Objectives In 2015, a publicly funded human papillomavirus (HPV) vaccination programme was implemented for gay, bisexual and other men who have sex with men (gbMSM) up to age 26 years in British Columbia, Canada. We assessed trends and correlates of HPV vaccine uptake from 2012 to 2019 in a cohort of gbMSM in Vancouver.
Methods We recruited sexually active gbMSM aged ≥16 years using respondent-driven sampling from February 2012 to February 2015 and followed them until July 2019. We evaluated self-reported HPV vaccine trends using mixed-effects logistic regression and identified factors associated with uptake using multivariable mixed-effects Poisson regression.
Results A total of 719 participants were recruited and completed the baseline visit, of whom 549 were unvaccinated with at least one follow-up visit. The median age was 33 years and 23% were living with HIV. HPV vaccination increased from 4% in 2012 to 28% in 2019 (p<0.001) among gbMSM >26 years, and from 9% in 2012 to 20% in 2017 (p<0.001) among gbMSM ≤26 years. Vaccination uptake increased after September 2015, following vaccination policy expansion (adjusted rate ratio (aRR)=1.82, 95% CI 1.06 to 3.12). In multivariable models, increased vaccination was associated with age ≤26 years vs ≥45 years (aRR=3.90; 95% CI 1.75 to 8.70), age 27–44 vs ≥45 years (aRR=2.86; 95% CI 1.46 to 5.62), involvement in gay community sports teams (aRR=2.31; 95% CI 1.15 to 4.64) and other groups (aRR=1.71; 95% CI 1.04 to 2.79), awareness of HIV-postexposure prophylaxis (aRR=5.50; 95% CI 1.31 to 23.09), recent sexually transmitted infection testing (aRR=2.72; 95% CI 1.60 to 4.60) and recent sex-work (aRR=2.59; 95% CI 1.08 to 6.19).
Conclusions Although we observed increases in HPV vaccination uptake from 2012, by 2019 HPV vaccination still remained below 30% among gbMSM in Vancouver, BC. Additional interventions are needed to increase vaccine uptake.
- public health
- sexual and gender minorities
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Handling editor Jane S Hocking
Contributors JK contributed to creating the research proposal, leading manuscript writing and data interpretation. JMS supported JK and contributed to manuscript writing and data interpretation. CW assisted in data analysis and manuscript preparation. NB assisted in cleaning the data and manuscript preparation. NJL contributed to manuscript writing and data interpretation. AL contributed to manuscript writing and data collection. ER contributed to manuscript writing. TG and ANB contributed to the manuscript with content expertise and manuscript writing. RH contributed to manuscript writing. KC contributed to manuscript writing. DM contributed to the research proposal, manuscript writing and data interpretation.
Funding This work was supported by the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes of Health Research (MOP-107544, FDN-143342, PJT-153139). NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DM and NJL are supported by Michael Smith Foundation for Health Research Scholar Awards (#5209, #16863). ANB is a Canada Research Chair in Sexually Transmitted Infection Prevention and was supported by the Family and Community Medicine Non-Clinician Research Scientist Award. KC is supported by a Canadian Institutes of Health Research Health Systems Impact Fellowship award, a Michael Smith Foundation for Health Research Trainee award and a Canadian HIV Trials Network/Canadian Foundation for AIDS Research Postdoctoral Fellowship award.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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