Klo - these are good questions. Regarding a delay in women catching up to men at some point in the future, my question would be; when compared to other viral infections which have no gender bias in incidence or latency of occurrence, why would this virus be any different? Remember what we know about this virus has been explored heavily in the cervical arena and there is no guarantee that that experience will transfer exactly to oral. For instance, we know that it can take upwards of a year for the immune system to clear an HPV16 infection from the cervix, but it certainly does it. Normal defenders of the mutation cascade in a cell that exist, (there are many but the most common would be p53 regulated apoptosis) are likely different in different cell types. One possibility that has be postulated is that HPV infections in the mouth will be cleared more quickly by the immune system than on the cervix because of the significantly shorter normal life span of cells in the oral mucosa and lymphoid tissues than of the cervix. Programed normal cell death time lines, could potentially influence the impact of a necessarily cellular cascade of events to malignancy, and that is a core component of our natural immunity to things.

Time line bias is certainly an issue in some cancers. The most published example is in men's prostate cancer. There is no evidence that in the diagnosed HPV+ OC patent population going back more than a decade that there is any gender based time line bias in oral HPV carcinogenesis. If there is a genetic protection based on gender, it hasn't been identified, and to my knowledge no one is looking at that in the research world as an area of exploration. (given that the cell types in both sexes are identical)

The couples issue is a different thing. First, the virus is only a freely circulating entity for a very short period of time, and it must enter a cell (become episomal) to survive. Even if and when that happens, that does not mean that the invasion will not trigger the immune response that destroys the cell and the contained virus. As stated earlier this happens in 99.1% of those that encounter the virus. Couples are still each unique biological entities, and just because one immune system defends against it or does not defend against it, is no guarantee that the partner will have exactly the same response to the virus. And since in 99.1% of the people that are exposed to the virus naturally clear it without incident, they will not be impacted by it, so how would they know that they have even been infected by it, unless they were also a person with no immune protection against it? There are only a couple of published cases of husband/wife oral HPV+ oral cancers ever documented�. So the mathematical probabilities of it occurring are not zero, but very very small. So in essence it likely does transfer between couples orally, both routinely and commonly, it just does not progress into a negative event.

The FDA cut off vaccinations for HPV at age 26. Why? Because they determined by that time/age everyone has been exposed to the versions of the virus that it protects against. The vaccine does not work in previously exposed individuals.