Human papillomavirus (HPV) vaccine uptake among a community recruited sample of gay, bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019

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dc.contributor.authorGrewal, R.
dc.contributor.authorHart, T. A.
dc.contributor.authorDeeks, S. L.
dc.contributor.authorCox, J.
dc.contributor.authorDe Pokomandy, A.
dc.contributor.authorGrennan, T.
dc.contributor.authorLambert, G.
dc.contributor.authorMoore, D.
dc.contributor.authorBrisson, M.
dc.contributor.authorCoutlée, F.
dc.contributor.authorGaspar, M.
dc.contributor.authorGeorge, C.
dc.contributor.authorGrace, D.
dc.contributor.authorJollimore, J.
dc.contributor.authorLachowsky, Nathan J.
dc.contributor.authorNisenbaum, R.
dc.contributor.authorOgilvie, G.
dc.contributor.authorSauvageau, C.
dc.contributor.authorTan, D. H. S.
dc.contributor.authorYeung, A.
dc.contributor.authorBurchell, A. N.
dc.date.accessioned2022-03-08T19:07:02Z
dc.date.available2022-03-08T19:07:02Z
dc.date.copyright2021en_US
dc.date.issued2021
dc.descriptionThe authors would like to thank the Engage/Momentum II study participants, office staff, and community engagement committee members, as well as our community partner agencies. The authors also wish to acknowledge the support of Catharine Chambers and Ashley Mah and their contribution(s) to the work presented here.en_US
dc.description.abstractIntroduction: In 2015/2016, Canada’s largest provinces implemented publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) lesser than or equal to 26 years old. We sought to describe HPV vaccine uptake among GBM and determine barriers and facilitators to vaccine initiation with a focus on healthcare access and utilization. Methods: Engage is a cohort study among GBM aged 16 + years in three Canadian cities recruited from 2017 to 2019 via respondent driven sampling (RDS). Men completed a comprehensive questionnaire at baseline. By publicly-funded vaccine eligibility (lesser than or equal to 26 years old = eligible for vaccination, greater than or equal to 27 years old = ineligible), we described HPV vaccine uptake (initiation = 1 + dose, completion = 3 doses) and explored factors associated with vaccine initiation using Poisson regression. All analyses were weighted with the RDS-II Volz-Heckathorn estimator. Results: Across the three cities, 26–35% and 14–21% of men lesser than or equal to 26 years and 7–26% and 2–9% of men greater than or equal to 27 years initiated and completed HPV vaccination, respectively. Vaccine initiation was significantly associated with STI/HIV testing or visiting a HIV care specialist in the past six months (lesser than or equal to 26: prevalence ratio[PR] = 2.15, 95% confidence interval[CI] 1.06–4.36; greater than or equal to 27: PR = 2.73, 95%CI 1.14–6.51) and past hepatitis A or B vaccination (lesser than or equal to 26: PR = 2.88, 95%CI 1.64–5.05; greater than or equal to 27: PR = 2.03, 95%CI 1.07–3.86). Among men greater than or equal to 27 years old, vaccine initiation was also positively associated with accessing PrEP, living in Vancouver or Toronto, but negatively associated with identifying as Latin American and increasing age. Vaccine initiation was twice as likely among men greater than or equal to 27 years with private insurance versus no insurance. Conclusions: Sixty-five to 74% of men eligible for publicly-funded vaccine across the three cities remained unvaccinated against HPV by 2019. High vaccine cost may partly explain even lower uptake among men greater or less than 27 years old. Men seeking sexual health care were more likely to initiate vaccination; bundling vaccination with these services may help improve HPV vaccine uptake.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipEngage-HPV is funded by the Canadian Institutes for Health Research (CIHR) Canadian Immunization Research Network (CIRN, 151944) and a CIHR Foundation Grant awarded to ANB (148432). Engage/Momentum II is funded by CIHR (#TE2-138299, FDN- 143342, PJT-153139), the Canadian Association for HIV/AIDS Research (CANFAR, #Engage), the Ontario HIV Treatment Network (OHTN, #1051), and the Public Health Agency of Canada (#4500370314), and Ryerson University. RG is supported by a CIRN Trainee Scholarship. ANB is a Canada Research Chair in Sexually Transmitted Infection Prevention and a recipient of a Department of Family and Community Medicine Non-Clinician Research Scientist Award, University of Toronto. DM and NJL are supported with scholar awards from the Michael Smith Foundation for Health Research (#5209, #16863). TAH is supported by a Chair in Gay and Bisexual Men’s Health from the OHTN. DG is a Canada Research Chair in Sexual and Gender Minority Health. GO is a Canada Research Chair in Global Control of HPV-Related Disease and Cancer. DHST is a Tier 2 Canada Research Chair in HIV Prevention and Sexually Transmitted Infection Research.en_US
dc.identifier.citationGrewal, R., Deeks, S. L., Hart, T. A., Cox, J., De Pokomandy, A., Grennan, T., Lambert, G., Moore, D., Brisson, M., Coutlée, F., Gaspar, M., George, C., Grace, D., Jollimore, J., Lachowsky, N. J., Nisenbaum, R., Ogilvie, G., Sauvageau, C., Tan, D. H. S., Yeung, A., & Burchell, A. N. (2021). “Human papillomavirus (HPV) vaccine uptake among a community recruited sample of gay, bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019.” Vaccine, 39, 3756-3766. DOI: https://doi.org/10.1016/j.vaccine.2021.05.031en_US
dc.identifier.urihttps://doi.org/10.1016/j.vaccine.2021.05.031
dc.identifier.urihttp://hdl.handle.net/1828/13790
dc.language.isoenen_US
dc.publisherVaccineen_US
dc.subjectHuman papillomavirus
dc.subjectMen who have sex with men
dc.subjectVaccine uptake
dc.subjectVaccine preventable disease
dc.subjectImmunization program
dc.subjectPrimary prevention
dc.subject.departmentSchool of Public Health and Social Policy
dc.titleHuman papillomavirus (HPV) vaccine uptake among a community recruited sample of gay, bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019en_US
dc.typeArticleen_US

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