College Males' HPV Risks, Vaccination Rates, and Vaccine Perceptions

Background: 

Limited studies have examined male HPV vaccine rates, including initiation and completion of the series, and there is a gap in understanding factors associated with male vaccination.  The purpose of this study was to examine HPV vaccination patterns, and uncover factors associated with vaccination as well as barriers to vaccination in a sample of male college students approximately 3 years post vaccine availability.

Methods:  Mixed methods, utilizing a cross sectional electronic survey with open ended questions was distributed to enrolled college males at a large public university in the fall of 2012. Quantitative data included demographics, vaccination rates, and sexual health behaviors. Qualitative data sought to describe the males’ perspective for those who had not obtained the HPV vaccination.

Results:  Complete data was reported on 735 sexually active males, ages 18-25. Greater than 50% of the sample reported inconsistent or absent condom use and the mean number of lifetime sexual partners was 5.2. Despite this, 93% reported a belief that they were not at risk for sexually transmitted infections. Only 14% of the sample had completed the HPV vaccine series, and 74% had not obtained any dose. Age was significantly associated (p<.001) with vaccination, for every year older there was a 35% lower odds of having obtained the vaccine. Condom use was also significantly associated (p<.008) and those reporting “always” had a 54% higher odds of obtaining the vaccine as compared to those who report “never” or “sometimes”. Four themes emerged in the qualitative data (N=336): lack of awareness and knowledge, barriers for vaccination, belief not at risk, and belief vaccine not for men. 

Conclusions:  There is a clear disconnect between actual and perceived risks for acquiring HPV, and barriers to HPV vaccination among male college students exist and are persistent 3 years post vaccine availability for men.