Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA.
Hum Vaccin Immunother. 2022 Nov 30;18(6):2114258. doi: 10.1080/21645515.2022.2114258. Epub 2022 Aug 26.
Gay, bisexual, and other men who have sex with men (GBM), in addition to transgender women who have sex with men (TW), are at disproportionate risk for anal cancer. Anal cancer can be prevented with HPV vaccination, but uptake among adult GBM/TW is low. Targeted HPV vaccination during the clinical management of pre-exposure prophylaxis (PrEP) is an unexplored strategy relevant to these populations. The purpose of this study was (1) to determine the need for HPV vaccination among GBM and transgender women PrEP users and (2) to identify correlates of HPV vaccination among PrEP users. Secondary analysis of the 2020 Pennsylvania LGBT Health Needs Assessment was conducted to estimate prevalence ratios of HPV vaccination among PrEP users. Overall, 43.8% of the sample had initiated HPV vaccination. Vaccine initiation was significantly lower among respondents 27 to 35 (PR = 0.64; 95% CI: 0.49-0.83) and 36 to 45 (PR = 0.38; 95% CI: 0.25-0.58). Respondents who had received Hepatitis A vaccination were significantly more likely to have had initiated HPV vaccination after adjusting for age (aPR = 2.60; 95% CI: 1.75-3.84). Overall, more than half of eligible GBM and TW engaged in PrEP care have not initiated HPV vaccination and represent potential missed opportunities for anal cancer prevention.
男同性恋者、双性恋者和其他与男性发生性行为的男性（GBM），以及与男性发生性行为的跨性别女性（TW），罹患肛门癌的风险不成比例地高。HPV 疫苗接种可预防肛门癌，但成年 GBM/TW 的接种率较低。在暴露前预防（PrEP）的临床管理中针对 GBM/TW 进行 HPV 疫苗接种是一个尚未探索的策略，与这些人群有关。本研究的目的是：（1）确定 PrEP 用户中 GBM 和跨性别女性接种 HPV 疫苗的需求；（2）确定 PrEP 用户中 HPV 疫苗接种的相关因素。对 2020 年宾夕法尼亚州 LGBT 健康需求评估进行了二次分析，以估计 PrEP 用户中 HPV 疫苗接种的患病率比。总体而言，43.8%的样本已开始接种 HPV 疫苗。在 27 至 35 岁（PR=0.64；95%CI：0.49-0.83）和 36 至 45 岁（PR=0.38；95%CI：0.25-0.58）的受访者中，疫苗接种的启动明显较低。在调整年龄后，接种过甲型肝炎疫苗的受访者更有可能接种 HPV 疫苗（aPR=2.60；95%CI：1.75-3.84）。总体而言，超过一半符合条件的 GBM 和 TW 参与了 PrEP 护理，但尚未开始接种 HPV 疫苗，这代表了预防肛门癌的潜在错失机会。
