# Evaluating immunity to oral human papillomavirus to understand the lower oropharyngeal cancer risk among MSM

> **NIH NIH R21** · UNIVERSITY OF MARYLAND BALTIMORE · 2021 · $247,642

## Abstract

Project Abstract
Oral human papillomavirus (HPV) is associated with 60-70% of oropharyngeal cancers (OPC), which are
highly preventable with vaccination prior to HPV exposure. Men who have sex with men (MSM) living with HIV
are at high risk for HPV, but they have a paradoxically low risk of OPC. It is hypothesized that repeated
mucosal exposures to HPV in the anal canal generates protective antibody responses, potentially preventing
oral HPV acquisition and persistence, resulting in a lower risk of OPC. It remains unclear whether site-specific
exposures contribute to systemic immunity and whether systemic immunity is correlated with differential
expression of HPV DNA between mucosal sites. The objective of this proposal is to test whether HPV-specific
antibodies are associated with oral and rectal mucosal exposures and whether type-specific immunity induced
by oral and rectal exposures protect the oral cavity from detectable HPV DNA. We are leveraging archived
samples collected cross-sectionally from 620 participants from a well characterized cohort (TRUST/RV368) of
MSM and transgender women in Nigeria to disentangle the interactions between mucosal site exposures,
systemic immunity, and oral HPV DNA detection. To achieve this goal, we address the following specific aims:
AIM 1: Quantify HPV type-specific immunity in relationship to mucosal exposure (penile, rectal, both oral and
rectal) indexed to self-reported sexual behavior; AIM 2: Compare the concordance between type-specific
serum antibodies with type-specific DNA detection in the oral cavity and anal canal. Findings will yield
information on type-specific immunity in the oral cavity and whether it has a differential effect on detection of
HPV DNA by mucosal site. With the oral cavity being an uncharacterized site of HPV modulation, our research
is key to the development of therapies that control oral HPV and prevent OPC.

## Key facts

- **NIH application ID:** 10401518
- **Project number:** 1R21DE031516-01
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Rebecca G. Nowak
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $247,642
- **Award type:** 1
- **Project period:** 2021-09-21 → 2023-09-21

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10401518

## Citation

> US National Institutes of Health, RePORTER application 10401518, Evaluating immunity to oral human papillomavirus to understand the lower oropharyngeal cancer risk among MSM (1R21DE031516-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10401518. Licensed CC0.

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