Lueck Johnathon S, Sandhu Lovesimrjit S, Richman Jessica, Walker Crystal, Trujillo Jon Philip, Callahan Daniel, Smith Aidan Collier, Ivatury Srinivas J
Dell Medical School, The University of Texas at Austin, 1501 Red River Street, Austin, TX, 78712, USA.
School of Public Health, The University of Texas at Houston Health Science Center, Houston, TX, USA.
AIDS Behav. 2025 Jun 2. doi: 10.1007/s10461-025-04752-5.
Anal cancer incidence has risen significantly over the past four decades, with HIV-positive men who have sex with men (HIV + MSM) facing a disproportionately higher disease burden. Although human papillomavirus (HPV) vaccination can prevent most HPV-related cancers, uptake remains low within this population. To explore perceptions of HPV infection and vaccination, this study employed a cross-sectional survey based on the Health Belief Model (HBM). Recruitment took place at a federally qualified health center in Austin, Texas, serving primarily low-income people living with HIV. Biological males over 18 years old, who have sex with men and are HIV-positive, were eligible. A 36-item survey assessed demographics, sexual behavior, and awareness of HPV and the HPV vaccine within the context of the HBM. Among 49 participants, only 22.45% had received at least one dose of the HPV vaccine. Of those who were unvaccinated, only 23.68% planned to receive the HPV vaccine within the next six months. Overall HPV knowledge was low, with fewer than half recognizing HPV's role in anal cancer. Among the vaccine acceptance group (participants who were vaccinated or intended to be vaccinated), there was a higher perceived severity of HPV-related disease, greater perceived benefits of vaccination, fewer perceived barriers, and a stronger response to physician recommendations. Cost was the only barrier notably linked to non-acceptance. These findings highlight an urgent need to address gaps in awareness of HPV's link to anal cancer and underscore how key HBM constructs-particularly high perceived severity and benefits, and low barriers-predict vaccine acceptance. Interventions should focus on informing HIV + MSM about their susceptibility and emphasizing healthcare provider recommendations. Although the small sample size and single-site recruitment limit generalizability, this study offers critical insights into HPV-related perceptions among HIV + MSM, underscoring the importance of targeted strategies to boost vaccination and reduce HPV-related cancer in this underserved group.
在过去四十年中，肛门癌的发病率显著上升，与男性发生性行为的艾滋病毒阳性男性（HIV+男男性行为者）面临着极高的疾病负担。尽管人乳头瘤病毒（HPV）疫苗接种可以预防大多数与HPV相关的癌症，但该人群的接种率仍然很低。为了探究对HPV感染和疫苗接种的看法，本研究采用了基于健康信念模型（HBM）的横断面调查。招募工作在德克萨斯州奥斯汀的一家联邦合格健康中心进行，主要服务于低收入的HIV感染者。年龄超过18岁、与男性发生性行为且HIV呈阳性的生物学男性符合条件。一项包含36个条目的调查评估了人口统计学、性行为以及在HBM背景下对HPV和HPV疫苗的知晓情况。在49名参与者中，只有22.45%的人至少接种过一剂HPV疫苗。在未接种疫苗的人群中，只有23.68%的人计划在未来六个月内接种HPV疫苗。总体而言，HPV知识水平较低，不到一半的人认识到HPV在肛门癌中的作用。在疫苗接受组（已接种或打算接种疫苗的参与者）中，对HPV相关疾病的感知严重性更高，对疫苗接种的感知益处更大，感知障碍更少，对医生建议的反应更强。费用是唯一与不接受疫苗显著相关的障碍。这些发现凸显了迫切需要填补对HPV与肛门癌关联认识上的差距，并强调了关键的HBM结构——特别是高感知严重性和益处以及低障碍——如何预测疫苗接受情况。干预措施应侧重于告知HIV+男男性行为者他们的易感性，并强调医疗保健提供者的建议。尽管样本量小和单中心招募限制了普遍性，但本研究为HIV+男男性行为者中与HPV相关的看法提供了重要见解，强调了针对性策略对于在这个服务不足的群体中促进疫苗接种和减少与HPV相关癌症的重要性。
