杭州市下城区男男性接触者人群对人乳头瘤病毒及其预防性疫苗认知的研究

目的调查男男性接触者(men who have sex with men,MSM)人群对人乳头瘤病毒(human papilloma virus,HPV)及其疫苗的认知情况与影响因素,为今后HPV疫苗的MSM人群推广应用提供参考依据。方法以艾滋病自愿咨询检测(HIV voluntary counseling and testing,VCT)的MSM人群为调查对象,采用现况调查的流行病学调查方法,问卷内容主要包括基本情况、HPV疾病及其疫苗认知,疫苗接种意愿等内容。结果本研究共调查MSM人群422例,HPV、HPV疫苗知晓率分别为42.65%(180人)、27.73%(117人)。73.46%(310人)的MSM表示愿意接种HPV疫苗,73.22%(309人)的MSM表示愿意鼓励朋友接种,77.49%(327人)的MSM赞成疫苗推广接种。结论 MSM人群作为特殊男性群体,具有较高的HPV及相关疾病知晓率,HPV疫苗知晓率低但伴有较高的接受度,并具有较强的同伴教育意向。借鉴艾滋病防治同伴教育模式,有利于HPV疫苗在MSM人群中推广和使用。     

重庆市成年女性对人乳头瘤病毒疫苗的认知和接种意愿调查

了解重庆市成年女性对人乳头瘤病毒（HPV）疫苗的认知情况、接种意愿和影响因素,为今后推广HPV疫苗接种、消除宫颈癌工作提供参考。方法 采用便利抽样法,选取重庆市18岁及以上的成年女性作为调查对象。利用“问卷星”设计编制问卷,利用“育苗通”微信服务号向调查对象推送问卷,调查对象自愿填写相关内容,同时强化质量控制,确保问卷应答质量。利用SPSS 25.0软件进行统计分析,对可能影响调查对象HPV疫苗认知和接种意愿的因素进行多因素Logistic回归分析。结果 此次共调查4 885名成年女性,其中96.46%听说过宫颈癌,94.60%听说过HPV,96.62%听说过HPV疫苗。99.43%的调查对象愿意接种HPV疫苗,93.33%的调查对象愿意让女儿接种HPV疫苗。如果9~14岁的女孩能免费接种国产2价HPV疫苗,89.27%的调查对象会让女儿接种,选择不会让女儿接种的人群中,有86.64%觉得2价疫苗覆盖面不够,想让女儿接种覆盖面更广的4价或9价疫苗。结论 重庆市成年女性对HPV疫苗的认知较过去的研究有明显提升,接种意愿很强烈;但仅有34.45%的调查对象认为女性接种HPV疫苗的最佳年龄是9~14岁,未来需要针对这点进一步强化科普宣传;做好推广HPV疫苗普遍接种工作,需要兼顾个人选择权,因此制定普惠、公平、灵活的接种政策至关重要。     

钱袋子

公安部提醒:警惕九价HPV疫苗诈骗!作为首个能预防宫颈癌的疫苗,九价HPV疫苗一直“一苗难求”。由于有16~26岁的接种年龄限制,更让不少女性十分焦虑。于是,催生了诈骗。不久前,公安部网安局就发文提醒,近年涉九价HPV疫苗诈骗案件高发,须警惕。     

