加拿大男同性恋、双性恋和其他男男性行为者中接种和未接种人乳头瘤病毒疫苗者的人乳头瘤病毒流行率。

Anal Human Papillomavirus Prevalence Among Vaccinated and Unvaccinated Gay, Bisexual, and Other Men Who Have Sex With Men in Canada.

机构信息

Department of Epidemiology, Biostatistics and Occupational Health, McGill University.

McGill University Health Centre Research Institute, McGill University, Montréal.

出版信息

Sex Transm Dis. 2022 Feb 1;49(2):123-132. doi: 10.1097/OLQ.0000000000001560.

DOI:10.1097/OLQ.0000000000001560

PMID:34561370

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8746886/

Abstract

BACKGROUND

Starting in 2015, human papillomavirus (HPV) vaccine has been publicly funded for gay, bisexual, and other men who have sex with men (GBM) 26 years or younger in Canada.

METHODS

Self-identified GBM who reported having sex with another man within the past 6 months were enrolled using respondent-driven sampling (RDS) between February 2017 and August 2019 in Montreal, Toronto, and Vancouver, Canada. Men aged 16 to 30 years self-collected anal specimens for HPV-DNA testing. Prevalence was estimated using RDS-II weights. We compared the prevalence of quadrivalent (HPV-6/11/16/18) and 9-valent (HPV-6/11/16/18/31/33/45/52/58) vaccine types between GBM who self-reported HPV vaccination (≥1 dose) and those reporting no vaccination using a modified Poisson regression for binary outcomes.

RESULTS

Among 645 GBM who provided a valid anal specimen (median age, 26 years; 5.9% HIV positive), 40.3% reported receiving ≥1 dose of HPV vaccine, of whom 61.8% received 3 doses. One-quarter were infected with ≥1 quadrivalent type (crude, 25.7%; RDS weighted, 24.4%). After adjustment for potential confounders, vaccinated GBM had a 27% lower anal prevalence of quadrivalent types compared with unvaccinated GBM (adjusted prevalence ratio [aPR], 0.73; 95% confidence interval [CI], 0.54-1.00). Lower prevalence ratios were found among vaccinated participants who were vaccinated >2 years before enrollment (aPR, 0.47; 95% CI, 0.25-0.86) or received their first vaccine dose at age ≤23 years (aPR, 0.64; 95% CI, 0.42-0.99). Point estimates were similar for ≥2 or 3 doses and 9-valent types.

CONCLUSIONS

Human papillomavirus vaccination was associated with a lower anal prevalence of vaccine-preventable HPV types among young, sexually active GBM. Findings will help inform shared decision making around HPV vaccination for GBM and their healthcare providers.

摘要

背景

自 2015 年起，加拿大开始为 26 岁及以下的男同性恋、双性恋和其他与男性发生性行为者（GBM）提供人乳头瘤病毒（HPV）疫苗的公共资助。

方法

2017 年 2 月至 2019 年 8 月期间，采用响应驱动抽样（RDS）方法在加拿大的蒙特利尔、多伦多和温哥华招募了自我认同为 GBM 且在过去 6 个月内与另一名男性发生过性行为的参与者。年龄在 16 至 30 岁之间的男性自行采集肛门标本进行 HPV-DNA 检测。使用 RDS-II 权重估计患病率。我们比较了报告接种（≥1 剂）和未接种 HPV 疫苗的 GBM 之间四价（HPV-6/11/16/18）和九价（HPV-6/11/16/18/31/33/45/52/58）疫苗类型的患病率，使用二项结果的修正泊松回归进行比较。

结果

在 645 名提供有效肛门标本的 GBM 中（中位年龄 26 岁；5.9% HIV 阳性），40.3%的人报告至少接种过 1 剂 HPV 疫苗，其中 61.8%接种了 3 剂。四分之一的人感染了≥1 种四价型（未校正率，25.7%；RDS 校正率，24.4%）。在调整了潜在混杂因素后，与未接种疫苗的 GBM 相比，接种疫苗的 GBM 肛门四价型的患病率降低了 27%（调整后的患病率比[aPR]，0.73；95%置信区间[CI]，0.54-1.00）。在疫苗接种≥2 年或 2 年以前（aPR，0.47；95%CI，0.25-0.86）或首次接种年龄≤23 岁（aPR，0.64；95%CI，0.42-0.99）的参与者中，比值比更低。对于≥2 剂或 3 剂和 9 价类型，点估计值相似。