Alcohol consumption and oral human papillomavirus infection among men living with HIV: a cross-sectional study from the ULACNet 201 trial

Alcohol consumption is recognized as a risk factor for oropharyngeal cancer. However, its role in oral human papillomavirus (HPV) infection among people living with HIV (PLWH) remains unclear. This cross-sectional study analyzed baseline data from 699 men living with HIV (MLWH) enrolled in the multicenter ULACNet-201 trial (NCT04255849) to assess oral HPV infection by drinking behavior, examine the association between alcohol consumption and HPV infection, exploring smoking as a potential effect modifier. Oral gargle specimens were tested for high-risk (HR-HPV) and low-risk (LR-HPV) HPV genotypes using SPF10 PCR-DEIA-LiPA25. Logistic regression estimated adjusted odds ratios (ORs, 95% CIs) controlling for key covariates and explored heterogeneity by smoking status. Alcohol use in the past month was reported by 76.4% of participants, with 6% classified as heavy drinkers and 27% as binge drinkers. Oral HPV infection was similar between drinkers and nondrinkers (27.7% vs. 28.5%), with comparable rates for HR-HPV (11% vs. 10.9%) and LR-HPV (18.7% vs. 19.7%). Alcohol consumption was not associated with HR-HPV overall, and exploratory analysis found no evidence of effect modification by smoking status. A possible interaction between alcohol consumption and smoking status was observed for LR-HPV, but these findings should be interpreted cautiously. Further longitudinal studies are needed.