16～26岁女性接种人乳头瘤病毒疫苗的经济性研究

目的 从卫生体系角度评价接种2、4、9价人乳头瘤病毒(Human Papilloma Virus, HPV)疫苗相比不接种疫苗的经济性。方法 构建静态模型并嵌入宫颈癌马尔可夫模型,模拟16～26岁女性未来60年的健康状态与成本消耗,两两比较增量成本效果比(Increased cost-effectiveness ratio, ICER),并计算意愿支付阈值(Willingness to pay, WTP)下的净效益,判断经济性。结果 基础分析显示接种2、4、9价HPV疫苗相对于不接种疫苗的ICER分别为2 281.2元/QALY、22 878.07元/QALY和45 497.56元/QALY,净效益分别为1 298.15元、1 079.84元和593.57元; 接种4价疫苗相对于接种2价疫苗的ICER为139 756.95元/QALY,净效益为251.64元; 9价疫苗相较于2、4价疫苗的ICER值分别为272 399.41元/QALY和1 807 163.88元/QALY。单因素敏感性显示,是否接种疫苗与4价、2价疫苗的对比中,参数变化不会导致ICER值超过经济性阈值。概率敏感性分析显示,当WTP为72 447元/QALY时,接种2价疫苗的经济性概率为98.8%; 当WTP为217 341元/QALY时,接种4价疫苗的经济性概率为94.8%。结论 从卫生体系角度看,在1倍人均GDP的WTP下,接种2、4、9价HPV疫苗均具有经济性,在3倍人均GDP的WTP下,接种4价疫苗最具有经济性。     

乌鲁木齐市HIV阴性男男性行为人群自费人乳头瘤病毒疫苗接种意愿分析

目的了解乌鲁木齐市男男性行为人群(MSM))人乳头瘤病毒(HPV)疫苗接种意愿及影响因素。方法2016年3—9月,在乌鲁木齐市采用滚雪球的非概率抽样方法,招募500名HIV阴性的MSM,对其进行问卷调查,收集其人口学和性行为特征资料、HPV疫苗接种意愿。结果 500名MSM中,95.2%的人愿意接种免费的HPV疫苗,68.6%的人愿意自费购买HPV疫苗,免费疫苗与自费疫苗接受率间差异有统计学意义(x2=31.556,P0.01)。多因素logistic回归分析显示,文化程度为高中及以下的MSM相对于文化程度为本科及以上的MSM更不愿意接种自费HPV疫苗(OR=0.375,95%CI=0.229~0.616);曾被诊断为性病的MSM相对未曾被医生诊断为性病的MSM更愿意接受自费HPV疫苗(OR=2.067,95%CI=1.949~4.919)。结论男男性行为人群有较高的自费HPV疫苗接种意愿,可在该人群中推广有偿HPV疫苗。     

你家女儿,打HPV疫苗了吗

宫颈癌,是目前唯一病因明确,且有疫苗的癌症——HPV疫苗,就是防宫颈癌的. 性行为是HPV传播的起点.所以,在开始性行为之前接种HPV疫苗,获益最高. 13～15岁的女孩,尽早打 接种年龄越低,HPV疫苗诱导出的抗体水平越高,预防效果越好. 接种后,推荐30岁后开始进行宫颈癌筛查,3～5年筛查一次. 没必要等九价! 2价性价比更高 有些人执着于接种9价HPV疫苗,但9价又经常缺货.甚至预约了两年多,都没约上.     

2019—2021年汉中市南郑区人乳头瘤病毒疫苗接种情况分析

目的：分析汉中市南郑区人乳头瘤病毒（简称HPV）疫苗接种实施、受种人群分布情况,为科学使用HPV疫苗提供指导意见。方法：通过免疫规划信息系统统计HPV疫苗接种者的个人信息,描述性分析接种者地区、人群分布等情况。结果：2019—2021年汉中市南郑区HPV疫苗接种人数逐年增加,2020—2021年二、四价HPV疫苗接种者中,≤15岁人群仅占接种总人数的0.3%;四价HPV疫苗接种者中,31～35岁人群最多,占四价HPV疫苗接种总人数的29.4%;二价HPV疫苗接种者中,36～40岁人群最多,占二价HPV疫苗接种总人数的28%。2019—2021年九价HPV疫苗接种者中,24～25岁人群最多,占九价HPV疫苗接种总人数的45%。结论：南郑区HPV疫苗接种人群年龄结构不科学,应将≤15岁女性作为HPV疫苗的首要接种对象,早接种,早受益。     

