2012-2014 年美国 2 个城市男男性行为者和跨性别女性中年轻人的人乳头瘤病毒疫苗接种
Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men and Transgender Women in 2 US Cities, 2012-2014.
机构信息
From the *Department of Epidemiology, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA; †Howard Brown Health, Chicago, IL; ‡College of Public Health, University of Kentucky, Lexington, KY; and §Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
出版信息
Sex Transm Dis. 2017 Jul;44(7):436-441. doi: 10.1097/OLQ.0000000000000626.
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 TGW aged 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.
背景
自 2011 年以来，美国已向 11 至 12 岁男孩、21 岁以下男性以及男男性行为者（MSM）推荐接种四价人乳头瘤病毒（HPV）疫苗。我们评估了在 2 个城市中，年轻男男性行为者（YMSM）和跨性别女性（TGW）的 HPV 疫苗接种率和与接种相关的因素。
方法
在 2012-2014 年期间，在洛杉矶和芝加哥的 3 个性传播疾病（STD）诊所，808 名年龄在 18 至 26 岁的 YMSM 和 TGW 通过自我管理的计算机化问卷报告了疫苗接种状况。使用双变量和多变量模型评估 HPV 疫苗接种的关联，以计算调整后的优势比（aOR）和 95%置信区间（CI）。
结果
在这些不同背景的参与者中（西班牙裔/拉丁裔，38.0%；白人，27.0%；黑人和非裔美国人，17.9%），很少有人（n = 111，13.7%）报告接种了 1 剂或多剂 HPV 疫苗，报告接种了 3 剂的人更少（n = 37，4.6%）。多变量模型发现，接种疫苗与拥有 4 年制大学学位或更高学历（aOR，2.83；CI，1.55-5.17）和自我报告的性传播疾病（aOR，1.21；CI，1.03-1.42）之间存在关联。在包括推荐变量的模型中，接种疫苗的最强预测因素是卫生保健提供者的推荐（aOR，11.85；CI，6.70-20.98）。
结论
在这项来自 2 个美国城市的研究中，YMSM 和 TGW 的 HPV 疫苗接种率较低。我们的研究结果表明，需要进一步努力接触在 STD 诊所寻求治疗的 YMSM，增强卫生保健提供者的强烈推荐，并将 HPV 疫苗接种与其他临床服务（如性传播疾病检测）相结合。
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