Male Human Papillomavirus Vaccination Research Articles

Health beliefs and attitudes associated with HPV vaccine intention among young gay and bisexual men in the southeastern United States

Gay and bisexual men are at increased risk of anal cancer as a result of human papillomavirus (HPV) infection. Prophylactic vaccination is a potentially effective strategy for preventing anal cancer in this population. The purpose of this study was to identify factors associated with gay and bisexual men's intention to receive HPV vaccine. In the fall of 2010, 179 self-identified gay and bisexual men (mean age 22 years) completed an Internet-based questionnaire assessing beliefs and attitudes toward HPV vaccination. Men were recruited from college-based and Internet venues throughout the southeastern United States. The probability of intent to receive HPV vaccine was modeled using logistic regression. A majority of men (93%) had heard of HPV prior to participation but were generally unaware of the association of HPV with anal, penile, and oral cancers. Only 26% were aware of an HPV vaccine for males. Of the 179 participants, 64 (36%) were likely to be vaccinated. Men most likely to receive HPV vaccine perceived stronger physical and psychological benefits from vaccination and had more positive attitudes toward the vaccine. Conversely, intent to be vaccinated was negatively associated with concern over the financial cost of vaccination. Findings from this study can inform college-based health education programs aimed at increasing vaccine uptake among gay and bisexual men.

Human papillomavirus (HPV): college male's knowledge, perceived risk, sources of information, vaccine barriers and communication

Background Human papillomavirus (HPV) is a common sexually transmitted infection. With the U.S. Food and Drug Administration (FDA) approval of an indication for the HPV vaccine for males, it is important to assess male college student's HPV knowledge, perceived risk, and sources of information, as well as HPV vaccine barriers and communication. Methods This was a cross-sectional survey study of 165 male college students. The participants completed a survey about HPV and the HPV vaccine. Results Among the 165 participants, most males had poor HPV knowledge, in that 132 (80.0%) reported having had sexual intercourse, but only 20 (12.1%) perceived being at risk for acquiring HPV. Information sources about HPV were commercials/advertisements, friends, news and health education programs. Concern about the HPV vaccine's long-term effects and cost were the most frequently reported barriers. Most students reported having a regular healthcare provider, but had difficulty getting to their provider, and finding time to discuss the HPV vaccine with their provider. Additionally, most students reported relying on their parents when making medical decisions and being willing to discuss the HPV vaccine with their healthcare provider to make an informed decision about the vaccine. Conclusions Educational programs providing information about HPV, the HPV vaccine, and communication skills training are needed for male college students, parents, and healthcare providers. Findings from this study will guide the development of HPV vaccine messages and educational programs that should be tested in future research.

The cost-effectiveness of male HPV vaccination in the United States

The objective of this study was to estimate the cost-effectiveness of adding human papillomavirus (HPV) vaccination of 12-year-old males to a female-only vaccination program for ages 12-26 years in the United States. We used a simplified model of HPV transmission to estimate the reduction in the health and economic burden of HPV-associated diseases in males and females as a result of HPV vaccination. Estimates of the incidence, cost-per-case, and quality-of-life impact of HPV-associated health outcomes were based on the literature. The HPV-associated outcomes included were: cervical intraepithelial neoplasia (CIN); genital warts; juvenile-onset recurrent respiratory papillomatosis (RRP); and cervical, vaginal, vulvar, anal, oropharyngeal, and penile cancers. The cost-effectiveness of male vaccination depended on vaccine coverage of females. When including all HPV-associated outcomes in the analysis, the incremental cost per quality-adjusted life year (QALY) gained by adding male vaccination to a female-only vaccination program was $23,600 in the lower female coverage scenario (20% coverage at age 12 years) and $184,300 in the higher female coverage scenario (75% coverage at age 12 years). The cost-effectiveness of male vaccination appeared less favorable when compared to a strategy of increased female vaccination coverage. For example, we found that increasing coverage of 12-year-old girls would be more cost-effective than adding male vaccination even if the increased female vaccination strategy incurred program costs of $350 per additional girl vaccinated. HPV vaccination of 12-year-old males might potentially be cost-effective, particularly if female HPV vaccination coverage is low and if all potential health benefits of HPV vaccination are included in the analysis. However, increasing female coverage could be a more efficient strategy than male vaccination for reducing the overall health burden of HPV in the population.

