Abstract B092: High prevalence of oral HPV infection among people with HIV in Puerto Rico: Time for improved prevention strategies

Abstract Introduction/Background: Human papillomavirus (HPV) is the most common sexually transmitted infection, with estimates for the probability of infection exceeding 3% for women and 12% for males across their lifetime.People with HIV (PWH) are at a higher risk of acquiring oral HPV infection and thereby more susceptible to the development of oropharyngeal cancer (OPC), despite antiretroviral therapy. Puerto Rico (PR) ranks within the top ten in terms of HIV prevalence among the US, has a significant burden and disparity of HPV infections as well as socio-economic disadvantages, which can limit the access to preventive health care and the HPV vaccine. While HPV vaccination rates in the US are 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 181 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. A self-administered questionnaire collected sociodemographic characteristics and lifestyle variables. Statistical analyses were performed using R-statistical software. Results: There was a 34% prevalence of oral HPV infection among PWH, of which 62% were high-risk genotypes. Among the high-risk genotypes HPV-18 was the most abundant a 33% prevalence, followed by HPV-16 and HPV-33 with 7%. Prevalence of HPV infection was higher in males than females (90% vs. 10%), and high-risk genotypes were only present in male participants. While 63% of the participants have knowledge of HPV infection, 62% of the participants did not have the HPV vaccine. Additionally, males had more knowledge about HPV infections (57%) than females (12%), however, vaccination rates were still very low (25% males vs 12% 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. Since the incidence of OPC is increasing it is essential to establish improved preventive public health strategies from an educational standpoint, as well as medical care access promoting the HPV vaccine not only for cervical cancer but for all HPV-related cancers. Citation Format: Jurelis Torres-Reyes, Juliana M. Serrano-Rodriguez, Gabriel Borges-Velez, Jeannette L. Salgado-Montilla, Maria Sanchez-Vazquez, Magaly Martienez-Ferrer, Ana P. Ortiz-Martinez, Josue Perez-Santiago. High prevalence of oral HPV infection among people with HIV in Puerto Rico: Time for improved prevention strategies [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B092.