TL;DR: HPV vaccine acceptability was high among gay and bisexual men, and these findings identify potentially important beliefs and attitudes for future communication efforts about HPV and HPV vaccine among gay or bisexual men.
Abstract: Objective: Due to higher rates of human papillomavirus (HPV) infection and anal cancer among gay and bisexual men, we aimed to characterize their willingness to get HPV vaccine and identify correlates of vaccine acceptability. Methods: We surveyed a national sample of men aged 18 to 59 who self-identified as either gay (n 236) or bisexual (n 70) during January 2009. We analyzed data using multivariate logistic regression. Results: Most men had heard of HPV vaccine (73%, 224/306) and were willing to get it (74%, 225/306). HPV vaccine acceptability was higher among men who believed their doctor would recommend getting the vaccine (OR 12.87, 95% CI: 4.63‐35.79) and those who were unsure (OR 3.15, 95% CI: 1.47‐6.76), as compared to men who believed their doctor would not recommend it. Acceptability was also higher among men who reported 5 or more lifetime sexual partners (OR 3.39, 95% CI: 1.34‐8.55), perceived greater severity of HPVrelated disease (OR 1.92, 95% CI: 1.18‐3.14), perceived higher levels of HPV vaccine effectiveness (OR 1.97, 95% CI: 1.27‐3.06), or reported higher levels of anticipated regret if they did not get vaccinated and later developed an HPV infection (OR 2.39, 95% CI: 1.57‐3.61). Conclusions: HPV vaccine acceptability was high among gay and bisexual men. These findings identify potentially important beliefs and attitudes for future communication efforts about HPV and HPV vaccine among gay and bisexual men.
TL;DR: HPV vaccine acceptability for an adolescent daughter was associated with women's beliefs about their own healthcare needs and insights can inform future health communication activities intended to increase vaccination uptake in other high-risk populations of rural Southern women.
Abstract: Background: Although cervical cancer rates in the United States are highest in Southern and rural areas, research on human papillomavirus (HPV) vaccine acceptability has focused on other geographic areas. Methods: To address this gap, we surveyed women from a rural area in North Carolina with elevated rates of cervical cancer to identify predictors of HPV vaccine acceptability for themselves and their daughters. Results: One hundred forty-six women completed questionnaires about HPV infection, cervical cancer, and HPV vaccination. The majority (62%) of respondents were African American. Most respondents intended to vaccinate an adolescent daughter against HPV. Older and African American women reported lower vaccination intentions. Higher intentions to vaccinate an adolescent daughter against HPV were associated with knowing more about HPV, believing that HPV infection and cervical cancer are both likely and have negative consequences, and believing that the HPV vaccine is effective against cervic...
Cites background from "Acceptability of HPV vaccine among ..."
...Age, years 42 (15) Raceb African American 91 (62) White 47 (32) American Indian 3 (2) Not stated 5 (3) Education High school diploma 83 (57) Completed some college 63 (43) or a technical degree Married 60 (41) Had children 124 (85) Employed 64 (44) Insured 109 (75) Sufficient finances 78 (53) History of HPV-related 20 (14) cervical abnormality Had HPV infection 8 (5) Had cancer-causing HPV 10 (7) infection Had genital warts 11 (8) Had cervical cancer 6 (4) Recruited at public clinic 118 (81)...
TL;DR: HPV vaccine uptake was nearly nonexistent a year after permissive national recommendations were first issued for males, and efforts to increase vaccine uptake among adolescent males should consider the important role of peer acceptance and anticipated regret.
