Mixed-methods study in England and Northern Ireland to understand young men who have sex with men’s knowledge and attitudes towards human papillomavirus vaccination

Kesten, J.M., Flannagan, C., Ruane-McAteer, E., Merriel, S.W.D., Nadarzynski, T., Shapiro, G.K., Rosberger, Z. and Prue, G. 2019. Mixed-methods study in England and Northern Ireland to understand young men who have sex with men’s knowledge and attitudes towards human papillomavirus vaccination. BMJ Open. 9 (e025070). doi:10.1136/bmjopen-2018-025070

TitleMixed-methods study in England and Northern Ireland to understand young men who have sex with men’s knowledge and attitudes towards human papillomavirus vaccination
TypeJournal article
AuthorsKesten, J.M., Flannagan, C., Ruane-McAteer, E., Merriel, S.W.D., Nadarzynski, T., Shapiro, G.K., Rosberger, Z. and Prue, G.
Abstract

Objectives: Men-who-have-sex-with-men (MSM) are at greater risk for HPV-associated cancers. Since 2016, MSM have been offered the HPV vaccination, which is most effective when received prior to sexual debut, at Genitourinary Medicine clinics in the United Kingdom. In September 2019, the national HPV vaccination programme will be extended to boys. This study aimed to understand young MSM’s (YMSM) knowledge and attitudes towards human papillomavirus (HPV) vaccination.
Design: Questionnaires assessed YMSM demographics, sexual behaviour, culture, knowledge and attitudes towards HPV vaccination, and stage of vaccine decision-making using the Precaution Adoption Process Model. Focus groups explored sexual health information sources, attitudes, barriers and facilitators to vaccination, and strategies to support vaccination uptake. Questionnaire data were analysed using descriptive statistics and focus group data were analysed thematically.
Setting: Questionnaires were also completed online. Focus groups were conducted within Lesbian Gay Bisexual Trans Queer (LGBTQ) organisational settings and a university student’s union in England and Northern Ireland.
Participants: Seventeen YMSM (M=20.5 years) participated in four focus groups and 51 (M=21.1 years) completed questionnaires.
Results: Over half of YMSM were aware of HPV (54.9%), yet few (21.6%) had previously discussed vaccination with a Healthcare Professional (HCP). Thematic analyses found YMSM were willing to receive the HPV vaccine. Vaccination programmes requiring YMSM to request the vaccine, particularly prior to sexual orientation disclosure to family and friends, were viewed as unfeasible. Educational campaigns explaining vaccine benefits were indicated as a way to encourage uptake.
Conclusions: This study suggests that to effectively implement HPV vaccination for YMSM, this population requires clearer information and greater discussion with their HCP. In support of the decision made by the JCVI, universal vaccination is the most feasible and equitable option. However, the absence of a catch-up programme will leave a significant number of YMSM at risk of HPV infection.

KeywordsHPV, sexual health, adolescent, attitudes, vaccination
Article numbere025070
JournalBMJ Open
Journal citation9 (e025070)
ISSN2044-6055
Year2019
PublisherBMJ
Digital Object Identifier (DOI)doi:10.1136/bmjopen-2018-025070
Publication dates
Published14 May 2019
LicenseCC BY 2.0

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