Human papillomavirus (HPV)-related head and neck malignancies are becoming more common, particularly among men. It is uncertain if reported sex epidemiological disparities are explained by variations in sexual exposure and/or immunological response. The seroprevalence of antibodies to HPV L1 capsid antigen was compared by patient characteristics in this cross-sectional, multi-institutional research of 374 adult patients without cancer. Women had a substantially greater seroprevalence of HPV16 and HPV18 L1 antibodies compared to males. After adjusting for a lifetime and recent sexual activity, this difference remained for HPV16. After adjusting for gender, HPV16 and HPV18 L1 seroprevalence were linked with a greater number of lifetime and recent oral sexual partners but not vaginal sexual partners. These findings might imply that women have a more strong immune response to HPV16/18 than males, which may not be explained by variations in the number of sexual partners, and therefore presumably HPV exposure. 

The independent relationship of HPV16/18 L1 seroprevalence with a greater number of oral sexual partners implies that the location of mucosal exposure may play a role in the HPV immune response.