Abstract: In 2009, the United States approved quadrivalent HPV vaccine for males 9–26 years old, but data on vaccine uptake are lacking. We determined HPV vaccine uptake among adolescent males, as well as stage of adoption and vaccine acceptability to parents and their sons. A national sample of parents of adolescent males ages 11–17 years (n = 547) and their sons (n = 421) completed online surveys during August and September 2010. Analyses used multivariate linear regression. Few sons (2%) had received any doses of HPV vaccine, and most parents and sons were unaware the vaccine can be given to males. Parents with unvaccinated sons were moderately willing to get their sons free HPV vaccine (mean = 3.37, SD = 1.21, possible range 1–5). Parents were more willing to get their sons vaccinated if they perceived higher levels of HPV vaccine effectiveness (β = 0.20) or if they anticipated higher regret about their sons not getting vaccinated and later developing an HPV infection (β = 0.32). Vaccine acceptability was also modest among unvaccinated sons (mean = 2.98, SD = 1.13, possible range 1–5). Sons were more willing to get vaccinated if they perceived higher peer acceptance of HPV vaccine (β = 0.39) or anticipated higher regret about not getting vaccinated and later developing an HPV infection (β = 0.22). HPV vaccine uptake was nearly nonexistent a year after permissive national recommendations were first issued for males. Vaccine acceptability was moderate among both parents and sons. Efforts to increase vaccine uptake among adolescent males should consider the important role of peer acceptance and anticipated regret.
Cites result from "Acceptability of HPV vaccine among ..."
...Our results are similar to previous HPV vaccine acceptability studies among males (pre-vaccine licensure) [19,21,22] and females [49,50], as well as studies examining HPV vaccine uptake among females [29,51,52]....
TL;DR: Public health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men.
Abstract: Objective To understand rates of human papillomavirus (HPV) vaccine acceptability and factors correlated with HPV vaccine acceptability. Design Meta-analyses of cross-sectional studies. Data sources We used a comprehensive search strategy across multiple electronic databases with no date or language restrictions to locate studies that examined rates and/or correlates of HPV vaccine acceptability. Search keywords included vaccine, acceptability and all terms for HPV. Review methods We calculated mean HPV vaccine acceptability across studies. We conducted meta-analysis using a random effects model on studies reporting correlates of HPV vaccine acceptability. All studies were assessed for risk of bias. Results Of 301 identified studies, 29 were included. Across 22 studies (n=8360), weighted mean HPV vaccine acceptability=50.4 (SD 21.5) (100-point scale). Among 16 studies (n=5048) included in meta-analyses, perceived HPV vaccine benefits, anticipatory regret, partner thinks one should get vaccine and healthcare provider recommendation had medium effect sizes, and the following factors had small effect sizes on HPV vaccine acceptability: perceived HPV vaccine effectiveness, need for multiple shots, fear of needles, fear of side effects, supportive/accepting social environment, perceived risk/susceptibility to HPV, perceived HPV severity, number of lifetime sexual partners, having a current sex partner, non-receipt of hepatitis B vaccine, smoking cigarettes, history of sexually transmitted infection, HPV awareness, HPV knowledge, cost, logistical barriers, being employed and non-white ethnicity. Conclusions Public health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men. Future investigations employing rigorous designs, including intervention studies, are needed to support effective HPV vaccine promotion among men.
TL;DR: Vaccination against HPV remained low in this study and willingness to vaccinate may be decreasing, and physician recommendation and education about HPV vaccine for males may be key strategies for improving vaccination.
Abstract: Objectives. We conducted a longitudinal study to examine human papillomavirus (HPV) vaccine uptake among male adolescents and to identify vaccination predictors.Methods. In fall 2010 and 2011, a national sample of parents with sons aged 11 to 17 years (n = 327) and their sons (n = 228) completed online surveys. We used logistic regression to identify predictors of HPV vaccination that occurred between baseline and follow-up.Results. Only 2% of sons had received any doses of HPV vaccine at baseline, with an increase to 8% by follow-up. About 55% of parents who had ever received a doctor’s recommendation to get their sons HPV vaccine did vaccinate between baseline and follow-up, compared with only 1% of parents without a recommendation. Fathers (odds ratio = 0.29; 95% confidence interval = 0.09, 0.80) and non-Hispanic White parents (odds ratio = 0.29; 95% confidence interval = 0.11, 0.76) were less likely to have vaccinated sons. Willingness to get sons HPV vaccine decreased from baseline to follow-up among...