Factors Associated With Parental Intentions for Male Human Papillomavirus Vaccination: Results of a National Survey

In October 2009, a quadrivalent vaccine for human papillomavirus (HPV) was licensed in the United States for males aged 9 to 26 years. The attitudes and beliefs of parents play a critical role in uptake of this vaccine because parental consent is typically required for adolescent HPV vaccination. This study aimed to determine attitudes about, and intention for, male HPV vaccination among a national sample of parents and to evaluate the effect of different types of messages regarding benefits of male HPV vaccination on these outcomes. A nationally representative sample of parents completed a cross-sectional survey shortly before licensure of the HPV vaccine for men. Parents of boys (n = 1178) were asked questions about future intent to vaccinate their sons against HPV after randomly receiving one of 2 different messages about the potential benefits of male HPV vaccination. Survey completion rate was 62%. Most parents (90%) believed that male HPV vaccination was generally important. However, only 51% of parents of boys intended to have their own sons vaccinated against HPV. The strongest predictors of vaccination intent included high perceived benefits of being vaccinated and low perceived barriers to vaccination. Black race and having less than a high school education were also associated with higher vaccination intent, but only among parents of adolescents (9-17 years), not among parents of younger boys (0-8 years). There were no differences in parental intentions or beliefs between the different message groups. There is a significant discrepancy between parents' general support of male HPV vaccination and their intentions to have their own sons vaccinated. Our results highlight the beliefs and attitudes associated with increased parental intention for male HPV vaccination.

Role and uptake of human papillomavirus vaccine in adolescent health in the United States

Both the prophylactic human papillomavirus (HPV) vaccines, Gardasil® and Cervarix®, are licensed for the prevention of cervical cancer in females, and Gardasil is also licensed for the prevention of genital warts and anal cancer in both males and females. This review focuses on the uptake of these vaccines in adolescent males and females in the USA and the barriers associated with vaccine initiation and completion. In the USA in 2009, approximately 44.3% of adolescent females aged 13–17 years had received at least one dose of the HPV vaccine, but only 26.7% had received all three doses. In general, the Northeast and Midwest regions of the USA have the highest rates of HPV vaccine initiation in adolescent females, while the Southeast has the lowest rates of vaccine initiation. Uptake of the first dose of the HPV vaccine in adolescent females did not vary by race/ethnicity; however, completion of all three doses is lower among African Americans (23.1%) and Latinos (23.4%) compared with Caucasians (29.3%). At present, vaccination rates among adolescent females are lower than expected, and thus vaccine models suggest that it is more cost-effective to vaccinate both adolescent males and females. Current guidelines for HPV vaccination in adolescent males is recommended only for “permissive use,” which leaves this population out of routine vaccination for HPV. The uptake of the vaccine is challenged by the high cost, feasibility, and logistics of three-dose deliveries. The biggest impact on acceptability of the vaccine is by adolescents, physicians, parents, and the community. Future efforts need to focus on HPV vaccine education among adolescents and decreasing the barriers associated with poor vaccine uptake and completion in adolescents before their sexual debut, but Papanicolau screening should remain routine among adults and those already infected until a therapeutic vaccine can be developed.

Economic burden of HPV-related cancers in France

Human papillomavirus (HPV) infection is associated with a range of diseases and cancers at different anatomical sites. In addition to its role as a necessary cause of cervical cancer, HPV is also associated with cancers of the vulva, vagina, anus, penis, head and neck. With the exception of cervical cancer, however, very few data are available on the economic burden of HPV-associated cancers. We assessed the annual costs associated with management of HPV-related cancers in France from the healthcare payers’ perspective. We used data from studies that employed similar methodologies to estimate the costs during 2006 for cervical cancer, vulvar and vaginal cancers, anal cancer, and penile cancer, and during 2007 for head and neck cancers. Data on hospital-management costs for cancer were derived from the French national hospital database. The costs of outpatient care and daily allowance costs were estimated using data from the French National Institute of Cancer report for 2007. The costs for HPV-related cancers were estimated according to the percentage of each cancer type attributable to HPV infection. The estimated total costs associated with HPV-related cancers in France were €239.7 million. The overall costs in men were €107.2 million, driven mainly by head and neck cancers (€94.6 million). The total costs in women were €132.5 million, due mainly to invasive cervical cancer (€83.9 million). The costs associated with HPV-related cancers are important to consider when evaluating the overall benefits of HPV vaccination in males and females.

