AI Insight
One to two years after Quebec extended publicly-funded HPV vaccination to gay, bisexual, and other men who have sex with men (GBM) aged 26 or younger, vaccine coverage among eligible individuals in Greater Montreal reached only 42%. However, among those who disclosed their sexual orientation to a healthcare provider and discussed HPV vaccination, coverage rose substantially to 82%. Anal HPV prevalence was 26.5% for at least one vaccine-targeted genotype among eligible GBM, with no statistically significant difference observed between vaccinated and unvaccinated individuals, likely reflecting the early stage of program implementation.
Why it matters
These findings highlight that healthcare provider-patient communication about sexual orientation is a critical barrier to HPV vaccine uptake in GBM, and suggest that school-based preadolescent vaccination programs may be more effective at achieving population-level protection than targeted adult programs. Improving provider-level disclosure environments and expanding universal vaccination could meaningfully reduce HPV-related disease burden in this high-prevalence population.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Objectives In Quebec, Canada, vaccination against human papillomavirus (HPV) has been publicly-funded since January 2016 for gay, bisexual, and other men who have sex with men (GBM) aged [≤]26 years. The study aimed to analyze data collected in Greater Montreal (Engage study) to evaluate the HPV vaccination program for GBM in Quebec. Study Design Engage is a cohort of sexually active GBM aged [≥]16 recruited via respondent-driven-sampling (RDS) in Canada. Participants completed a questionnaire and tested for sexually transmitted infections. Methods RDS-II weights were applied to adjust for recruitment. Subgroups were compared using standardized mean differences. Odds ratios of HPV vaccination and prevalence ratios of anal HPV infection adjusted for potential confounders were estimated using robust regression models. Results Of 1179 participants, 309 were eligible for free HPV vaccination. Vaccine coverage among eligible GBM was 42%. Among those who disclosed same-sex sexual activity and discussed HPV vaccination with their healthcare provider, coverage reached 82%. Anal HPV prevalence among eligible GBM was 26.5% for [≥]1 HPV-6/11/16/18 genotypes without significant difference between vaccinated and unvaccinated individuals. Among unvaccinated GBM aged [≤]26 who were aware of the vaccine, 60% intended to get vaccinated within the next year. Conclusions One to two years after GBM aged [≤]26 were included in the Quebec HPV vaccination program, 42% of eligible GBM in Greater Montreal had been vaccinated. Anal HPV prevalence was high among GBM. Vaccinees were more likely to self-report a prior STI diagnosis. Offering vaccination to all preadolescents in schools appears essential to maximize vaccination benefits.