a JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong , Hong Kong , China.
b School of Public Health, Shanghai University of Traditional Chinese Medicine , Shanghai , China.
Hum Vaccin Immunother. 2019;15(7-8):1737-1744. doi: 10.1080/21645515.2019.1622975. Epub 2019 Jun 20.
Men who have sex with men (MSM) are recommended to take up human papillomavirus (HPV) vaccination. There are concerns that MSM would increase sexual risk behaviors after taking up HPV vaccination, a phenomenon known as risk compensation. This study investigated the prevalence of and factors associated with behavioral intention to reduce the frequency of condom use with men after receiving the HPV vaccination. The study was based on the baseline sample of an ongoing randomized controlled trial promoting HPV vaccination among MSM in Hong Kong. Hong Kong Chinese-speaking MSM who have never vaccinated against HPV were recruited from multiple sources. A total of 624 participants completed the baseline survey during July to December 2017. The prevalence of behavior intention to reduce the frequency of condom use with regular and non-regular male sex partners after receiving HPV vaccination was 6.9% and 4.0%; 8.0% of them intended to reduce condom use with either type of male partners after receiving the HPV vaccination. Adjusting for significant background variables (education level and condomless anal intercourse with men in the last six months), two constructs of the pre-intentional phase of Health Action Process Approach model were significantly associated with the dependent variable in the expected direction. They were (1) positive outcome expectancies of condomless anal intercourse after receiving HPV vaccination (adjusted odds ratios [AOR]: 1.29, 95% confidence interval [CI]: 1.12, 1.48, < 0.001) and (2) perceived self-efficacy of consistent condom use after receiving HPV vaccination (AOR: 0.83, 95% CI: 0.70, 0.92, = 0.001). Risk compensation may not be a major concern when promoting HPV vaccination among MSM. The results should be assuring health-care providers and policymakers.
男男性行为者（MSM）被推荐接种人乳头瘤病毒（HPV）疫苗。有人担心，MSM 在接种 HPV 疫苗后会增加性行为风险，这种现象被称为风险补偿。本研究调查了接受 HPV 疫苗接种后与减少与男性发生性行为时避孕套使用频率相关的行为意向的流行率和相关因素。该研究基于在香港为 MSM 推广 HPV 疫苗接种的正在进行的随机对照试验的基线样本。从多个来源招募了从未接种过 HPV 疫苗的香港华裔 MSM。共有 624 名参与者在 2017 年 7 月至 12 月期间完成了基线调查。接种 HPV 疫苗后，与定期和非定期男性性伴侣发生性行为时减少避孕套使用频率的行为意向的流行率分别为 6.9%和 4.0%；8.0%的人表示接种 HPV 疫苗后，打算减少与这两种类型的男性伴侣发生性行为时使用避孕套。调整显著背景变量（教育水平和过去六个月与男性无保护肛交）后，健康行动过程方法模型的前意向阶段的两个结构与预期方向的因变量显著相关。它们是（1）接种 HPV 疫苗后无保护肛交的积极结果预期（调整后的优势比 [AOR]：1.29，95%置信区间 [CI]：1.12，1.48，<0.001）和（2）接种 HPV 疫苗后持续使用避孕套的感知自我效能（AOR：0.83，95% CI：0.70，0.92，=0.001）。在 MSM 中推广 HPV 疫苗接种时，风险补偿可能不是一个主要问题。这些结果应该让医疗保健提供者和政策制定者感到放心。