TL;DR: The attitudes of parents, young men, and HCPs toward HPV vaccination and other sexually transmitted infections (STI) appear that parents are interested in vaccinating their sons against HPV and other STI, and adolescent and adult males areinterested in receipt of HPV vaccine and other vaccines for prevention of STI.
Abstract: The quadrivalent vaccine has been shown to be safe and efficacious against HPV infection in men. It is expected, though, that male vaccination rates will remain low. Therefore this literature review examines the attitudes of parents, young men, and HCPs toward HPV vaccination and other sexually transmitted infections (STI). It appears that parents are interested in vaccinating their sons against HPV and other (STI). In addition, adolescent and adult males are interested in receipt of HPV vaccine and other vaccines for prevention of STI. Health care providers have a general preference for vaccinating females, but they indicate a willingness to recommend HPV vaccine for their male patients. This is important given the "permissive" recommendation for male HPV vaccination issued by the US Advisory Committee on Immunization Practices (ACIP). Cost effectiveness studies have shown that vaccinating males and females is less cost effective than vaccinating females alone. With low female vaccination rates, both cost effectiveness and health benefits increase. It is clear that males have poor knowledge of HPV infection, morbidity, transmission and prevention. Regardless of vaccination strategies adopted, efforts should be made to educate males about HPV and its health implications. In addition, there are more challenges to overcome before male vaccination can be successfully implemented.
Abstract: These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States. Genital HPV is the most common sexually transmitted infection in the United States; an estimated 6.2 million persons are newly infected every year. Although the majority of infections cause no clinical symptoms and are self-limited, persistent infection with oncogenic types can cause cervical cancer in women. HPV infection also is the cause of genital warts and is associated with other anogenital cancers. Cervical cancer rates have decreased in the United States because of widespread use of Papanicolaou testing, which can detect precancerous lesions of the cervix before they develop into cancer; nevertheless, during 2007, an estimated 11,100 new cases will be diagnosed and approximately 3,700 women will die from cervical cancer. In certain countries where cervical cancer screening is not routine, cervical cancer is a common cancer in women. The licensed HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. No evidence exists of protection against disease caused by HPV types with which females are infected at the time of vaccination. However, females infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types. The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.
TL;DR: HPV vaccine programs in the United States should emphasize high vaccine effectiveness, the high likelihood of HPV infection, and physicians' recommendations, and address barriers to vaccination.
Abstract: Objective. To inform future human papillomavirus (HPV) vaccination programs, we systematically reviewed studies of HPV-related beliefs and HPV vaccine acceptability, organizing the findings using health behavior theory and cervical cancer risk factors. Methods. We searched Medline, CINAHL, and PsycINFO from 1995 to January, 2007 for studies of HPV beliefs and HPV vaccine acceptability among adolescents, young adults, and parents of adolescents in the United States. Results. We identified 28 studies. Most were small, cross-sectional studies of parents and adults. Most parents reacted positively to the possibility of vaccinating their daughters against HPV. Vaccination acceptability was higher when people believed the vaccine was effective, a physician would recommend it, and HPV infection was likely. Cost and, for 6% to 12% of parents, concerns that vaccination would promote adolescent sexual behavior were barriers to vaccination. African American, Hispanic, and white respondents were equally accepting of the HPV vaccine. Parents with lower levels of education reported higher vaccine acceptability. Many studies inadequately reported on other variables associated with cervical cancer mortality. Conclusions. HPV vaccine programs in the United States should emphasize high vaccine effectiveness, the high likelihood of HPV infection, and physicians' recommendations, and address barriers to vaccination.
