Prevalence of human papillomavirus and human papilloma virus vaccine completion rates among gay and bisexual men
1
Psychiatry and mental health, Muhimbili university of health and allied sciences, Dar es salaam, Tanzania, United Republic of
2
Medical education research and evaluation, Case western reserve university, Cleveland, United States
3
Central pathology laboratory, Muhimbili national hospital, Dar es salaam, Tanzania, United Republic of
4
Department of psychiatry and behavioral medicine, Medical college of wisconsin, Milwaukee, United States
5
Department of family medicine, University of minnesota, Minneapolis, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
High-risk Human Papillomavirus (HPV) is a sexually transmissible virus that causes cancer. Gay and bisexual men (GBM) are at high-risk for oropharyngeal and anal cancers caused by HPV. As a pilot study of HPV prevention in GBM, we assessed rates of HPV and offered HPV vaccination to GBM in Dar es Salaam, Tanzania.
METHODS:
Utilizing Respondent Driven Sampling (RDS), in march 2023 we recruited eligible participants from their social networks using seeds. Eighty-three of a possible one hundred participants (mean age 26) were enrolled, tested, and given a first vaccination dose (cervarix). Anal swabs were tested for twenty-eight HPV genotypes, both high and low risk for carcinogenicity.
RESULTS:
A median of seven different HPV genotypes was found in participants. A total of 87% of participants carried at least one HPV genotype, and 76% carried at least one high-risk genotype. As a result of harassment and unanticipated risk to participants and staff at the unmarked community-based site, this study was terminated before the sample size was reached. Since a full course of vaccine was the standard of care, participants were contacted using the contact method they had provided to arrange follow up vaccination doses at an alternative clinical site. Twenty-nine percent received the additional vaccination, 10% refused re-vaccination without incentives. The HIV rate was 45%.
CONCLUSIONS:
Anal HPV rates, including high-risk HPV rates were significantly high. It is possible to provide HPV vaccination to GBM and have approximately 45% potentially reattend for a second dose if they are incentivized. Great care must be used to situate vaccination to avoid stigma leading to harassment, especially where homosexuality is criminalized. We infer that the high-risk harassment faced by participants and lack of incentives for the second visit depressed the return rate for revaccination.
High-risk Human Papillomavirus (HPV) is a sexually transmissible virus that causes cancer. Gay and bisexual men (GBM) are at high-risk for oropharyngeal and anal cancers caused by HPV. As a pilot study of HPV prevention in GBM, we assessed rates of HPV and offered HPV vaccination to GBM in Dar es Salaam, Tanzania.
METHODS:
Utilizing Respondent Driven Sampling (RDS), in march 2023 we recruited eligible participants from their social networks using seeds. Eighty-three of a possible one hundred participants (mean age 26) were enrolled, tested, and given a first vaccination dose (cervarix). Anal swabs were tested for twenty-eight HPV genotypes, both high and low risk for carcinogenicity.
RESULTS:
A median of seven different HPV genotypes was found in participants. A total of 87% of participants carried at least one HPV genotype, and 76% carried at least one high-risk genotype. As a result of harassment and unanticipated risk to participants and staff at the unmarked community-based site, this study was terminated before the sample size was reached. Since a full course of vaccine was the standard of care, participants were contacted using the contact method they had provided to arrange follow up vaccination doses at an alternative clinical site. Twenty-nine percent received the additional vaccination, 10% refused re-vaccination without incentives. The HIV rate was 45%.
CONCLUSIONS:
Anal HPV rates, including high-risk HPV rates were significantly high. It is possible to provide HPV vaccination to GBM and have approximately 45% potentially reattend for a second dose if they are incentivized. Great care must be used to situate vaccination to avoid stigma leading to harassment, especially where homosexuality is criminalized. We infer that the high-risk harassment faced by participants and lack of incentives for the second visit depressed the return rate for revaccination.
| eISSN: | 2654-1459 |
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