青少年女性,更适合接种HPV疫苗

青少年女性接种HPV疫苗的预防效果更好。研究发现:我国城市女性初次性行为的中位年龄为22岁,农村女性为21岁;超过10%的15-19岁女性已有性生活;17-24岁和40~44岁的女性,高危型HPV的感染率较高。因此,我国2020年发布的《HPV疫苗临床应用中国专家共识》优先推荐9~26岁女性接种HPV疫苗,特别是17岁之前的女性,同时推荐27-45岁有条件的女性接种。     

青少年女性,更适合接种HPV疫苗

青少年女性接种HPV疫苗的预防效果更好。研究发现:我国城市女性初次性行为的中位年龄为22岁,农村女性为21岁;超过10%的15-19岁女性已有性生活;17-24岁和40~44岁的女性,高危型HPV的感染率较高。因此,我国2020年发布的《HPV疫苗临床应用中国专家共识》优先推荐9~26岁女性接种HPV疫苗,特别是17岁之前的女性,同时推荐27-45岁有条件的女性接种。     

HPV疫苗接种:产后期是一个非常理想的疫苗接种阶段

美国HPV疫苗的接种率和完成率较低.在2013年一项调查中,2077名19～26岁女性中,只有37％的人接种过HPV疫苗.接种人群中,18～26岁的年轻人占43.5％.这说明疫苗补种是非常重要的.产前检查时通常建议女性行宫颈癌筛查,并接种流感、破伤风、白喉和百白破疫苗.尽管妊娠期间不予注射HPV疫苗,但产后期和哺乳期接种是非常安全的.对于未接种者,产后期可以补种HPV疫苗.在一项研究中,女性认为产后接种HPV疫苗是可以接受的,95％感兴趣的女性最终接种了HPV疫苗.为了估计可接种HPV疫苗的女性产后一年内接种HPV疫苗的比例,评估在医疗保健制度下女性可能错失的疫苗接种机会,美国北卡罗来纳大学医院妇产科的Kilfoyle教授等对48001名女性(商业保险投保者)接种疫苗情况研究分析,文章发表在近期JournalOfWome'sHealth杂志上.基于数据分析结果,研究群体中产后一年内接种HPV疫苗的比例<2％,而接种的女性中也只有1/3的人接受了完整的3次HPV疫苗注射.同产后未接种疫苗的女性相比,接种的女性群体较年轻,并且从分娩前后高异常宫颈涂片率和HPV诊断率推测,其很可能已有HPV暴露.年轻女性是HPV感染风险最高的人群.     

Human papillomavirus vaccination coverage among men who have sex with men—National HIV Behavioral Surveillance,United States, 2017

Men who have sex with men (MSM) are at high risk for infections and diseases caused by human papillomavirus (HPV), many of which are vaccine-preventable. In the United States, routine HPV vaccination has been recommended for adolescent males since 2011. This analysis evaluated self-reported receipt of ≥ 1 HPV vaccine dose by age group and HIV status among adult MSM using 2017 data from National HIV Behavioral Surveillance (NHBS) and compared the proportion vaccinated to prior years. Among 10,381 MSM aged ≥ 18 years, 17.9% of MSM overall and 28.4% of MSM living with HIV reported any HPV vaccination. Among 2,482 MSM aged 18–26 years, 32.8% overall and 51.3% living with HIV reported HPV vaccination. Since 2011, the proportion of MSM aged 18–26 years reporting HPV vaccination has increased over six-fold. As vaccinated adolescents age into young adults, coverage will continue to increase overall, including among MSM.     

Anal human papillomavirus infections in young unvaccinated men who have sex with men attending a sexual health clinic for HPV vaccination in Melbourne,Australia

The Victorian Government introduced a time-limited quadrivalent human papillomavirus (HPV) vaccination catch-up program targeting gay and bisexual men who have sex with men (MSM) aged up to 26 years in 2017. As of 2017, men aged ≥20 years were not eligible for the school-based HPV vaccination program. This study examined the prevalence of anal HPV among 496 MSM aged 20–26 years before they received the first dose of the HPV vaccine at the Melbourne Sexual Health Centre, Australia. More than half (56.5%) had any high-risk HPV genotypes detected in the anus. Almost half (43.1%) had at least one quadrivalent HPV vaccine-preventable genotype (6, 11, 16 or 18) and one-fifth (21.0%) had HPV 16 detected in the anus. These findings suggest that a targeted catch-up HPV vaccination program for MSM is still beneficial to protect against high-risk HPV genotypes associated with anal cancer, as well as low-risk HPV genotypes.     

