The Psychosocial Impact of Human Papilloma Virus (HPV) and Related Interventions Among Heterosexual Men (HSM) and Men Who Have Sex with Men (MSM)

Background: Little data are available about the psychosocial impact of HPV-disease or related interventions, especially among men.

Objectives: To assess physical, social, and emotional consequences related to HPV from the male patient’s perspective.

Methods: Individual, in-depth, semi-structured interviews were conducted in a New York City surgical practice among five groups of men (total n=31) with various HPV-related diagnoses occurring within 3 months of interview: 1) HSM with genital warts; 2) MSM with penile warts; 3) MSM with anal warts; 4) MSM with abnormal anal Pap cytology results without definitive histology; and 5) MSM diagnosed with high-grade dysplasia.

Results: Most HSM and MSM considered genital warts to be a “nuisance” and high levels of anxiety about transmission to a partner or starting new sexual relationships were mentioned; both groups cited recurrence as “frustrating” or “disappointing”.  Compared to penile warts, anal warts had a high impact among MSM that triggered lifestyle changes, fears of cancer, worries about transmission, depression, negative body image and concern about recurrence.  Abnormal anal Paps had limited impact on body image or daily activities but anxiety, depression or the need to limit sexual activity were dominant themes.  High-grade anal dysplasia caused MSMs to feel different about themselves. One man described feeling “substantially less sexy”; another felt “I’ve crossed a line [into STDs] and can never go back”. Most MSM reported that the follow-up procedures (eg, biopsies) were uncomfortable, embarrassing, humiliating, and sometimes painful.  Both HSM and MSM reported limited knowledge about HPV.

Conclusions: HPV-disease and related interventions appear to cause a degree of psychosocial burden in HSM and MSM.

Implications for Programs, Policy, and/or Research: Further research and measurement tools to assess the burden of HPV in men can help shape education and intervention messages related to HPV prevention.