Socioeconomic and Health-Related Characteristics Associated with Initiation and Completion of Human Papillomavirus Vaccination among Males in the United States: An In-Depth Systematic Review and Meta-Analysis.

Abstract

Human papillomavirus (HPV) vaccination among males is poorly understood. We systematically reviewed individual socioeconomic/health-related characteristics associated with HPV vaccine initiation and vaccination series completion among males in the United States. We searched for literature up to August 1, 2023, and pooled appropriate multivariable-adjusted results using an inverse variance random effects model, with results expressed as odds ratios. Among pediatric males (<18 years old), we observed moderately increased odds of vaccine initiation in urban residence, with being a Black/Hispanic male versus White male, public versus private health insurance, and visiting a health care provider in the past year. Influenza vaccination in the past year strongly increased the odds. Further, urban residence and having a parent with lower/no education moderately increased the odds of vaccination series completion, whereas influenza vaccination strongly increased the odds. Among adult males (≥18 years old), we observed moderately increased odds of vaccine initiation in the US-born, unemployed, unmarried/separated/divorced/widowed; among the states in the Northern versus Western region; having had a sexually transmitted infection; and being gay/bisexual. Younger age, living in the states in the Northern versus Southern region, having health insurance, and having visited a health care provider in the past year strongly increased the odds. Further, higher education, unmarried/separated/divorced/widowed, being a White male versus Black male, living in the states in the Northern versus Western region, and having a primary care physician moderately increased the odds of vaccination series completion, whereas having health insurance and being gay/bisexual strongly increased the odds. These findings may inform age-targeted future vaccination program planning.