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Baseline HPV prevalence in rectal swabs from men attending a sexual health clinic in Scotland: assessing the potential impact of a selective HPV vaccination programme for men who have sex with men
  1. Ross Liam Cameron1,
  2. Kate Cuschieri2,
  3. Kevin G J Pollock1
  1. 1 Health Protection Scotland, Glasgow, UK
  2. 2 Scottish Human Papillomavirus Reference Laboratory, Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Ross Liam Cameron, Health Protection Scotland, Glasgow G2 6QE, UK; ross.cameron{at}


Objectives A human papillomavirus (HPV) vaccination programme targeted towards men who have sex with men who are disproportionately affected by HPV anogenital infection and related disease was established in Scotland in July 2017. We aimed to establish a baseline HPV prevalence to assess the potential impact of the programme.

Methods Residual rectal swabs taken in a sexual health clinic (n=1 248) were tested for the presence of HPV and HPV-type prevalence was collated and stratified by age. Prevalence of HPV types included in the quadrivalent and nonavalent vaccines was specifically assessed.

Results 72.8% (95% CI 70.2% to 75.3%) of swabs were positive for HPV with 59.1% (95% CI 56.3% to 61.9%) of samples positive for at least one high-risk type. A least one of HPV 6, 11, 16 and 18 was detected in approximately half of the swabs. HPV prevalence generally increased with age but did not significantly differ between older age groups. The presence of more than one HPV type increased with age and over half of samples had multiple types present.

Conclusions While HPV prevalence in this population is high, the potential impact of the vaccination programme is substantial given that 50% are not infected with a vaccine type. Defining a preimmunisation baseline in this group will be important for longitudinal monitoring of impact.

  • HPV
  • gay men
  • vaccination
  • anogenital cancer

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  • Handling editor Jonathan Ross

  • Contributors RLC performed the analysis and drafting of the initial manuscript. KC collated and typed the rectal swab samples and helped write the manuscript. KGJP helped write the manuscript and conceived the idea for the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sector.

  • Competing interests KGJP has received a travel grant to attend IPV conference in September 2015 from Merck. KC's (non-personal) institution has received grant funding or associated consumables to support research from Qiagen, Hologic, SelfScreen, GeneFirst, EuroImmun, Cepheid, Genomica and LifeRiver.

  • Patient consent Not required.

  • Ethics approval Ethical approval was obtained from the East of Scotland Research Ethics Service REC 1 to use residual samples which have fulfilled their diagnostic requirement. Approval number: 15/ES/0094.

  • Provenance and peer review Not commissioned; externally peer reviewed.