Using an integrated approach to understand vaccination behavior among young men who have sex with men: stages of change, the health belief model, and self-efficacy.

Studies continue to show that the majority of men who have sex with men (MSM) in the United States remain unvaccinated against hepatitis A (HAV); such limited vaccination coverage is a missed opportunity for preventing disease. This study sought to identify beliefs and attitudes associated with motivational readiness for vaccination against HAV among MSM, using a theoretically-integrated framework. Questionnaire data were collected from 358 MSM through bar outreach. MSM with increased readiness to complete the two-dose series perceived lower practical barriers and reported greater healthcare provider communication about their sexual orientation and risk behavior. They also perceived higher benefits to vaccination and higher severity of infection, and had higher self-efficacy to complete the vaccine series. Relationships between stages of change and theory-based constructs from the health belief model and the social learning theory follow predicted patterns suggesting that these theories may provide useful frameworks for understanding vaccination readiness and intervention strategy development among MSM.