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Shah A, Meites E, Lin J, Hughes JP, Gorbach PM, Mustanski B, Crosby RA, Unger ER, Querec T, Golden M, Markowitz LE, Winer RL. Determinants of Type-Specific Human Papillomavirus Concordance Across Anatomic Sites in Young Men Who Have Sex With Men and Transgender Women, 3 U.S. Cities, 2016-2018. Sex Transm Dis 2024; 51:260-269. [PMID: 38534083 PMCID: PMC10977647 DOI: 10.1097/olq.0000000000001926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Among men who have sex with men (MSM) and transgender women (TGW), the dynamics of human papillomavirus (HPV) infections at different anatomical sites are not well understood. Information on HPV concordance between anatomic sites can inform the extent of autoinoculation, and susceptibility of different anatomic areas to HPV infection. We described and assessed correlates of HPV concordance across anal, oral, and genital samples. METHODS We enrolled 1876 MSM and TGW aged 18 to 26 years in 3 US cities. Oral, genital, and anal samples were self-collected for type-specific HPV DNA testing (37 types). Demographics, sexual behaviors, and health history were self-reported. Kappa statistics based on percent positive agreement (kappa+) and generalized estimating equations were used to describe and identify correlates of HPV type-specific concordance between anatomic sample pairs. RESULTS Any HPV was detected in 69.9%, 48.6%, and 7.4% of anal, genital, and oral samples, respectively. Detection of any HPV (concurrence) was most common in anal-genital pairs (40.9%) and uncommon in oral-genital and oral-anal pairs (3.4% and 6.5% respectively). Type-specific concordance was poor across all sample pairs (kappa+ <0.20). Younger age and older age at first sex were positively associated with type-concordant anal-genital infections. Sexual behaviors were unassociated with concordance. CONCLUSIONS Poor oral/anogenital concordance suggests the oral mucosa has different susceptibility to HPV infection, differential clearance and/or autoinoculation between oral and anogenital sites is unlikely. There was some observed concurrence and concordance between anal and genital sites, unassociated with sexual behavior, suggesting autoinoculation. Longitudinal studies are necessary to further elucidate mechanisms of multisite infections.
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Affiliation(s)
- Adeel Shah
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
| | - Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - John Lin
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
| | - James P. Hughes
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing and Department of Medical Social Sciences, Northwestern University and Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Troy Querec
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew Golden
- Center for AIDS & STD, University of Washington, Seattle, WA
| | - Lauri E. Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rachel L. Winer
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
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Wei L, Huang K, Han H, Liu RY. Human Papillomavirus Infection in Penile Cancer: Multidimensional Mechanisms and Vaccine Strategies. Int J Mol Sci 2023; 24:16808. [PMID: 38069131 PMCID: PMC10706305 DOI: 10.3390/ijms242316808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Penile cancer (PC) is a rare male malignant tumor, with early lymph node metastasis and poor prognosis. Human papillomavirus (HPV) plays a key role in the carcinogenesis of PC. This review aims to summarize the association between HPV infection and PC in terms of virus-host genome integration patterns (the disrupted regions in the HPV and PC genome), genetic alterations, and epigenetic regulation (methylation and microRNA modification) occurring in HPV and PC DNA, as well as tumor immune microenvironment reprogramming. In addition, the potential of HPV vaccination strategies for PC prevention and treatment is discussed. Understanding of the HPV-related multidimensional mechanisms and the application of HPV vaccines will promote rational and novel management of PC.
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Affiliation(s)
- Lichao Wei
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Kangbo Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Hui Han
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ran-yi Liu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
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Ellingson MK, Sheikha H, Nyhan K, Oliveira CR, Niccolai LM. Human papillomavirus vaccine effectiveness by age at vaccination: A systematic review. Hum Vaccin Immunother 2023; 19:2239085. [PMID: 37529935 PMCID: PMC10399474 DOI: 10.1080/21645515.2023.2239085] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023] Open
Abstract
Human papillomavirus (HPV) vaccines work by preventing infections prior to natural exposure. Thus, it is likely more effective at younger ages, and it is important to understand how effectiveness might be diminished when administered at older ages. We conducted a systematic review of HPV vaccine effectiveness studies published between 2007 and 2022 that included an analysis of effectiveness against vaccine-type HPV infections, anogenital warts, cervical abnormalities and cervical cancer by age at vaccine initiation or completion. Searching multiple databases, 21 studies were included and results were summarized descriptively. Seventeen studies found the highest vaccine effectiveness in the youngest age group. Vaccine effectiveness estimates for younger adolescents ages 9-14 years ranged from approximately 74% to 93% and from 12% to 90% for adolescents ages 15-18 years. These results demonstrate that the HPV vaccine is most effective against HPV-related disease outcomes when given at younger ages, emphasizing the importance of on-time vaccination.
