Evaluation of a Text Messaging-Based Human Papillomavirus Vaccination Intervention for Young Sexual Minority Men: Results from a Pilot Randomized Controlled Trial

Abstract

Background Men who have sex with men (MSM) are at high risk for human papillomavirus (HPV) infection and HPV-related anal cancer. Although a safe and effective vaccine is available to prevent HPV infection, HPV vaccine uptake among young MSM remains low. Purpose This pilot randomized controlled trial tested the acceptability, feasibility, and preliminary efficacy of a text messaging-based HPV vaccination intervention for young sexual minority men. Methods In 2018, unvaccinated sexual minority men aged 18–25 years were recruited from Chicago to participate in a 9 month sexual health program called txt2protect. Participants (N = 150) were randomized to the intervention or control condition. Intervention condition messages focused primarily on HPV vaccination, with only a brief mention of other sexual health practices (e.g., condom use and HIV testing), while control condition messages focused on a variety of sexual health practices with only a brief mention of HPV vaccination. Participants received daily text messages for the first 3 weeks and monthly text messages for the remaining ~8 months of the trial. Participants completed surveys at baseline and 3 week and 9 month follow-ups. Results Participants reported high satisfaction with the intervention. Although trial retention was high (with over 88% completing the 9 month survey), the study fell short of meeting its recruitment goal. HPV vaccine series initiation was significantly higher among intervention participants (19.4%) compared to control participants (6.6%), odds ratio = 3.43, 95% confidence interval: 1.17, 10.08. Conclusions Findings suggest that txt2protect is an acceptable and potentially promising intervention for increasing HPV vaccine initiation among young sexual minority men. Clinical Trial Registration NCT02994108.

Two Web-Based and Theory-Based Interventions With and Without Brief Motivational Interviewing in the Promotion of Human Papillomavirus Vaccination Among Chinese Men Who Have Sex With Men: Randomized Controlled Trial

“…About 30% of MSM in Hong Kong intended to take up HPV vaccination at the market rate [ 27 , 28 ]. Our literature search identified 4 studies that promoted HPV vaccination among MSM [ 29 - 32 ]. In a pilot intervention study conducted in the United States, young MSM were recruited via a popular web-based dating app and linked to a mobile health (mHealth) tool providing information and fostering access to HPV vaccination [ 31 ].…”

“…An ongoing RCT is comparing the efficacy of the same web-based intervention plus 2 different types of reminders (interactive vs noninteractive) versus the provision of simple HPV vaccination information among MSM in the United States [ 30 ]. In addition, an RCT tested the efficacy of texting-based intervention in the promotion of HPV vaccination among young MSM in the United States [ 32 ]. Participants who were assigned to the intervention group received daily SMS text messages for the first 3 weeks related to HPV vaccination, whereas those in the control group received SMS text messages related to other sexual health topics [ 32 ].…”

“…In addition, an RCT tested the efficacy of texting-based intervention in the promotion of HPV vaccination among young MSM in the United States [ 32 ]. Participants who were assigned to the intervention group received daily SMS text messages for the first 3 weeks related to HPV vaccination, whereas those in the control group received SMS text messages related to other sexual health topics [ 32 ]. The intervention was effective in promoting HPV vaccination initiation (19.4% vs 6.6%) [ 32 ].…”

“…Participants who were assigned to the intervention group received daily SMS text messages for the first 3 weeks related to HPV vaccination, whereas those in the control group received SMS text messages related to other sexual health topics [ 32 ]. The intervention was effective in promoting HPV vaccination initiation (19.4% vs 6.6%) [ 32 ]. To our knowledge, no HPV vaccination promotion targeting MSM was conducted outside the United States.…”

Evaluation of the Internal and External Validity of Social Media and Mobile Technology Driven HPV Vaccination Interventions: Systematic Review Using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework

“…Authors should explicitly describe the handling of any deviations from randomized allocation and discuss missing responses and their potential effect on the studies' outcomes [58]. However, the use of randomization in some of the studies [15,38,40,42,43,45,52] may attenuate the possible confounding bias. Although most of the articles reported short-term pre-post assessments, only four articles [38,43,45,53] calculated short-term attrition rates.…”