HPV Vaccine Coverage Among Men Who Have Sex with Men — United States, 2011

Background:  Quadrivalent HPV vaccine was licensed in the United States for females in 2006 and for males in 2009. At the end of 2011, ACIP added it to the routine immunization schedule for boys at age 11 or 12 and through age 21 if not previously vaccinated or through age 26 for men who have sex with men (MSM). MSM are at high risk for HPV-associated disease; anal cancer prevalence is 35/100,000 among HIV-uninfected MSM, compared with 2/100,000 for all men. We assessed 2011 baseline HPV vaccine uptake among MSM.

Methods:  We analyzed data from the 2011 National HIV Behavioral Surveillance System, an anonymous cross-sectional survey. MSM age ≥18 were recruited using time-space sampling at venues where MSM congregate in 20 U.S. cities. Using chi-square analysis, we assessed self-reported HPV vaccine uptake according to demographic characteristics, behavioral risk factors, and other sexual health care.  

Results:  Among 3221 MSM age 18–26, 157 (4.9%) reported having received ≥1 dose of HPV vaccine by 2011. Coverage was significantly higher (p<.05) among men who had a usual place of care (5.4%), had seen a health care provider in the past year (5.9%), had disclosed male-male sexual attraction/behavior to a health care provider (6.3%), had been vaccinated against hepatitis (7.2%), had been tested for an STD in the past year (7.8%), or reported having had an STD (7.8%) or a positive HIV test (13.4%). Of unvaccinated MSM, 75.9% had seen a health care provider in the past year. 

Conclusions:  These are the first national data on HPV vaccine coverage among MSM. Coverage was low before HPV vaccine was routinely recommended for males. These data serve as a baseline for future studies of HPV vaccine uptake among U.S. MSM as vaccination recommendations are implemented. Health care settings may offer opportunities to increase coverage in this population.