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Affiliation(s)
- Mallory K. Ellingson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, USA
| | - Hassan Sheikha
- Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, USA
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, USA
| | - Carlos R. Oliveira
- Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, USA
- Department of Biomedical Informatics and Data Science, Yale School of Medicine, Yale University, New Haven, USA
| | - Linda M. Niccolai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, USA
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Li Y, Lin YF, Wu X, Zhou X, Tian T, Guo Z, Fu L, Yang L, Lu Z, Fan S, Lu Y, Ke W, Zou H. Effectiveness and cost-effectiveness of human papillomavirus vaccination strategies among men who have sex with men in China: a modeling study. Front Immunol 2023; 14:1197191. [PMID: 37426648 PMCID: PMC10324564 DOI: 10.3389/fimmu.2023.1197191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The health and economic benefits of human papillomavirus (HPV) vaccination targeted at men who have sex with men (MSM) in developing settings have been rarely assessed. This study aimed to evaluate the effectiveness and cost-effectiveness of different HPV vaccination strategies among MSM in China. Methods A Markov model was developed to simulate HPV transmission dynamics among a total of 30.73 million MSM in China. The corresponding natural history included 6 states: susceptible, infected with low-risk subtypes, high-risk subtypes, anogenital warts and anal cancer, and deaths from anal cancer. MSM were divided into three age groups with cut-off points of 27 and 45 years. Alternative vaccination strategies were built by allocating bivalent, quadrivalent, nine-valent, or no vaccine to each of the groups. We generated the prevented infections and deaths by vaccination compared with baseline (no vaccination) and calculated incremental cost-effectiveness ratios (ICERs) to determine the optimal strategy. Results The model showed that in 10 years, at baseline, the existing cases of anogenital warts would reach 5,464,225 (IQR, 4,685,708-6,174,175); that of anal cancer would reach 1,922.95 (1,716.56-2,119.93), resulting in 940.55 (732.27-1,141.87) deaths. Under 50% vaccination coverage among one age group, the prevented cases of anogenital warts were maximized with quadrivalent vaccines allocated to MSM aged 27-45 years; that of anal cancer were maximized when offering nine-valent vaccines to the same group. Under 50% vaccination coverage among all groups, the lowest ICER (34,098.09 USD/QALY, 31,146.54-37,062.88) was reached when only quadrivalent vaccines were provided. Based on this strategy, when the annual vaccination rate increased by 30%, the ICER (33,521.75 USD/QALY, 31,040.73-36,013.92) would fall below three times China's per capita GDP. When the vaccine price decreased by 60%, the ICER was reduced to 7,344.44 USD/QALY (4,392.89-10,309.23), indicating good cost-effectiveness taking China's per capita GDP as a threshold. Conclusions HPV vaccination can effectively reduce the prevalence and mortality of related diseases among MSM in China, especially quadrivalent vaccines for anogenital warts and nine-valent vaccines for anal cancer. MSM aged 27-45 years were the optimal group for vaccination. Annual vaccination and appropriate adjustment of vaccine price are necessary to further improve the cost-effectiveness.
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Affiliation(s)
- Yuwei Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yi-Fan Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinsheng Wu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xinyi Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zhihui Guo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Luoyao Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Song Fan
- School of Public Health, Southwest Medical University, Sichuan, China
| | - Yong Lu
- College of Public Health and Health Professions, Guizhou Medical University, Guizhou, China
| | - Wujian Ke
- Department of Sexually Transmitted Disease (STD) Clinic, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia
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Pan H, He W, Lin B, Zhong X. Factors influencing HPV vaccination willingness among men who have sex with men in China: a structural equation modeling analysis. Hum Vaccin Immunother 2022; 18:2038504. [PMID: 35275513 PMCID: PMC9009954 DOI: 10.1080/21645515.2022.2038504] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Men who have sex with men (MSM) are at high risk of infection with human papillomavirus (HPV). Some countries have incorporated MSM into their HPV vaccination strategies. The acceptance of the HPV vaccine is an important factor affecting vaccine promotion in MSM. This study aims to analyze the factors influencing HPV vaccination willingness among MSM in China. Non-probability sampling was used to recruit MSM in China in June 2021. The information collected included demographic characteristics, HPV knowledge, attitude, behavior, history of sexually transmitted diseases (STDs), and HPV vaccination intention. A structural equation model was used to analyze the data based on the theory of knowledge-attitude-behavior. Among 889 participants, 736 (82.79%) of the MSM were willing to receive the HPV vaccine. The results of the structural equation model showed that knowledge, attitude, behavior, and STD history influenced the vaccination intention, of which knowledge (total effect of .36) and attitude (total effect of .31) had the greatest influence. Since most MSM in China were willing to be vaccinated against HPV, they should be considered for inclusion in the HPV vaccination program. Enhancing HPV awareness and improving risk awareness may be useful in increasing the vaccination willingness of MSM in China.
