In the world of viruses, some announce their presence loudly—fever, cough, fatigue. Others? They slip in unnoticed, hitching a ride in the body’s most intimate moments, lingering in silence. Oral human papillomavirus (HPV) is one of these silent passengers. And in southwestern Kenya, a team of researchers is determined to expose its secrets.

A Mystery Worth Solving

For years, oral HPV has remained an enigma—especially in regions where HIV prevalence is high. While some strains cause no harm, others can lead to serious complications, including oropharyngeal cancers. Yet, in Kenya, we know very little about how oral HPV moves, who it targets, and whether HIV plays a role in its persistence.

The Oral HPV Study, launched in August 2022, is on a mission to change that.

Following the Trail: How the Study Works

At the Anza Mapema Centre of Excellence, researchers are tracking 398 men—199 living with HIV and 199 without—to map the journey of oral HPV in the human body. The goal? To uncover how often men acquire oral HPV, how long it lingers, and what makes some infections stick around longer than others.

The process starts with careful detective work:

🔹 Step 1: Gathering Clues – Men who are sexually active and unvaccinated for HPV are screened. Their medical histories, sexual behaviors, alcohol use, and overall health are recorded.

🔹 Step 2: Testing for the Suspect – Participants undergo HIV testing, viral load measurements, CD4 count assessments (for HIV-positive individuals), and oral swabs to detect HPV strains.

🔹 Step 3: Tracking Movements Over Time – Every six months for two years, participants return for follow-ups, allowing researchers to see whether HPV clears up or stubbornly persists.

The Big Questions

🔎 Who is most at risk? – Do HIV-positive men have a harder time clearing oral HPV than those who are HIV-negative?

🔎 What factors help HPV thrive? – Could immune suppression, specific sexual behaviors, or lifestyle choices make oral HPV infections more persistent?

🔎 Does antiretroviral therapy (ART) make a difference? – In HIV-positive men, does ART improve clearance rates or have no effect at all?

Why This Matters

Oral HPV may be silent, but its impact is anything but. With a rising number of HPV-related throat cancers worldwide, understanding its prevalence, persistence, and risk factors is crucial—especially for men already living with HIV.

This study, sponsored by MERCK, SHARP & DOHME, and approved by Kenya Medical Research Institute ERC, could provide life-saving insights. If researchers can pinpoint who is most at risk and why, interventions—like early screening, targeted education, and possibly even HPV vaccination for men—could be introduced to protect future generations.

What Comes Next?

The study is still ongoing, with follow-ups continuing through 2024. But when the results come in, they could reshape the way we approach oral HPV prevention and treatment in Kenya—turning whispers of infection into loud, evidence-backed action