Trends in HPV and HPV Vaccine Awareness among Gay and Bisexual Males in the U.S

Abstract

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (US). It is often discussed within the context of women's sexual health due to its association with cervical cancer. However, HPV is also associated with other cancers and conditions which affect men. Gay and bisexual males (GBM) in the US have higher risks of HPV infection and a higher incidence of HPV-associated anal cancer than heterosexual males. In addition, GBM in the US have a higher prevalence of some high-risk strains of HPV than in other regions. HPV vaccination is highly effective at preventing HPV-associated cancers and genital warts. Several resources have been directed towards improving HPV awareness in the US over the past couple of years to improve vaccination rates. Given the low rates of HPV vaccination among GBM in the US, this study aimed to assess the trends in HPV and HPV vaccine awareness using a nationally representative sample of GBM. We found an overall increase in HPV and HPV vaccine awareness between 2017 and 2020. However, the sociodemographic differences in awareness levels highlight the need for more interventions to improve vaccination rates, especially in this high-risk population.

Keywords: HPV; HPV awareness; HPV vaccine; HPV vaccine awareness; bisexual; gay.

Figure 1

Overall awareness of HPV and the HPV vaccine among gay and bisexual males between 2017 and 2020. The awareness of HPV was consistently greater than the awareness of the HPV vaccine. Overall, the awareness of both was higher in 2020 compared to 2017.

Figure 2

Awareness of HPV among gay and bisexual males according to race/ethnicity between 2017 and 2020. There was a large decrease in awareness about HPV among Hispanic GBM between 2017 and 2018. Annually, non-Hispanic (NH) white and black GBM gained awareness of HPV.

Figure 3

Awareness of HPV among gay and bisexual males according to education status between 2017 and 2020. Over 80% of GBM with college or postgraduate levels of education were aware of HPV each year. The largest increase in awareness occurred between 2018 and 2019 among GBM with a high school level of education or less; HS = high school.

Figure 4

Awareness of HPV among gay and bisexual males according to income levels between 2017 and 2020. A higher percentage of GBM with incomes above $50,000 were aware of HPV compared to GBM with incomes below $50,000 in 2017, 2018, and 2020.

Figure 5

Awareness of HPV among gay and bisexual males according to age group between 2017 and 2020. The highest percentage of GBM with knowledge about HPV were between the ages of 18 and 34. Smaller proportions of GBM between the age of 35 and 64 were aware of HPV from 2017 to 2019.

Figure 6

Awareness of the HPV vaccine among gay and bisexual males according to race/ethnicity between 2017 and 2020. There was a decrease in awareness about the HPV vaccine among Hispanic GBM between 2017 and 2018, followed by increased awareness during the rest of the study period. NH = non-Hispanic.

Figure 7

Awareness of HPV among gay and bisexual males according to education levels between 2017 and 2020. GBM with college or postgraduate levels of education were the most aware of the HPV vaccine each year. Levels of vaccine awareness fluctuated among GBM with post-high school or some college-level education; HS = high school.

Figure 8

Awareness of the HPV vaccine among gay and bisexual males according to income levels between 2017 and 2020. A higher percentage of GBM with incomes above $50,000 were aware of the vaccine compared to GBM with incomes below $50,000 throughout the study period.

Figure 9

Awareness of the HPV vaccine among gay and bisexual males is illustrated according to specific age groups between 2017 and 2020. The highest percentage of GBM with knowledge about HPV over the entire study period were between the ages of 18 and 34. A gradual decline in HPV vaccine awareness was observed in GBM aged 65 and older.