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Affiliation(s)
- Haiying Pan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Wei He
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Bing Lin
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
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Meites E, Wilkin TJ, Markowitz LE. Review of human papillomavirus (HPV) burden and HPV vaccination for gay, bisexual, and other men who have sex with men and transgender women in the United States. Hum Vaccin Immunother 2022; 18:2016007. [PMID: 35294325 PMCID: PMC8993076 DOI: 10.1080/21645515.2021.2016007] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Gay, bisexual, and other men who have sex with men (MSM) and transgender women, particularly those who are living with HIV, are disproportionately affected by human papillomavirus (HPV). For this narrative review of HPV health outcomes and vaccination for gay, bisexual, and other MSM and transgender women in the United States, we highlighted 71 publications regarding 1) burden of HPV infections and related diseases; 2) HPV vaccine efficacy; 3) HPV vaccination recommendations; 4) HPV vaccination coverage; 5) real-world vaccine effectiveness and health impacts; and 6) HPV vaccination acceptability. Vaccination is effective at reducing HPV infections among MSM; in the United States, routine HPV vaccination is recommended for all adolescents at age 11-12 years and for all persons through age 26 years. Efforts are ongoing to increase vaccination coverage and monitor health impacts of vaccination. Increasing vaccination coverage before sexual exposure to HPV is expected to reduce the burden of HPV-related disease.
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Affiliation(s)
- Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy J Wilkin
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA
| | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Pleuhs B, Walsh JL, Quinn KG, Petroll AE, Nyitray A, John SA. Uptake of Human Papillomavirus Vaccination by HIV Status and HIV Pre-exposure Prophylaxis (PrEP) Care Engagement Among Young Sexual Minority Men 17-24 Years Old in the USA. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:1944-1953. [PMID: 36687804 PMCID: PMC9857745 DOI: 10.1007/s13178-022-00740-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 05/09/2023]
Abstract
Introduction HIV and human papillomavirus (HPV) are common sexually transmitted infections among young sexual minority men (YSMM) that are prevented by pre-exposure prophylaxis (PrEP) and HPV vaccination, respectively. We sought to determine the association between a history of PrEP use and HPV vaccination uptake among YSMM. Methods Data were collected from an online survey of YSMM (n = 287; M age = 20.6 years, range: 17-24; 58% Black or Latinx) recruited from social media and men-for-men geosocial networking apps in 2020 and analyses were conducted using chi-squared comparisons and Poisson regression using STATA (IC) version 15.1. Results About half (45.0%) of YSMM reported receiving at least one dose of the HPV vaccine. Controlling for other factors, YSMM who were living with HIV or had used PrEP were significantly more likely to have received at least one dose of an HPV vaccine (PR = 2.48, 95% CI = 1.52-4.07; PR = 1.70, 95% CI = 1.26-2.31, respectively). Conclusions YSMM living with HIV or with PrEP use experience reported higher rates of HPV vaccination compared to their counterparts, potentially due to greater utilization of health care or contacts with providers attuned to their health needs. Nevertheless, HPV vaccination uptake is suboptimal given the high prevalence of high-risk HPV genotypes among YSMM. Policy Implications Standard of care for YSMM should include revisiting HPV vaccination status and discussion of PrEP and other HIV prevention methods given suboptimal rates of HPV and PrEP uptake among this priority population for HPV vaccination, anal cancer, and HIV prevention.
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Affiliation(s)
- Benedikt Pleuhs
- Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jennifer L. Walsh
- Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katherine G. Quinn
- Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andrew E. Petroll
- Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alan Nyitray
- Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven A. John
- Center for AIDS Intervention Research (CAIR), Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Chen Q, Zhou T, Zhong X. Factors Related to HPV Vaccination Intention among MSM in China: A Bayesian Network Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15532. [PMID: 36497608 PMCID: PMC9735536 DOI: 10.3390/ijerph192315532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection, and HPV vaccination is the best strategy to prevent HPV infection. Accepting HPV vaccination is an essential factor affecting vaccine promotion among MSM. We aimed to explore the factors related to HPV vaccination intention among MSM and analyze the potential relationship between these factors. (2) Methods: We adopted a nonprobability sampling method to recruit MSM volunteers. Information collection included general demographics, personal behavioral characteristics, knowledge of HPV/vaccine attitudes, and risk threat perception. Bayesian networks (BNs) were used to analyze the data statistically. (3) Results: The BNs showed that perceived HPV risk and attitudes toward vaccine promotion were directly correlated factors, whereas knowledge of HPV/vaccines, a history of HIV testing, and the number of male sexual partners in the past 6 months were indirectly correlated factors. (4) Conclusions: The results of this study illustrate that MSM have a relatively high propensity to receive HPV vaccines. The proposal that strengthening the propagation of HPV and its relevant vaccines, encouraging MSM to undergo regular corresponding tests, and improving their risk perception of HPV infection can be raised to promote HPV vaccination among MSM.
