R Grewal1,2, S L Deeks2,3, T A Hart2,4, J Cox5,6, A De Pokomandy7, T Grennan8,9, G Lambert6, D Moore9,10, F Coutlée11,12, M Gaspar2, C George13, D Grace2, J Jollimore14, N J Lachowsky10,14,15, R Nisenbaum1,2,16, G Ogilvie8,17, C Sauvageau18,19, D H S Tan1,20, A Yeung1, A N Burchell1,2,21. 1. MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada. 2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 3. Nova Scotia Department of Health and Wellness, Halifax, Canada. 4. Department of Psychology, Ryerson University, Toronto, Canada. 5. Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Montréal, McGill University. 6. Direction régionale de santé publique, CIUSSS-Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada. 7. Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada. 8. BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, Canada. 9. Department of Medicine, University of British Columbia, Vancouver, Canada. 10. BC Centre for Excellence in HIV/AIDS, Vancouver, Canada. 11. Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Canada. 12. Department of Microbiology and Immunology, Université de Montréal, Montréal, Canada. 13. Department of Exercise, Health, and Sport Sciences, University of Maine, Portland, USA. 14. Community-Based Research Centre, Vancouver, Canada. 15. School of Public Health and Social Policy, University of Victoria, Victoria, Canada. 16. Applied Health Research Centre, Unity Health Toronto, Toronto, Canada. 17. School of Population and Public Health, University of British Columbia, Vancouver, Canada. 18. Faculty of Medicine, Université Laval, Québec City, Canada. 19. Institut National de santé publique du Québec, Québec, Canada. 20. Department of Medicine, University of Toronto, Toronto, Canada. 21. Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Some Canadian jurisdictions offer publicly funded HPV vaccine to gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years. We characterized factors associated with being in different stages of HPV vaccination. METHODS: Engage is a sexual health study of GBM in the three largest Canadian cities recruited via respondent driven sampling (RDS). We categorized participants as: (1) unaware of HPV vaccine, (2) undecided/unwilling to get vaccinated, (3) willing to get vaccinated, (4) vaccinated with one or more doses. Our RDS-II weighted analyses used multinomial logistic regression to identify factors associated with being in earlier stages of the cascade compared to Stage 4. RESULTS: Across the cities, 26-40%, 7-14%, 33-39%, and 13-28% were in Stages 1 to 4, respectively. Compared to Stage 4, being in earlier stages of the cascade was associated with bisexual-identification (Stage 1: adjusted odds ratio[aOR] = 2.84, 95% confidence interval[CI] = 1.06-7.62; Stage 2: aOR = 3.09, 95%CI = 1.19-8.05), having immigrated to Canada (Stage 1: aOR = 1.79, 95%CI 1.07-2.99), preference to keep same-sex romantic relationships private (Stage 1: aOR = 1.25, 95% CI = 1.05-1.48; Stage 2: aOR = 1.24, 95%CI = 1.05-1.46), not receiving sexual health information (Stage 1: aOR = 0.31, 95% CI = 0.13-0.71; Stage 2: aOR = 0.27, 95%CI = 0.12-0.64), not accessing a health-care provider (Stage 2: aOR = 0.36, 95%CI = 0.15-0.83), and no past hepatitis A/B vaccination (Stage 1: aOR = 0.16, 95% CI = 0.09-0.30; Stage 2: aOR = 0.18, 95%CI = 0.09-0.35; Stage 3: aOR = 0.38, 95%CI = 0.21-0.61). DISCUSSION: Interventions are needed to reduce social and financial barriers, increase sexual health knowledge, and improve GBM-competent health-care access to increase vaccine uptake among GBM.
BACKGROUND: Some Canadian jurisdictions offer publicly funded HPV vaccine to gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years. We characterized factors associated with being in different stages of HPV vaccination. METHODS: Engage is a sexual health study of GBM in the three largest Canadian cities recruited via respondent driven sampling (RDS). We categorized participants as: (1) unaware of HPV vaccine, (2) undecided/unwilling to get vaccinated, (3) willing to get vaccinated, (4) vaccinated with one or more doses. Our RDS-II weighted analyses used multinomial logistic regression to identify factors associated with being in earlier stages of the cascade compared to Stage 4. RESULTS: Across the cities, 26-40%, 7-14%, 33-39%, and 13-28% were in Stages 1 to 4, respectively. Compared to Stage 4, being in earlier stages of the cascade was associated with bisexual-identification (Stage 1: adjusted odds ratio[aOR] = 2.84, 95% confidence interval[CI] = 1.06-7.62; Stage 2: aOR = 3.09, 95%CI = 1.19-8.05), having immigrated to Canada (Stage 1: aOR = 1.79, 95%CI 1.07-2.99), preference to keep same-sex romantic relationships private (Stage 1: aOR = 1.25, 95% CI = 1.05-1.48; Stage 2: aOR = 1.24, 95%CI = 1.05-1.46), not receiving sexual health information (Stage 1: aOR = 0.31, 95% CI = 0.13-0.71; Stage 2: aOR = 0.27, 95%CI = 0.12-0.64), not accessing a health-care provider (Stage 2: aOR = 0.36, 95%CI = 0.15-0.83), and no past hepatitis A/B vaccination (Stage 1: aOR = 0.16, 95% CI = 0.09-0.30; Stage 2: aOR = 0.18, 95%CI = 0.09-0.35; Stage 3: aOR = 0.38, 95%CI = 0.21-0.61). DISCUSSION: Interventions are needed to reduce social and financial barriers, increase sexual health knowledge, and improve GBM-competent health-care access to increase vaccine uptake among GBM.
Entities:
Keywords:
Human papillomavirus; barriers; facilitators; knowledge; men who have sex with men; primary prevention; publicly funded program; uptake; willingness
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