HPV Knowledge and Vaccine Acceptability: Sample of Heterosexual Men
HPV Knowledge and Vaccine Acceptability: Sample of Heterosexual Men
Objectives If approved for use in young males in the United States, prophylactic human papillomavirus (HPV) vaccine may reduce the incidence of HPV-related disease in vaccinated males and their sexual partners. We aimed to characterise heterosexual men's willingness to get HPV vaccine and identify correlates of vaccine acceptability.
Methods Participants were from a national sample of heterosexual men (n=297) aged 18–59 y from the United States who were interviewed in January 2009. We analysed data using multivariate logistic regression.
Results Most men had not heard of HPV prior to the study or had low HPV knowledge (81%; 239/296). Most men had heard of HPV vaccine prior to the study (63%; 186/296) and 37% (109/296) were willing to get HPV vaccine. Men were more willing to get vaccinated if they reported higher perceived likelihood of getting HPV-related disease (OR 1.80, 95% CI 1.02 to 3.17), perceived HPV vaccine effectiveness (OR 1.86, 95% CI 1.22 to 2.83) or anticipated regret if they did not get vaccinated and an HPV infection later developed (OR 2.01, 95% CI 1.40 to 2.89). Acceptability was also higher among men who thought (OR 9.02, 95% CI 3.45 to 23.60) or who were unsure (OR 2.67, 95% CI 1.30 to 5.47) if their doctor would recommend they get HPV vaccine if licenced for males.
Conclusions Men had low HPV knowledge and were moderately willing to get HPV vaccine. These findings underscore the need for HPV educational efforts for men and provide insight into some of the factors that may affect the HPV vaccination decision making process among men.
Human papillomavirus (HPV) infection is common among men, with most studies reporting prevalence levels of at least 20%. Approximately 75% of infections clear within 1 year, but men infected with HPV still face potentially severe health consequences. Oncogenic HPV types (mainly types 16 and 18) may be responsible for up to 63% of oropharyngeal cancers, 93% of anal cancers and 36% of penile cancers in the United States. Genital warts are primarily attributable to infection with nononcogenic HPV types 6 and 11. Men infected with HPV also put their female partners at increased risk for cervical disease.
The United States has approved a quadrivalent HPV vaccine against types 6, 11, 16 and 18 for use in females aged 9–26 y to protect against cervical cancer and genital warts. Research suggests the vaccine may also reduce the incidence of persistent HPV infection and genital warts among young men not infected with HPV types included in the vaccine. Statistical models differ as to whether vaccinating males against HPV will be cost-effective, with more favourable conclusions reached when models accounted for diseases in addition to cervical cancer in females or HPV-related diseases in males. A US Food and Drug Administration advisory panel recently recommended approving HPV vaccine for males aged 9–26 y, although formal Food and Drug Administration approval has not yet occurred.
For optimal public health benefit, HPV vaccination should occur before first sexual intercourse. The population-level benefit of vaccinating adult men against HPV is unknown and may not outweigh the costs. However, if HPV vaccine is licenced for adolescent males, adult men will still have to decide whether 'off-label' vaccination offers potential individual benefits that outweigh out-of-pocket costs. Similar off-label HPV vaccination is already occurring among adult women in the United States. Thus, it is of interest to examine HPV vaccine acceptability among adult men. HPV vaccine acceptability among college students or other convenience samples of adult men has previously ranged from modest (33%–48%) to relatively high (78%).
In this study, we aimed to characterise correlates of HPV vaccine acceptability among a national sample of heterosexual men. We focused on constructs from health behaviour theories and previous research on HPV vaccine among adult women, parents and adolescent females.
Abstract and Introduction
Abstract
Objectives If approved for use in young males in the United States, prophylactic human papillomavirus (HPV) vaccine may reduce the incidence of HPV-related disease in vaccinated males and their sexual partners. We aimed to characterise heterosexual men's willingness to get HPV vaccine and identify correlates of vaccine acceptability.
Methods Participants were from a national sample of heterosexual men (n=297) aged 18–59 y from the United States who were interviewed in January 2009. We analysed data using multivariate logistic regression.
Results Most men had not heard of HPV prior to the study or had low HPV knowledge (81%; 239/296). Most men had heard of HPV vaccine prior to the study (63%; 186/296) and 37% (109/296) were willing to get HPV vaccine. Men were more willing to get vaccinated if they reported higher perceived likelihood of getting HPV-related disease (OR 1.80, 95% CI 1.02 to 3.17), perceived HPV vaccine effectiveness (OR 1.86, 95% CI 1.22 to 2.83) or anticipated regret if they did not get vaccinated and an HPV infection later developed (OR 2.01, 95% CI 1.40 to 2.89). Acceptability was also higher among men who thought (OR 9.02, 95% CI 3.45 to 23.60) or who were unsure (OR 2.67, 95% CI 1.30 to 5.47) if their doctor would recommend they get HPV vaccine if licenced for males.
Conclusions Men had low HPV knowledge and were moderately willing to get HPV vaccine. These findings underscore the need for HPV educational efforts for men and provide insight into some of the factors that may affect the HPV vaccination decision making process among men.
Introduction
Human papillomavirus (HPV) infection is common among men, with most studies reporting prevalence levels of at least 20%. Approximately 75% of infections clear within 1 year, but men infected with HPV still face potentially severe health consequences. Oncogenic HPV types (mainly types 16 and 18) may be responsible for up to 63% of oropharyngeal cancers, 93% of anal cancers and 36% of penile cancers in the United States. Genital warts are primarily attributable to infection with nononcogenic HPV types 6 and 11. Men infected with HPV also put their female partners at increased risk for cervical disease.
The United States has approved a quadrivalent HPV vaccine against types 6, 11, 16 and 18 for use in females aged 9–26 y to protect against cervical cancer and genital warts. Research suggests the vaccine may also reduce the incidence of persistent HPV infection and genital warts among young men not infected with HPV types included in the vaccine. Statistical models differ as to whether vaccinating males against HPV will be cost-effective, with more favourable conclusions reached when models accounted for diseases in addition to cervical cancer in females or HPV-related diseases in males. A US Food and Drug Administration advisory panel recently recommended approving HPV vaccine for males aged 9–26 y, although formal Food and Drug Administration approval has not yet occurred.
For optimal public health benefit, HPV vaccination should occur before first sexual intercourse. The population-level benefit of vaccinating adult men against HPV is unknown and may not outweigh the costs. However, if HPV vaccine is licenced for adolescent males, adult men will still have to decide whether 'off-label' vaccination offers potential individual benefits that outweigh out-of-pocket costs. Similar off-label HPV vaccination is already occurring among adult women in the United States. Thus, it is of interest to examine HPV vaccine acceptability among adult men. HPV vaccine acceptability among college students or other convenience samples of adult men has previously ranged from modest (33%–48%) to relatively high (78%).
In this study, we aimed to characterise correlates of HPV vaccine acceptability among a national sample of heterosexual men. We focused on constructs from health behaviour theories and previous research on HPV vaccine among adult women, parents and adolescent females.