How very young men who have sex with men view vaccination against human papillomavirus

Background

HPV vaccination of men who have sex with men (MSM) prior to the commencement of sexual activity would have the maximum impact on preventing HPV and anal cancer in this population. However, knowledge and attitudes towards HPV vaccination among very young MSM have not been previously studied.

Methods

Two hundred MSM aged 16 to 20 were recruited via community and other sources. Participants were asked about their knowledge and attitudes towards HPV and HPV vaccination.

Results

Most (80%, 95% confidence interval (CI) 72.2–87.2%) men were not willing to purchase the vaccine because of its cost (AUD$450). However, if the vaccine was offered to MSM free of charge, 86% (95% CI: 80–90%) reported they would be willing to disclose their sexuality to a health care provider in order to obtain the vaccine. Over half (54%, 95%: 47–61%) of men would only be willing to disclose their sexuality to receive the HPV vaccine after their first experience of anal intercourse. The age at first insertive anal intercourse and the age at first receptive anal intercourse were 0.21 (IQR: −2.5 to 3.2) and 0.17 (IQR: −2.9 to 2.7) years earlier than the age that men would be willing to disclose their sexuality to receive the HPV vaccine, respectively. Willingness to receive the vaccine at a younger age was associated with younger age at first insertive anal intercourse.

Conclusion

Overall, very young MSM expressed high acceptance of HPV vaccination. Early, opportunistic vaccination of very young MSM may be feasible in settings where very young MSM have not been vaccinated through universal programs targeting school aged males. However, given HPV infections occur early on, the effectiveness of this approach will be less than vaccination targeting school aged boys.     

HPV vaccine uptake in men who have sex with men in Scotland

Human papillomavirus (HPV) vaccines are currently utilised globally in national immunisation programmes. In July 2017, a national HPV vaccine programme for men who have sex with men (MSM) was initiated across Scotland with vaccine being offered in the sexual health clinic setting. During the first year of this targeted vaccination programme, there were 5905 individuals who received at least one dose of HPV vaccine, representing 63.7% of eligible MSM attendees in this period. Vaccine uptake was relatively stable across all age groups (range 49.8–55.5%). The vaccination programme appears to have dovetailed well with pre-existing sexual health services and appears to be popular with MSM attending the service. The MSM HPV vaccine programme is a robust adjunct to the national girls programme but gender-neutral immunisation will reduce stigma and inequality in HPV-driven disease.     

Acceptability of human papillomavirus vaccination and sexual experience prior to disclosure to health care providers among men who have sex with men in Vancouver, Canada: Implications for targeted vaccination programs

BACKGROUND: Men who have sex with men (MSM) may benefit from human papillomavirus (HPV) vaccine due to increased risk for HPV infection and related disease. We assessed HPV vaccine acceptability and sexual experience prior to disclosure to Health Care Providers (HCP) to understand implications of targeted vaccination strategies for MSM. METHODS: From July 2008 to February 2009, 1169 MSM aged ≥19 years were recruited at community venues in Vancouver. We assessed key variables from a self-administered questionnaire and independent predictors of HPV vaccine acceptability using multivariate logistic regression. RESULTS: Of 1041 respondents, 697 (67.0%) were willing to receive HPV vaccine and 71.3% had heard of HPV. Significant multivariate predictors of higher vaccine acceptability were (adjusted odds ratio [95% CI]): previous diagnosis of genital warts (1.7 [1.1, 2.6]), disclosure of sexual behavior to HCP (1.6 [1.1, 2.3]), annual income at least $20,000 (1.5 [1.1, 2.1]), previous hepatitis A or B vaccination (1.4 [1.0, 2.0]), and no recent recreational drug use (1.4 [1.0, 2.0]). Most MSM (78.7%) had disclosed sexual behavior to HCP and median time from first sexual contact with males to disclosure was 6.0 years (IQR 2-14 years); for men ≤26 years these were 72.0% and 3.0 years (IQR 1-8 years) respectively. CONCLUSIONS: Willingness to receive HPV vaccine was substantial among MSM in Vancouver; however, acceptability varied by demographics, risk, and health history. HPV vaccine programs delivered by HCP would offer limited benefit given the duration of time from sexual debut to disclosure to HCP.     

