Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Krystle Kuhs

Committee Member

Thomas Tucker

Committee Member

Jaclyn McDowell


Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). Based on mean fluorescence intensity (MFI), HPV16 E6 seroprevalence was further evaluated by moderate (MFI ≥484 and

Results: Seroreactivity against HPV16 L1 was most common (23.01%), followed by HPV16 E4 (10.58%), HPV16 E6 (5.79%), HPV16 E2 (5.01%), and HPV16 E7 (4.11%). Of the 135 men with HPV16 E6 antibodies, 55 (2.36%) had moderate antibody levels and 80 (3.43%) had high antibody levels. HPV16 E6 seropositive men were more likely to be seroreactive against at least one other HPV16 protein (OR: 2.44 [95% CI: 1.72-3.47]; PPP

Conclusions: This is the largest study to date to evaluate HPV antibodies among men living with HIV and the only centered in the southeastern region – an area with the highest incidence of HPV-OPC in the nation. HPV16 E6 seroprevalence was elevated compared to prior studies in both in the general and HIV populations, likely reflecting the high incidence of HPV-OPC in this region.

Available for download on Tuesday, April 22, 2025