Effectiveness of a Community-Based Organization—Private Clinic Service Model in Promoting Human Papillomavirus Vaccination among Chinese Men Who Have Sex with Men

Zixin Wang,Paul Shing-Fong Chan,Francois Fong,Joseph T F Lau,Andrew Chidgey,Mary Ip,Yuan Fang

doi:10.3390/vaccines9111218

Abstract

This study evaluated the effectiveness of the community-based organization (CBO)-private clinic service model in increasing human papillomavirus (HPV) vaccination uptake among unvaccinated men who have sex with men (MSM) in Hong Kong during a 12-month follow-up period. A CBO-private clinic model was implemented to promote HPV vaccination among Chinese MSM. A CBO with good access to MSM approached MSM aged 18–45 years who had never received an HPV vaccination, invited them to receive an online health promotion, and referred them to receive HPV vaccination at gay-friendly private clinics. A baseline survey and a follow-up evaluation at Month 12 were conducted. A total of 350 participants completed the baseline survey. Among 274 participants who were followed up at Month 12, 46 (16.8%) had taken up at least one dose of HPV vaccination. After adjusting for significant baseline characteristics, the perceived susceptibility (AOR:1.25, p = 0.002) and perceived severity (AOR:1.21, p = 0.003) of HPV and HPV-related diseases, perceived benefits (AOR:1.16, p = 0.03), self-efficacy to receive HPV vaccination (AOR:1.37, p = 0.001), and behavioral intention to take up HPV vaccination at baseline (AOR:6.99, p < 0.001) significantly predicted HPV vaccination uptake. The process evaluation of the program was positive. The CBO-private clinic service model was helpful in increasing HPV vaccination uptake among MSM.

Highlights

Across countries, men who have sex with men (MSM) have a much higher risk of contracting human papillomavirus (HPV) and its related diseases than the general male population [1,2,3,4]
The results showed that watching a 5-min online video based on the Health Belief Model [32] and receiving brief motivational interviewing (MI) through telephone was effective in improving HPV vaccination uptake over a 24-month study period [31]
This study evaluated the effectiveness of the community-based organization (CBO)-private clinics service model in increasing HPV vaccination uptake among unvaccinated MSM in Hong Kong during a 12-month follow-up period

Summary

Introduction

Men who have sex with men (MSM) have a much higher risk of contracting human papillomavirus (HPV) and its related diseases (e.g., genital warts and penile cancers) than the general male population [1,2,3,4]. As reported by a meta-analysis, the overall prevalence of genital HPV infection was very high among both human immunodeficiency virus (HIV)-negative (63.9%) and HIV-infected MSM (92.6%) [5]. The overall prevalence of high-grade anal histological lesions was 23.9% among HIV-infected MSM and 15.2% among HIV-negative MSM [5]. Slow clearance and increased persistence of high-risk HPV might explain why HIV-infected MSM are more susceptible to HPV and its related diseases compared with HIV-negative MSM [9,10,11,12,13]. In Hong Kong, among MSM with an experience of HPV screening, 25% were diagnosed with HPV infection [14]

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Discussion

Conclusion