39%). The prevalence of oral HPV was higher in males than females (34% vs. 17%), and high-risk genotypes were only present in males. High proportion of our cohort (67%) did not have the HPV vaccine while 60% have the knowledge of HPV infection. Knowledge of HPV infection was higher in males than females (56% vs 33%), but even then, vaccination rates were very low (20% males vs 11% females). Conclusion: High prevalence of oral HPV infection was observed in PWH, higher than previously observed in PR. Limited HPV vaccination rates may possibly be due to age ineligibility, access, or lack of awareness of the vaccine. Males had a higher prevalence of oral HPV infection and were the group in which high-risk HPV genotypes were detected. Although female vaccination rates were low, the lack of high-risk genotypes may be due to early access to HPV vaccine based on regular established screening protocols for cervical cancer, but these protocols have not been established for high HPV-related cancer risk male populations. The incidence in OPC is increasing and it is expected to exceed that of cervical cancer, these findings highlight the need to establish better preventive public health strategies from an educational standpoint, and medical care access. Citation Format: Jurelis Torres-Reyes, Juliana M. Serrano-Rodríguez, Gabriel Borgez-Vélez, Jeannette L. Salgado-Montilla, María Sánchez-Vázquez, Magaly Martínez-Ferrer, Ana P. Ortiz-Martínez, Josué Pérez-Santiago. Biological sex disparities in oral HPV infection and vaccination rates in people with HIV in Puerto Rico: a public health concern [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 971.