Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
Sex Transm Infect. 2019 May;95(3):181-186. doi: 10.1136/sextrans-2018-053619. Epub 2018 Nov 8.
In mid-2017, the Victorian Government funded a free time-limited human papillomavirus (HPV) vaccination catch-up programme for gay and bisexual men who have sex with men (MSM) aged up to 26 years through sexual health clinics or other immunisation centres. We aimed to examine the uptake of the HPV vaccine among young MSM attending the Melbourne Sexual Health Centre (MSHC).
MSM aged ≤26 attending MSHC between 27 April 2017 and 31 December 2017 were included in the analysis. HPV vaccine uptake was calculated based on the first consultation of each patient during the period. Multivariable logistic regression was performed to examine the association between vaccine uptake and patient factors.
There were 2108 MSM aged ≤26 who attended MSHC over the study period, with 7.6% (n=161) reporting previous HPV vaccination. Of the 1947 eligible men, 1134 (58.2%, 95% CI 56.0% to 60.4%) were offered the vaccine by the clinicians, and 830 men received it on the day. The vaccine coverage among all eligible MSM was 42.6% (95% CI 40.4% to 44.9%; 830 of 1947) and among MSM who were offered the vaccine by the clinicians was 73.2% (95% CI 70.5% to 75.8%; 830 of 1134). Men with a history of genital warts (adjusted OR (aOR)=3.11, 95%CI 1.39 to 6.99) and those who had >4male partners in the last 12 months (aOR=1.38, 95% CI 1.04 to 1.85) were more likely to receive the HPV vaccine on the day. 304 men declined the vaccine; most men did not specify the reason (31.3%, n=95), while 27.3% (n=83) needed time to think.
Although vaccine uptake was 73.2% among those offered, the actual coverage of those eligible remained unsatisfactory (42.6%) in a sexual health clinic. This highlights a clinic-based targeted MSM programme may not reach sufficiently high vaccine coverage to provide MSM with the same vaccine benefits as heterosexuals.
2017 年年中，维多利亚州政府通过性健康诊所或其他免疫接种中心，为年龄在 26 岁以下的男同性恋和双性恋男性（MSM）提供了一项免费的、限时的人乳头瘤病毒（HPV）疫苗补种计划。我们旨在研究参加墨尔本性健康中心（MSHC）的年轻 MSM 对 HPV 疫苗的接种情况。
分析了 2017 年 4 月 27 日至 2017 年 12 月 31 日期间在 MSHC 就诊的年龄≤26 岁的 MSM。根据该期间每位患者的首次就诊情况计算 HPV 疫苗接种率。采用多变量逻辑回归分析疫苗接种率与患者因素之间的关系。
在研究期间，共有 2108 名年龄≤26 岁的 MSM 在 MSHC 就诊，其中 7.6%（n=161）报告曾接种过 HPV 疫苗。在 1947 名符合条件的男性中，有 1134 名（58.2%，95%CI 56.0%至 60.4%）被临床医生建议接种疫苗，其中 830 名当天接种了疫苗。所有符合条件的 MSM 中疫苗接种率为 42.6%（95%CI 40.4%至 44.9%；1947 名中有 830 名），而在被临床医生建议接种疫苗的 MSM 中，疫苗接种率为 73.2%（95%CI 70.5%至 75.8%；1134 名中有 830 名）。有生殖器疣病史的男性（调整后的比值比（aOR）=3.11，95%CI 1.39 至 6.99）和过去 12 个月有 >4 名男性性伴侣的男性（aOR=1.38，95%CI 1.04 至 1.85）更有可能当天接种 HPV 疫苗。有 304 名男性拒绝接种疫苗；大多数男性没有说明原因（31.3%，n=95），而 27.3%（n=83）需要时间考虑。
尽管接种率在被建议接种的人群中达到了 73.2%，但符合条件的人群实际接种率（42.6%）仍不理想，这突显了以性健康诊所为基础的针对 MSM 的方案可能无法达到足够高的疫苗接种率，无法为 MSM 提供与异性恋者相同的疫苗效益。
