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YGBMSM have reported numerous barriers to HPV vaccination, including lack of knowledge about HPV and the HPV vaccine, concerns about vaccine safety, concerns about cost and/or health insurance, perceived stigma around the vaccine (eg, the vaccine is only for females), fear of potential health care discrimination, and lack of a health care provider recommendation to get vaccinated.
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Although HPV vaccine coverage may be slighter higher among GBMSM than among heterosexual men, the suboptimal coverage is still somewhat surprising, given that most GBMSM have expressed a willingness to get vaccinated. Studies have shown that about half or fewer YGBMSM have received any HPV vaccine doses, and fewer than 20% have received all recommended doses. ĭespite recommendations, HPV vaccine coverage is modest among young gay, bisexual, and other men who have sex with men (YGBMSM) in the United States. HPV vaccination is currently approved to prevent anal cancer and genital warts among males.
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The HPV vaccine series consists of 2 doses if it is initiated before the age of 15 years and 3 doses if it is initiated after the age of 15 years.
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The recent update also now recommends that adults aged 27 to 45 years make shared decisions with their doctors about getting the HPV vaccine. Before this recent update, catch-up vaccination was recommended only for males aged 13 to 21 years, although routine HPV vaccination was still recommended for men who have sex with men (including those who identify as gay or bisexual or who intend to have sex with men) through the age of 26 years. The ACIP now recommends routine HPV vaccination for both male and female adolescents aged 11 to 12 years and recently voted unanimously to support catch-up vaccination for persons through the age of 26 years who are not vaccinated. Īlthough the Advisory Committee on Immunization Practices (ACIP) began recommending routine HPV vaccination for females in the United States in 2006, routine vaccination was not recommended for males until 2011. Anal cancer incidence rates among GBMSM have ranged to more than 60 cases per 100,000 population, which is much higher than the national rate of about 2 cases per 100,000 population for men. Past research has shown that up to about 66% of GBMSM who are HIV negative have a current genital HPV infection, with prevalence estimates being even higher among those who are HIV positive. Several HPV-related disparities exist among gay, bisexual, and other men who have sex with men (GBMSM).
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Infection with oncogenic HPV types can cause several types of cancer among men (eg, anal, oropharyngeal, and penile cancers), and infection with nononcogenic types can cause genital warts. We will examine constructs from the intervention’s theoretical framework as potential mediators and demographic and health-related characteristics as potential moderators of intervention effects.Ībout 45% of men in the United States have a current genital infection with at least one type of human papillomavirus (HPV). Primary outcomes will include both HPV vaccine initiation (ie, receipt of 1 or more doses of the HPV vaccine) and completion (receipt of all 3 doses recommended for this age range). Participants will complete Web-based surveys at 4 time points during the study: baseline, immediately after engaging with Web-based content, 3 months after randomization, and 9 months after randomization. Participants will be recruited by means of paid advertisements on social media sites and randomized to receive (1) standard information on the Web about HPV vaccine (control group), (2) Outsmart HPV content on the Web with monthly unidirectional vaccination reminders sent via text messages, or (3) Outsmart HPV content on the Web with monthly interactive vaccination reminders sent via text messages. This study is a 3-arm prospective RCT that will enroll a projected 1995 YGBMSM who are aged 18 to 25 years, live in the United States, and have not received any doses of the HPV vaccine. Outsmart HPV was previously developed and pilot-tested.