Assessing knowledge of human papillomavirus among men who have sex with men (MSM) using targeted dating applications

BackgroundThe incidence of HPV-related oropharyngeal and anal cancer has been increasing significantly over the past 30 years, especially among males. This study sought to better understand the level of knowledge of HPV-related disease in the LGBTQ+ community, and serve as a method to increase awareness for HPV vaccination as a safe and effective method for cancer prevention.MethodsSCRUFF and Jack’d are geosocial networking and dating mobile applications for men who have sex with men (MSM). All users of the applications who were located in the US at the time of the study were invited to participate in a survey on HPV knowledge, the HPV vaccine, and vaccination status. The Pearson test was used to identify possible associations.ResultsHalf of the HPV vaccine-eligible respondents reported having received at least one dose of the HPV vaccine, while only 37.9% of the individuals aged 9–26 reported being vaccinated against HPV. Among the unvaccinated, 63.3% reported being interested in future vaccination, or learning more about it. No significant differences were noted regarding vaccination status nor HPV knowledge between respondents from rural vs urban locations. Respondents from the South were the least knowledgeable about cancer and genital warts caused by HPV (79.4%, p < 0.01), and had the lowest rate of vaccination compared to other regions (18.5%, p < 0.01). More than half of respondents reported being either somewhat comfortable (15.8%) or very comfortable (42.2%) with receiving the HPV vaccine from a dentist.ConclusionsThe findings of this study identify demographic groups and geographical areas where preventive campaigns for HPV would be most needed. The findings highlight dental providers as an underutilized source of HPV education and vaccine recommendation. The study reveals opportunities to close gaps in care and knowledge, and points to future directions for research and development of effective interventions.     

Men who have sex with men who do not access sexual health clinics nor disclose sexual orientation are unlikely to receive the HPV vaccine in the UK

BackgroundMen who have sex with men (MSM) are recommended the Human Papillomavirus (HPV) vaccination due to their higher risk of genital warts and anal cancer.PurposeTo examine HPV vaccine acceptability amongst MSM in the UK.MethodsUsing advertisements via Facebook, MSM were recruited to an online survey measuring motivations for HPV vaccination. Logistic regression was performed to identify predictors of HPV vaccine acceptability.ResultsOut of 1508 MSM (median age = 22, range: 14–63 years) only 19% knew about HPV. Overall, 55% of MSM were willing to ask for the HPV vaccine and 89% would accept it if offered by a healthcare professional (HCP). Access to sexual health clinics (SHCs) [OR = 1.82, 95% CI 1.29–2.89], the disclosure of sexual orientation to a HCP [OR = 2.02, CI 1.39–3.14] and HIV-positive status [OR = 1.96, CI 1.09–3.53] positively predicted HPV vaccine acceptability. After receiving information about HPV, perceptions of HPV risk [OR = 1.31, CI 1.05–1.63], HPV infection severity [OR = 1.89, CI 1.16–3.01), HPV vaccination benefits [OR = 1.61, CI 1.14–3.01], HPV vaccine effectiveness [OR = 1.54, CI 1.14–2.08], and the lack of perceived barriers to HPV vaccination [OR = 4.46, CI 2.95–6.73] were also associated with acceptability.ConclusionsAlthough nearly half of MSM would not actively pursue HPV vaccination, the vast majority would accept the vaccine if recommended by HCPs. In order to achieve optimal uptake, vaccine promotion campaigns should focus on MSM who do not access SHCs and those unwilling to disclose their sexual orientation.     

