Gay, bisexual, and other men who have sex with men (gbMSM) are at higher risk for cancers and other diseases caused by the human papillomavirus (HPV), compared to the general population. The Provinces of British Columbia, Ontario and Quebec offer publicly funded HPV vaccine to high-risk men, including men who have sex with men – but only those who are age 26 and under. For older men, the HPV vaccine must be covered by extended-health insurance or be paid out of pocket.
Based on clinical trials, the HPV vaccine should protect against persistent HPV infection about 60% of the time in young, healthy men who have limited sexual experience.
How well are HPV-vaccination programs working to reduce and prevent HPV-associated diseases among men who have sex with men?
To find out, we will:
- Find out what proportion of gbMSM are infected with HPV in their anal and oral tracts.
- Monitor HPV vaccine uptake among gbMSM.
- Identify which gbMSM are more likely to be vaccinated (or willing to be vaccinated) with HPV vaccine, according to their demographic characteristics or sexual exposures.
- Estimate how well the vaccine works against persistent HPV infection, a surrogate marker for HPV-associated cancers.
- Predict the impact of current and alternative vaccination strategies using economic analysis and mathematical modelling.
As part of the large, multi-city Engage Cohort Study, gbMSM complete a sexual-health survey every six months to tell us about their HPV vaccination history. Every 12 months, men also self-collect oral and anal specimens for HPV testing that will allow us to detect up to 36 different HPV types.
Our study will provide critically needed information about how common HPV disease is among gbMSM in Canada, and the effectiveness of provincial, targeted vaccination programs for high-risk males in Canada. We will share these findings and work with with public-health experts, clinicians, and community members to design HPV-prevention programs that better serve and protect gbMSM.