Facilitators and Barriers to Take Up Clinician-Collected and Self-Collected HPV Tests among Chinese Men Who Have Sex with Men

Abstract

Regular tests for human papillomavirus (HPV) and early treatment could represent an important strategy for preventing anal cancers among men who have sex with men (MSM). This study investigated facilitators and barriers to take up clinician-collected and self-collected HPV tests among Chinese MSM. This study was based on the baseline sample of a longitudinal study promoting HPV vaccination among 350 Chinese MSM who had never received an HPV vaccination. The baseline survey was conducted from August 2019 to April 2020. The prevalence of any HPV tests uptake in lifetime was 19.1%; 4.9% had HPV infection in anus, genital, oral cavity, and other places. Among the participants, 20% and 76.8% intended to take up self-financed and free clinician-collected HPV tests, and 76.8% intended to use free self-collected HPV tests. After adjusting for significant background characteristics, perceived risk of HPV infection, and perceived benefits, barriers, cue to action, and self-efficacy related to HPV tests in general and/or specific to self-collected HPV tests were associated with behavioral intention to take up free clinician-collected and/or self-collected HPV tests. Less than 20% of Chinese MSM reported HPV tests uptake. Modifying perceptions related to HPV tests may be useful to increase HPV tests coverage in this group.

Effectiveness of a Community-Based Organization—Private Clinic Service Model in Promoting Human Papillomavirus Vaccination among Chinese Men Who Have Sex with Men

“…Trained staff of a CBO providing HIV-related services recruited participants through multiple sources, including outreaching in gay bars or saunas in Hong Kong, online recruitment, and referrals made by peers and other CBOs. Detailed recruitment procedures were reported in a published paper [14]. Interested participants contacted fieldworkers through WhatsApp, telephone, email, or other means.…”

“…Moreover, uncontrolled HIV infection might increase the persistence of high-risk HPV through altered cell-mediated immunity, local molecular interactions, and reduced tight junction function [12,13]. In Hong Kong, among MSM with an experience of HPV screening, 25% were diagnosed with HPV infection [14].…”

Would Chinese Men Who Have Sex With Men Take Up Human Papillomavirus (HPV) Screening as an Alternative Prevention Strategy to HPV Vaccination?

“…Recruitment details were reported in previously published articles (29,32). Trained and experienced staff of a collaborative CBO providing HIV-related services worked as fieldworkers for recruitment.…”

“…MSM can also seek chargeable HPV screening (about HK$700 or US$90 per episode) and HPV vaccination (about HK$4,600 or US$593 for 3 doses) services at private hospitals/clinics. However, the utilization of HPV screening (19.1% in lifetime, and 9.7% in the past year) or HPV vaccination (almost 0%) was very low among MSM in Hong Kong (29)(30)(31).…”

“…Although a 10% discount from market price (about HK$4,200 or US$542 for 3 doses) was offered to MSM in the service model, only 16.8% of them had taken up HPV vaccination as many MSM still considered the cost to be unaffordable. The online intervention promoting HPV vaccination contained health communication messages about the risk and severity of HPV infection (32), which were associated with higher intention to receive HPV screening among local MSM (29). Such online health promotion might motivate local MSM to receive HPV screening.…”