TL;DR: It was found that in men, a history of receptive anal intercourse (related to homosexual behavior) was strongly associated with the occurrence of anal cancer (relative risk, 33.1; 95 percent confidence interval, 4.0 to 272.1).
Abstract: To elucidate the risk factors for anal cancer, we interviewed and obtained blood specimens from 148 persons with anal cancer and from 166 controls with colon cancer in whom these diseases were diagnosed during 1978-1985. We found that in men, a history of receptive anal intercourse (related to homosexual behavior) was strongly associated with the occurrence of anal cancer (relative risk, 33.1; 95 percent confidence interval, 4.0 to 272.1). Anal intercourse was only weakly associated with the risk of anal cancer in women (relative risk, 1.8; 95 percent confidence interval, 0.7 to 4.2). Among the subjects with squamous-cell anal cancer, 47.1 percent of homosexual men, 28.6 percent of heterosexual men, and 28.3 percent of women gave a history of genital warts, as compared with only 1 to 2 percent of controls and no patients with transitional-cell anal cancer. In patients without a history of warts, anal cancer was associated with a history of gonorrhea in heterosexual men (relative risk, 17.2; 95 percent confidence interval, 2.0 to 149.4) and with seropositivity for herpes simplex type 2 (relative risk, 4.1; 95 percent confidence interval, 1.9 to 8.8) and Chlamydia trachomatis (relative risk, 2.3; 95 percent confidence interval, 1.1 to 4.8) in women. Current cigarette smoking was a substantial risk factor in both women (relative risk, 7.7; 95 percent confidence interval, 3.5 to 17.2) and men (relative risk, 9.4; 95 percent confidence interval, 2.3 to 38.5). We conclude that homosexual behavior in men is a risk factor for anal cancer, and that squamous-cell anal cancer is also associated with a history of genital warts, an association suggesting that papillomavirus infection is a cause of anal cancer. Certain other genital infections and cigarette smoking are also associated with anal cancer.
TL;DR: HPV infection is highly prevalent in sexually active men and can be detected by use of a variety of specimens and methods, including site- or specimen-specific HPV DNA detection.
Abstract: BACKGROUND Human papillomavirus (HPV) infection is estimated to be the most common sexually transmitted infection; an estimated 62 million persons are newly infected every year in the United States There are limited data on HPV infection in heterosexual men METHODS We conducted a systematic review of the literature by searching MEDLINE using the terms "human papillomavirus," "HPV," "male," "seroprevalence," and "serology" to retrieve articles published from 1 January 1990 to 1 February 2006 We included studies that had data on population characteristics and that evaluated male genital anatomic sites or specimens for HPV DNA or included assessments of seropositivity to HPV type 6, 11, 16, or 18 in men We excluded studies that had been conducted only in children or immunocompromised persons (HIV infected, transplant recipients, or elderly) RESULTS We included a total of 40 publications on HPV DNA detection and risk factors for HPV in men; 27 evaluated multiple anatomic sites or specimens, 10 evaluated a single site or specimen, and 3 evaluated risk factors or optimal anatomic sites/specimens for HPV detection Twelve studies assessed site- or specimen-specific HPV DNA detection HPV prevalence in men was 13%-729% in studies in which multiple anatomic sites or specimens were evaluated; 15 (56%) of these studies reported > or =20% HPV prevalence HPV prevalence varied on the basis of sampling, processing methods, and the anatomic site(s) or specimen(s) sampled We included 15 publications reporting HPV seroprevalence Rates of seropositivity depended on the population, HPV type, and methods used In 9 studies that evaluated both men and women, all but 1 demonstrated that HPV seroprevalence was lower in men than in women CONCLUSION HPV infection is highly prevalent in sexually active men and can be detected by use of a variety of specimens and methods There have been few natural-history studies and no transmission studies of HPV in men The information that we have reviewed may be useful for future natural-history studies and for modeling the potential impact of a prophylactic HPV vaccine