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. 2021 Jan 22;18(3):963.
doi: 10.3390/ijerph18030963.

Impact of a Gender-Neutral HPV Vaccination Program in Men Who Have Sex with Men (MSM)

Javier Díez-Domingo  1 , Víctor Sánchez-Alonso  2 , Rafael-J Villanueva  2 , Luis Acedo  3 , José Tuells  4
Affiliations

Impact of a Gender-Neutral HPV Vaccination Program in Men Who Have Sex with Men (MSM)

Javier Díez-Domingo et al. Int J Environ Res Public Health. .

Abstract

A major challenge in human papillomavirus (HPV) vaccine programs is the universal gender-neutral recommendation, as well as estimation of its long-term effect. The objective of this study is to predict the added benefit of male vaccination, especially in men who have sex with men (MSM), and to analyze the impact of the program on society. We propose a mathematical model of the HPV infection based on a network paradigm. Data from Spain allowed constructing the sexual network. HPV force of infection was taken from literature. Different scenarios using variable vaccine coverage in both males and females were studied. Strong herd immunity is shown in the heterosexual population, with an important decrease of HPV 6/11 infections both in men and in unvaccinated women with an only-women vaccination at 14 years of age. No impact of this program occurred in the infection incidence in MSM. This group would only benefit from a vaccination program that includes males. However, the impact at short term would be lower than in heterosexual men. The protection of MSM can only be achieved by direct vaccination of males. This may have important consequences for public health.

Keywords: epidemiologic transition; human papillomavirus; men who have sex with men; network model; sexual behavior; sexual partners; vaccination strategies.

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Conflict of interest statement

J.D.-D. and its institution received research grants from MSD and GSK related to HPV vaccine. J.D.-D. also acted as advisor for these vaccines to GSK and MSD. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results, L.A., V.S.-A., R.-J.V. and J.T. declare no conflict of interest.

Figures

Figure 1
Figure 1
Decline of HPV 6/11 in men, MSM and women in the simulated scenarios 1 and 2. In the figures where a yellow line appears denoting the percentage of vaccinated, the difference between the yellow line and the blue lines is a measure of the community effect. MSM: men who have sex with men; HPV: Human Papilloma Virus.
Figure 2
Figure 2
Scenario 3: Vaccination girls’ coverage 70% and 20% of MSM 18 to 45 years vaccinated. Decline of HPV 6/11 in MSM depending on the vaccine effectiveness [39]. Note that there are small effects in the decline. MSM: men who have sex with men.
Figure 3
Figure 3
Comparison between the Base Case (vaccination of young girls with coverage 70% and 3.88% of MSM) with the same scenario with an increase of MSM up to 10%.
See this image and copyright information in PMC

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