Human papillomavirus vaccine uptake among young gay and bisexual men who have sex with men with a time-limited targeted vaccination programme through sexual health clinics in Melbourne in 2017

Abstract

ObjectiveIn mid-2017, the Victorian Government funded a free time-limited human papillomavirus (HPV) vaccination catch-up programme for gay and bisexual men who have sex with men (MSM) aged up to 26 years through sexual health clinics or other immunisation centres. We aimed to examine the uptake of the HPV vaccine among young MSM attending the Melbourne Sexual Health Centre (MSHC).MethodsMSM aged ≤26 attending MSHC between 27 April 2017 and 31 December 2017 were included in the analysis. HPV vaccine uptake was calculated based on the first consultation of each patient during the period. Multivariable logistic regression was performed to examine the association between vaccine uptake and patient factors.ResultsThere were 2108 MSM aged ≤26 who attended MSHC over the study period, with 7.6% (n=161) reporting previous HPV vaccination. Of the 1947 eligible men, 1134 (58.2%, 95% CI 56.0% to 60.4%) were offered the vaccine by the clinicians, and 830 men received it on the day. The vaccine coverage among all eligible MSM was 42.6% (95% CI 40.4% to 44.9%; 830 of 1947) and among MSM who were offered the vaccine by the clinicians was 73.2% (95% CI 70.5% to 75.8%; 830 of 1134). Men with a history of genital warts (adjusted OR (aOR)=3.11, 95%CI 1.39 to 6.99) and those who had >4male partners in the last 12 months (aOR=1.38, 95% CI 1.04 to 1.85) were more likely to receive the HPV vaccine on the day. 304 men declined the vaccine; most men did not specify the reason (31.3%, n=95), while 27.3% (n=83) needed time to think.ConclusionAlthough vaccine uptake was 73.2% among those offered, the actual coverage of those eligible remained unsatisfactory (42.6%) in a sexual health clinic. This highlights a clinic-based targeted MSM programme may not reach sufficiently high vaccine coverage to provide MSM with the same vaccine benefits as heterosexuals.

Hepatitis A vaccine uptake among men who have sex with men from a time-limited vaccination programme in Melbourne in 2018

“…Higher uptake may also be due to more regular contact with service, as men on PrEP return regularly for HIV/STI check-ups. A previous study also demonstrated that MSM taking PrEP were more likely to receive HPV vaccine than MSM who did not take PrEP 10. In addition, men who had a higher number of male partners are at higher risk of acquiring HAV, and our findings indicate that this group were more likely to receive the hepatitis A vaccine which will aid in preventing future outbreaks through their sexual networks.…”

“…All MSM in Victoria were eligible for the two-dose course of hepatitis A vaccine (Havrix 1440; GlaxoSmithKline), with the second dose given 6–12 months after the first dose 7. At the same time, the Victorian DHHS began to offer free meningococcal ACWY (Menactra; Sanofi) and human papillomavirus (HPV) (Gardasil; Merck & Co.) vaccines for eligible MSM, while an existing hepatitis B vaccination programme continued 7 10. The ‘Little Pricks’ campaign was launched in 2018 to increase the uptake of all four vaccines in MSM in Victoria, which was run by the Victorian DHHS in partnership with a community-based organisation Thorne Harbour Health (formerly Victorian AIDS Council).…”

Meningococcal vaccine uptake among men who have sex with men in response to an invasive meningococcal C disease outbreak in Melbourne, Australia

“…Our observation that MSM with more partners were more likely to receive the MenACWY vaccine fits with previous observations at our clinic with the HPV and hepatitis A vaccine, suggesting this core group is protected against the infection within wider sexual networks to prevent ongoing transmission 26 27. Our data show that MSM who have both male and female partners were less likely to receive the MenACWY vaccine, which was consistent with the HPV vaccine uptake 26. It is possible that men who have sex with men and women may consider themselves to have a lower risk of acquiring IMD compared with men who have sex with men only, but further research will be required to confirm this.…”

“…During the same time period, two other vaccines (ie, human papillomavirus (HPV) and hepatitis A) were also provided for free to eligible MSM as part of the government-funded vaccination programme in Victoria 26 27. Our observation that MSM with more partners were more likely to receive the MenACWY vaccine fits with previous observations at our clinic with the HPV and hepatitis A vaccine, suggesting this core group is protected against the infection within wider sexual networks to prevent ongoing transmission 26 27. Our data show that MSM who have both male and female partners were less likely to receive the MenACWY vaccine, which was consistent with the HPV vaccine uptake 26.…”

Human papillomavirus vaccination and sexual practices among men who have sex with men in Melbourne, Australia: a cross-sectional study

“…8 Therefore, MSM who are not eligible for the school-based vaccination programme have to pay for the vaccination. In mid-2017, the Victorian State Government introduced a free time-limited targeted HPV vaccination programme for MSM aged up to 26 years, 9 and it is estimated that about 43% of unvaccinated MSM aged 20–26 years had any quadrivalent vaccine-preventable genotypes detected at the anus before receiving the first dose of the HPV vaccine. 10…”