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Abstract
Objectives Men who have sex with men (MSM) are at greater risk for human papillomavirus (HPV)-associated cancers. Since 2016, MSM have been offered the HPV vaccination, which is most effective when received prior to sexual debut, at genitourinary medicine clinics in the UK. In September 2019, the national HPV vaccination programme will be extended to boys. This study aimed to understand young MSM’s (YMSM) knowledge and attitudes towards HPV vaccination.
Design Questionnaires assessed YMSM demographics, sexual behaviour, culture, knowledge and attitudes towards HPV vaccination and stage of vaccine decision-making using the precaution adoption process model. Focus groups explored sexual health information sources, attitudes, barriers and facilitators to vaccination and strategies to support vaccination uptake. Questionnaire data were analysed using descriptive statistics and focus group data were analysed thematically.
Setting Questionnaires were completed online or on paper. Focus groups were conducted within Lesbian Gay Bisexual Transgender Queer organisational settings and a university student’s union in England and Northern Ireland.
Participants Seventeen YMSM (M=20.5 years) participated in four focus groups and 51 (M=21.1 years) completed questionnaires.
Results Over half of YMSM were aware of HPV (54.9%), yet few (21.6%) had previously discussed vaccination with a healthcare professional (HCP). Thematic analyses found YMSM were willing to receive the HPV vaccine. Vaccination programmes requiring YMSM to request the vaccine, particularly prior to sexual orientation disclosure to family and friends, were viewed as unfeasible. Educational campaigns explaining vaccine benefits were indicated as a way to encourage uptake.
Conclusions This study suggests that to effectively implement HPV vaccination for YMSM, this population requires clearer information and greater discussion with their HCP. In support of the decision made by the Joint Committee on Vaccination and Immunisation, universal vaccination is the most feasible and equitable option. However, the absence of a catch-up programme will leave a significant number of YMSM at risk of HPV infection.
- HPV
- sexual health
- adolescent
- attitudes
- vaccination
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Footnotes
Contributors JMK, GP and ER-M drafted the manuscript and JMK led the analysis of the qualitative data supported by CF. CF conducted the focus groups and questionnaires. GP, JMK and SWDM conceived the research question. ZR’s research team developed the original questionnaires and use of the PAPM in college males and parents of young children eligible for the HPV vaccine (prior to adaption for MSM). GP led the research team. ER-M and GP conducted the analysis of the questionnaire data and led the writing of these sections of the paper. All coauthors (JMK, CF, ER-M, SWDM, TN, GS, ZR and GP) developed the research question, methodology and supported the management of the project. All authors (JMK, CF, ER-M, SWDM, TN, GS, ZR abd GP) have read, contributed to and approved the final manuscript.
Funding This study was funded by an Innovation award (#22091) from Cancer Research UK/BUPA Foundation. JMK is partly funded by National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West) at University Hospitals Bristol NHS Foundation Trust and NIHR Health Protection Research Unit in Evaluation of Interventions. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care. SWDM was the recipient of an academic clinical fellowship from NIHR. GS was supported by the Vanier Canada Graduate Scholarship and Queen Elizabeth II Diamond Jubilee Scholarship programmes.
Competing interests None declared.
Ethics approval This study was approved by the Queens University Belfast, School of Nursing and Midwifery Research Ethics Committee (39.GPrue.05.16.M8.V2). Written informed consent from each participant was obtained prior to participation in the focus groups.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
Patient consent for publication Not required.