Trends in and Characteristics Associated with HPV Vaccination Initiation Among Men Who Have Sex with Men, 2014 - 2017 Public

Abstract

BACKGROUND: Rates of HPV and HPV-associated cancers are high among MSM. Expansion of HPV vaccination in MSM up to age 26 was established in 2011. Since then, very little research has explored national trends in vaccine uptake among this population.

METHODS: Data from the 2014-2017 American Men’s Internet Survey was used. Men aged 15-32 were included in the analyses. Estimated annual percentage changes (EAPC) were used to evaluate relative change in vaccination initiation. Linear trends in vaccine uptake were assessed using Cochran-Armitage test for trend. Poisson regression was used to identify predictors of vaccination initiation.

RESULTS: The proportion of MSM reporting receipt of ≥ 1 HPV vaccine rose from 22.5% in 2014 to 37.6% in 2017 (test for trend p < 0.0001). MSM residing in the Midwest and in large metro areas show the greatest EAPC (24.85%, 17.35%). Trends in vaccine initiation among MSM in rural locations increased from 2014-2016, but has stayed constant from 2016 – 2017, with 28.25% coverage. Of the 4,290 men reporting HPV vaccine receipt across these years, predictors for vaccination included age (adjusted prevalence ratio (aPR): 3.07, 95% confidence interval (CI): 2.97, 3.17); having health insurance (aPR = 1.80, 95% CI: 1.53, 2.17); and having been seen by a healthcare provider (HCP) in the past 12 months (aPR = 1.80, 95% CI: 1.62, 2.07). Other significant predictors included residence in the Northeast and large metro areas, higher household income, disclosure to HCP, and gonorrhea and/or chlamydia diagnosis in the past 12 months.

CONCLUSIONS: Overall, HPV vaccine coverage among MSM appears to be increasing overall, with access to healthcare and insurance being important correlates of HPV vaccine initiation. Despite favorable trends in vaccine coverage, the 2017 coverage rate of 38% remains below the recommended coverage of 80% for MSM ≤ 26 years of age, with rural locations starting to fall behind.

Table of Contents

Introduction..........................................1

 

Methods...............................................3

 

Results..................................................5

 

Discussion.............................................8

 

References..........................................14

 

Table 1................................................19

 

Table 2................................................20

 

Table 3................................................24

 

Figure 1...............................................25

 

Figure 2...............................................26

 

Figure 3...............................................27

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Mot-clé	Homosexuality Vaccination trend HPV vaccine Risk factors
Committee Chair / Thesis Advisor	Jeb Jones, Emory University Allison Chamberlain, Emory University

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