Dynamics of genital human papillomavirus (HPV) infections among males eventually being uncovered

Dynamics of genital human papillomavirus (HPV) infections among males eventually being uncovered

Abstract SY32-01: Human papillomavirus vaccines in females and males

Abstract SY32-01: Human papillomavirus vaccines in females and males

Vaccine Coding Update

Coding guidelines for human papillomavirus vaccine for males

Human Papillomavirus Vaccination of Males: Attitudes and Perceptions of Physicians Who Vaccinate Females

We assessed U.S. physicians' attitudes and perceptions regarding potential human papillomavirus (HPV) vaccination of males. We surveyed a random sample of 2,714 pediatricians and family practitioners identified in administrative claims of a U.S. health plan as HPV vaccinators of females; 595 pediatricians and 499 family practitioners participated. Most physicians would recommend HPV vaccination to males aged 11-12 (63.9%), 13-18 (93.4%), and 19-26 (92.7%) years. Physicians agreed that males should be vaccinated to prevent them from getting genital and anal warts (52.9% strongly and 36.0% somewhat) and to protect females from cervical cancer (75.3% strongly and 20.8% somewhat). Physicians agreed that an HPV vaccine recommendation for males would increase opportunities to discuss sexual health with adolescent male patients (58.7% strongly, 35.3% somewhat). Most did not strongly agree (15.4% strongly, 45.4% somewhat) that parents of adolescent male patients would be interested in HPV vaccination for males, that a gender-neutral HPV vaccine recommendation would increase acceptance by adolescent females and their parents (19.6% strongly, 42.0% somewhat), or that a gender-neutral recommendation would improve current female vaccination rates (10.4% strongly, 26.0% somewhat). Physicians who currently vaccinate females against HPV supported the concept of vaccinating males for its benefits for both sexes. They agreed that a gender-neutral HPV vaccination recommendation would be appropriate with regard to public health and believed that it would increase opportunities for sexual health discussions, but were less sure that such a recommendation would change patient or parental attitudes toward HPV vaccination or improve current HPV vaccination efforts.

Cost Effectiveness of HPV Vaccine for Boys

Cost Effectiveness of HPV Vaccine for Boys

Acceptability of Human Papillomavirus Vaccine for Males: A Review of the Literature

The quadrivalent human papillomavirus virus vaccine was recently licensed for use in males in the United States. This study reviews available published literature on acceptability among parents, health care providers, and young males. Among 23 published articles, half were conducted in the United States. The majority (87%) used quantitative survey methodology, and 13% used more explorative qualitative techniques. Convenience samples were used in most cases (74%) and 26% relied on nationally representative samples. Acceptability of a human papillomavirus virus (HPV) vaccine that protects against cervical cancer and genital warts was high in studies conducted among male college students (74%-78%) but lower in a community sample of males (33%). Among mothers of sons, support of HPV vaccination varied widely from 12% to 100%, depending on the mother's ethnicity and type of vaccine, but was generally high for a vaccine that would protect against both genital warts and cervical cancer. Health providers' intention to recommend HPV vaccine to male patients varied by patient age but was high (82%-92%) for older adolescent patients. A preference to vaccinate females over males was reported in a majority of studies among parents and health care providers. Messages about cervical cancer prevention for female partners did not resonate among adult males or parents. Future acceptability studies might incorporate more recent data on HPV-related disease, HPV vaccines, and cost-effectiveness data to provide more current information on vaccine acceptability.