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PREVALENCE AND RISK FACTORS OF ANAL HPV INFECTION IN MSM LIVING WITH HIV: IDENTIFYING THE TARGET GROUPS TO PRIORITIZE FOR IMMUNIZATION. J Acquir Immune Defic Syndr 2022; 91:226-231. [DOI: 10.1097/qai.0000000000003057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/05/2022] [Indexed: 11/25/2022]
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10
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The Role of Healthcare Providers in Promoting Human Papillomavirus Vaccines among Men Who Have Sex with Men: A Scoping Review. Vaccines (Basel) 2022; 10:vaccines10060930. [PMID: 35746537 PMCID: PMC9231301 DOI: 10.3390/vaccines10060930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 02/08/2023] Open
Abstract
Background: The uptake of human papillomavirus vaccines (HPVV) among men who have sex with men (MSM) remains unsatisfactory. Healthcare providers play a crucial role in improving HPVV acceptability and uptake among MSM. This scoping review aims to provide an overview of (1) the perceived role of healthcare providers by MSM, and (2) the knowledge, beliefs and practices of healthcare providers themselves in promoting HPVV uptake. Methods: A literature search was performed with PubMed and Scopus databases using a specific search string. The relevant original research articles on this topic were identified, and the major findings were charted and discussed. Results: The literature search identified 18 studies on the perceived role of healthcare providers by MSM, and 6 studies on the knowledge, beliefs and practices of healthcare providers in promoting HPVV uptake among MSM. Recommendations by healthcare providers and disclosure of sexual orientation were important positive predictors of higher HPVV acceptability and uptake. Sexual healthcare providers were more confident in delivering HPVV to MSM clients compared to primary practitioners. Conclusion: Recommendation from, and disclosure of sexual orientation to healthcare providers are important in promoting HPVV uptake among MSM. The competency of healthcare providers in delivering HPVV to MSM can be improved by having clearer guidelines, education campaigns and better incentives.
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Amiling R, Winer RL, Newcomb ME, Gorbach PM, Lin J, Crosby RA, Mustanski B, Markowitz LE, Meites E. Human papillomavirus vaccination coverage among young, gay, bisexual, and other men who have sex with men and transgender women - 3 U.S. cities, 2016-2018. Hum Vaccin Immunother 2021; 17:5407-5412. [PMID: 35213950 PMCID: PMC8904010 DOI: 10.1080/21645515.2021.2005436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Gay, bisexual, and other men who have sex with men (MSM) and transgender women are disproportionately affected by human papillomavirus (HPV). HPV vaccination is routinely recommended for U.S. adolescents at age 11-12 years, with catch-up vaccination through age 26 years. We assessed HPV vaccination coverage and associated factors among young MSM and transgender women. The Vaccine Impact in Men study enrolled MSM aged 18-26 years from clinics in Seattle, Chicago, and Los Angeles, during February 2016-September 2018. Participants self-reported socio-demographic information and HPV vaccination status. Among 1416 participants, 673 (47.5%) reported ≥1 HPV vaccine dose. Among vaccinated participants, median age at first dose was 19 years and median age at first sex was 17 years; 493 (73.3%) reported that their age at first dose was older than their age at first sex. There were significant differences in HPV vaccination coverage by city (range 33%-62%), age, race/ethnicity, and gender identity. Coverage was highest in Seattle, where younger age was the only factor associated with vaccination. Differences in coverage by city may be due to variation in vaccination practices or enrollment at study sites. Increasing both routine and catch-up vaccination will improve coverage among MSM and transgender women.
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Affiliation(s)
- Raiza Amiling
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachel L. Winer
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Michael E. Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing and Department of Medical Social Sciences, Northwestern University and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA
| | - John Lin
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Richard A. Crosby
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing and Department of Medical Social Sciences, Northwestern University and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauri E. Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA,CONTACT Elissa Meites Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, H24-5, Atlanta, GA30329-4027, USA
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