Human papillomavirus vaccination uptake among men who have sex with men living with HIV.

Abstract

Background: Human papillomavirus (HPV) is a very common sexually transmitted infection. Persistent infection with high-risk subtypes can lead to a variety of cancers. Men who have sex with men (MSM), particularly those who are living with HIV (MSMLWH), have a high prevalence of HPV infection and are at greatest risk of HPV-related diseases such as anal cancer. HPV vaccines are effective in preventing new infections, and many countries have implemented HPV vaccination for MSM.

Methods: This systematic review aimed to examine HPV vaccine uptake among MSM and MSMLWH. Quantitative studies published between 2010 and 2022 were screened and included if they detailed HPV vaccination uptake data for MSM and MSMLWH. Identified studies were screened using Covidence, data were extracted from the final included studies and narratively synthesised, and risk of bias of studies was assessed using the Joanna Briggs Institute Checklist tool for prevalence studies.

Results: There were 19 studies all from high-income countries, included in the final review. This review showed a wide variety of HPV vaccine uptake, ranging from 2.7% to 91.5% for HIV-negative MSM and among MSMLWH ranging from 5.6% to 90%. Although limited by the heterogeneity of studies and settings, there was evidence of a consistent, steady increase in HPV vaccination particularly among younger men. MSMLWH generally had higher rates of HPV vaccination, but overall HPV vaccine uptake remained suboptimal.

Conclusion: MSMLWH are at high risk of HPV-related disease. Despite an available and efficacious vaccine in many countries, this review showed overall rates of HPV vaccination uptake remain inadequate. Further research and policy should aim to address and overcome barriers to HPV vaccination.PROSPERO registration numberCRD42023382251.