Cost-effectiveness of nonavalent HPV vaccination among males aged 22 through 26 years in the United States

IntroductionIn the United States, routine human papillomavirus (HPV) vaccination is recommended for females and males at age 11 or 12 years; the series can be started at age 9 years. Vaccination is also recommended for females through age 26 years and males through age 21 years. The objective of this study was to assess the health impact and cost-effectiveness of harmonizing female and male vaccination recommendations by increasing the upper recommended catch-up age of HPV vaccination for males from age 21 to age 26 years.MethodsWe updated a published model of the health impact and cost-effectiveness of 9-valent human papillomavirus vaccine (9vHPV). We examined the cost-effectiveness of (1) 9vHPV for females aged 12 through 26 years and males aged 12 through 21 years, and (2) an expanded program including males through age 26 years.ResultsCompared to no vaccination, providing 9vHPV for females aged 12 through 26 years and males aged 12 through 21 years cost an estimated $16,600 (in 2016 U.S. dollars) per quality-adjusted life year (QALY) gained. The estimated cost per QALY gained by expanding male vaccination through age 26 years was $228,800 and ranged from $137,900 to $367,300 in multi-way sensitivity analyses.ConclusionsThe cost-effectiveness ratios we estimated are not so favorable as to make a strong economic case for recommending expanding male vaccination, yet are not so unfavorable as to preclude consideration of expanding male vaccination. The wide range of plausible results we obtained may underestimate the true degree of uncertainty, due to model limitations. For example, the cost per QALY might be less than our lower bound estimate of $137,900 had our model allowed for vaccine protection against re-infection. Models that specifically incorporate men who have sex with men (MSM) are needed to provide a more comprehensive assessment of male HPV vaccination strategies.     

Immunogenicity and safety of the 9-valent HPV vaccine in men

ObjectivesThis study was designed to evaluate the immunogenicity and tolerability of a prophylactic 9-valent HPV (types 6/11/16/18/31/33/45/52/58) VLP (9vHPV) vaccine in young men 16–26 years of age in comparison to young women 16–26 years of age (the population that was used to establish 9vHPV vaccine efficacy). Safety and immunogenicity data from this study will be used to bridge 9vHPV vaccine efficacy findings in 16–26 year old women to 16–26 year old men.MethodsThis study enrolled 1106 heterosexual men (HM) and 1101 women who had not yet received HPV vaccination. In addition, 313 men having sex with men (MSM) were enrolled and were evaluated separately for immunogenicity because previous results showed that antibody responses to quadrivalent HPV (types 6/11/16/18) VLP (qHPV) vaccine were lower in MSM than in HM. All subjects were administered a 3-dose regimen (Day 1, Month 2, Month 6) of 9vHPV vaccine. Serum samples were collected for anti-HPV assays. Safety information was collected for ∼12 months.ResultsThe geometric mean titers (GMTs) for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 for HM were non-inferior to those of women at Month 7. For all vaccine HPV types, Month 7 GMTs were numerically lower in MSM than in HM. Over 99.5% of subjects were seropositive at Month 7 for each vaccine HPV type. Administration of 9vHPV vaccine to both 16–26 year old men and women was generally well tolerated.ConclusionsThese results support bridging the efficacy findings with 9vHPV vaccine in young women 16–26 years of age to men 16–26 years of age.     

Practical implementation of HPV vaccines in clinical practice

Human papillomavirus (HPV) currently infects approximately 20 million people in the United States. An effective new vaccine has been approved for girls and young women aged 9 to 26 years that can decrease the spread of infection due to HPV and the future incidence of cervical cancer and genital warts. Family physicians should be aware of parental or patient attitudes and knowledge about HPV and concerns about HPV vaccination if they are to successfully implement HPV vaccination in their practices.