Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men and Transgender Women in 2 US Cities, 2012–2014

Abstract

Background Since 2011, in the United States, quadrivalent human papillomavirus (HPV) vaccine has been recommended for boys aged 11 to 12 years, men through age 21, and men who have sex with men (MSM) through age 26. We assessed HPV vaccination coverage and factors associated with vaccination among young MSM (YMSM) and transgender women (TGW) in 2 cities. Methods During 2012–2014, 808 YMSM and TGWaged 18 to 26 years reported vaccination status in a self-administered computerized questionnaire at 3 sexually transmitted disease (STD) clinics in Los Angeles and Chicago. Associations with HPV vaccination were assessed using bivariate and multivariable models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results Few of the diverse participants (Hispanic/Latino, 38.0%; white, 27.0%; and black/African American, 17.9%) reported receiving 1 or more HPV vaccine doses (n = 111 [13.7%]) and even fewer reported 3 doses (n = 37 [4.6%]). A multivariable model found associations between vaccination and having a 4-year college degree or higher (aOR, 2.83; CI, 1.55–5.17) and self-reported STDs (aOR, 1.21; CI, 1.03–1.42). In a model including recommendation variables, the strongest predictor of vaccination was a health care provider recommendation (aOR, 11.85; CI, 6.70–20.98). Conclusions Human papillomavirus vaccination coverage was low among YMSM and TGW in this 2–US city study. Our findings suggest further efforts are needed to reach YMSM seeking care in STD clinics, increase strong recommendations from health care providers, and integrate HPV vaccination with other clinical services such as STD testing.

Facilitators of and barriers to HPV vaccination among sexual and gender minority patients at a Boston community health center

“…This gender bias among men and women in general has been investigated previously [41], albeit without a comprehensive focus on SGM subpopulations. Only one previous study included transgender women but grouped them with MSM when reporting results [17]. Most gay men and transgender women do not receive the HPV vaccine [14–17], which highlights the need for creating more SGM-inclusive media campaigns.…”

“…Only one previous study included transgender women but grouped them with MSM when reporting results [17]. Most gay men and transgender women do not receive the HPV vaccine [14–17], which highlights the need for creating more SGM-inclusive media campaigns. Of note, despite social constructs regarding HPV as a cisgender women’s issue, disparities in vaccination persist based on sexual orientation even among cisgender women: low percentages of lesbian-identified women from U.S. rural (28%) and urban (38%) areas report discussing HPV vaccination with their HCP or receiving their HCP’s recommendation for vaccination [42].…”

“…Among transgender women, transgender men, women who have sex with women (WSW) and other SGM, research on anal HPV infection, HPV-related cancers and HPV vaccination is very limited. One study investigating HPV vaccination among YMSM and transgender women in two U.S. cities has found that only 14% received ≥ 1-dose [17].…”

A Qualitative Analysis of Young Sexual Minority Men's Perspectives on Human Papillomavirus Vaccination

“…[7][8][9] Nevertheless, HPV vaccine uptake among young MSM is less than optimal, with fewer than 40% initiating the series (i.e., receiving ‡1 dose of the 3-dose series). [10][11][12][13][14] Although researchers have begun to identify promising strategies for promoting HPV vaccination among young MSM, [15][16][17] few evidence-based interventions are currently available.…”

Preventive healthcare services use among transgender young adults

“…However, receipt of preventive care provides critical opportunities screening and counseling about behavioral health risks that are the key source of morbidity and mortality among this age group (Eisenberg et al, 2017; Park et al, 2015; Ozer, Urquhart, Brindis, Park, & Irwin, 2012). This is one of the first studies, to our knowledge, to assess HPV vaccination among transgender youth (Gorbach et al, 2017). Only one-third of young adults in this sample had received at least one dose of HPV vaccine, a proportion that is similar to vaccination coverage among a national sample of female young adults in the general population during the same time period but higher than among males (37% and 6%, respectively; Williams et al, 2015).…”