Abstract
Background: Despite the insupportable burden caused by the human papillomavirus (HPV) and high vaccine acceptability, vaccination programs are not currently available for men who have sex with men (MSM). We aimed to assess HPV infection by examining the willingness for vaccination among MSM and cost-effectiveness of the Chinese 2-valent HPV vaccine.Methods: We recruited MSM in Shenyang, China between July and December 2020 to conduct anal HPV testing and an online survey regarding HPV-related knowledge and vaccine acceptability. We performed a cost-effectiveness analysis to evaluate the incremental cost-effectiveness ratios (ICERs) of the Chinese 2-valent HPV vaccine.Results: A total of 234 participants completed the online survey; of those, 203 were successfully tested for HPV. The median age was 30 years [interquartile range (IQR): 23–38 years]. Most participants had at least undergraduate education (136/234, 58.1%). The acceptability rate for the free HPV vaccine was 57.7% (135/234). The prevalence of HPV types 16 and 18 was 14.9% (18/121) and 26.8% (22/82) in the willing and unwilling to vaccinate groups, respectively (P > 0.05). The prevalence of high-risk HPV among participants aged <30 and ≥50 years was 48.6 and 38.9%, respectively. Using the Chinese per capita gross domestic product (GDP) as a threshold, the Chinese 2-valent HPV vaccine would be a “very cost-effective” strategy, with an ICER value of USD 4,411. This evidence showed that the Chinese 2-valent HPV vaccine was more cost-effective than other imported vaccines.Conclusions: Targeted strategies should be utilized in MSM with different rates of vaccine acceptability. A pilot HPV vaccination program based on the Chinese 2-valent HPV vaccine for MSM is urgently warranted to reduce the burden of HPV and anal cancer.
Highlights
Men who have sex with men (MSM) are at a higher risk of infection with human papillomavirus (HPV) than females and heterosexual males with a global prevalence of 53.6 and 89.0% among human immunodeficiency virus-negative (HIV-negative) and HIV-positive MSM, respectively [1, 2]
We conducted a cross-sectional study between July and December 2020 to investigate the acceptability of the HPV vaccine and anal infection with HPV among MSM
Coinciding with the increasing willingness for HPV vaccination among MSM in China and the release of the first locally produced HPV vaccine in 2019, which is associated with lower costs compared with imported vaccines, we analyzed the prevalence of infection with HPV in combination with the willingness for vaccination among MSM and cost-effectiveness of the Chinese 2-valent HPV vaccine
Summary
Men who have sex with men (MSM) are at a higher risk of infection with human papillomavirus (HPV) than females and heterosexual males with a global prevalence of 53.6 and 89.0% among human immunodeficiency virus-negative (HIV-negative) and HIV-positive MSM, respectively [1, 2]. In China, MSM are suffering a similar burden caused by HPV and anal cancer [5]. Considering the heavy burden caused by HPV, there is high acceptability of vaccination against HPV among MSM. Previous studies have only separately examined infection with HPV or vaccine acceptability among MSM [7,8,9,10,11]. Further investigation of the relationship between infection with HPV and willingness to receive a vaccine is warranted to determine the benefits of vaccination in MSM. Despite the insupportable burden caused by the human papillomavirus (HPV) and high vaccine acceptability, vaccination programs are not currently available for men who have sex with men (MSM). We aimed to assess HPV infection by examining the willingness for vaccination among MSM and cost-effectiveness of the Chinese 2-valent HPV vaccine
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