Human Papillomavirus Vaccine Acceptability Among Young Adult Men

For human papillomavirus (HPV) vaccination to have maximum benefit to public health, both men and women should be vaccinated. Although efficacy trials in men are still ongoing, the HPV vaccine will likely be licensed for men in the near future. Little is known about men's interest in HPV vaccination. This study assessed whether informing men about the benefits of male HPV vaccination for their female sexual partner(s) boosted interest in the HPV vaccine beyond informing them about the benefits to men alone. Predictors of HPV vaccine acceptability were also identified. Heterosexual male college students (n = 356) were randomly assigned to receive a self-protection versus a self-protection and partner protection message about HPV and the quadrivalent HPV vaccine. Participants provided demographic and sexual history information, HPV-related awareness and knowledge, health beliefs, and HPV vaccination intentions. : Men reported moderate interest in the HPV vaccine; vaccine acceptability did not differ by experimental condition. A multivariate regression model identified several independent predictors of HPV vaccine acceptability including sexual activity, perceived susceptibility to HPV, perceived benefits of the vaccine, perceived hassle and cost of vaccination, self-efficacy for vaccination, and perceived norms for vaccination. Informing men about the benefits of male HPV vaccination for reducing cervical cancer risk in women did not increase men's interest in the vaccine. Correlates of vaccine acceptability among men were generally consistent with those identified for women. Findings have important implications for future HPV vaccination campaigns targeting young adult men.

Human papillomavirus vaccination in males

Human papillomavirus (HPV) is one of the most common sexually transmitted diseases (STDs) and is frequently presented clinically as anogenital warts in both males and females. There is a high rate of transmission of HPV in female partners of men with pre-existing penile warts, and HPV infection in men has been shown to contribute to HPV infection and subsequent cervical disease in women. HPV is associated with significant morbidity and represents a substantial healthcare burden. Data indicate that males experienced a longer duration of genital warts and incurred greater treatment costs than women. The quadrivalent vaccine, the first vaccine to be approved for use in adolescent and young women aged 9 to 26 years for the prevention of cervical cancer and genital warts, targets HPV types -6, and -11 (responsible for genital warts), and HPV types-16 and -18 (involved in cervical cancer). Pharmacoeconomic data determined that routine administration of a prophylactic quadrivalent HPV vaccine to 12-year-old males and females in addition to catch-up vaccination of 12- to 24-year-old males and females, within the setting of organized cervical cancer screening within the US, was the most cost-effective strategy. It is also anticipated that widespread use of vaccines that offer protection against HPV-6 and -11 could potentially reduce the workload at STD clinics by approximately 10% without a substantial impact on the diagnosis and treatment of other STDs. To optimally control transmission of HPV, consideration should be given to vaccinating males as well as females.

The optical and electron microscopic determination of pulmonary asbestos fibre concentration and its relation to the human pathological reaction.

The quantitative extraction of asbestos fibres from asbestotic lung by alkali digestion has been refined by maceration of the tissue without prior drying, the minimum use of centrifugation, and the adoption of phase contrast microscopy. Preliminary experiments suggested that, using this technique, asbestos fibre counts were accurate to within at least +/- 20% and in most instances to within +/- 10%. The method was used to assess asbestos concentrations in lung tissue showing various degrees and forms of fibrosis. The results, as determined by light microscopy, indicated that uncoated fibres generally outnumbered coated fibres. In mild and moderate asbestosis there was a progressive increase in concentration of asbestos fibres, both coated and uncoated, with increasing severity of fibrosis, whereas in severe asbestosis no correlation existed between the fibre concentration and the form or the extent of the pathological reaction. It is suggested that the severe fibrosis results from the supervention of non-specific inflammatory processes. Asbestos fibre diameter distributions, gauged by electron microscopy, were fairly constant irrespective of the degree of fibrosis. Optically visible fibres constituted between 12 and 30% of the total, so that an optical count may be said to give an approximate indication of the total asbestos concentration and, so far as asbestosis is concerned, may well serve for comparative purposes. The relation between asbestos and neoplasia will, however, require identification and quantitation of particular types of the mineral by microanalytical techniques.