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Observational Study
. 2025 Dec 12;26(1):382.
doi: 10.1186/s12889-025-25746-x.

HPV knowledge and acceptance of HPV vaccination among men who have sex with men (MSM) in Germany: a multicenter, observational, cross-sectional study

Cornelia Wähner  1 , Lisa M Lang  2 , Maher Almahfoud  3 , Daniel Beer  4 , Stefan Esser  5 , Matthias C Müller  6 , Nils Postel  7 , Anja Potthoff  8 , Stephan Schneeweiß  9 , Sven Schellberg  10 , Agnes Luzak  2
Affiliations
Observational Study

HPV knowledge and acceptance of HPV vaccination among men who have sex with men (MSM) in Germany: a multicenter, observational, cross-sectional study

Cornelia Wähner et al. BMC Public Health. .

Abstract

Background: Men who have sex with men (MSM), especially those living with HIV, have a high prevalence of HPV infections that might lead to HPV-related diseases, including penile, oropharyngeal and anal carcinomas. Currently, beyond recommendations to get vaccinated during childhood, adult MSM are not included in the German national HPV vaccination recommendation. The aim of this cross-sectional study was to assess knowledge of HPV and HPV vaccination, and further acceptance and uptake of HPV vaccination among MSM in Germany.

Methods: Participants were recruited between 10/2023 and 07/2024 at 10 German study sites specialized on sexual and/or men's health. Main inclusion criteria were being MSM, being aged 18-45 years and a German health insurance. Data were obtained through an electronic questionnaire and analyzed descriptively. 20 HPV and 5 HPV vaccination knowledge questions were evaluated using sum scores, with each correct answer scoring 1 point.

Results: 929 participants, aged 18-45 years (median 31), were included in the analysis. 122 (13.1%) were living with HIV and 717 (77.2%) used HIV-PrEP. 731 (78.7%) had prior knowledge of HPV, and 604 (65.0%) were aware of HPV vaccination. Mean sum scores for HPV knowledge (N = 731) and HPV vaccination knowledge questions (N = 604) were 13.3 ± 4.3 and 3.0 ± 1.3, respectively. Among those aware of HPV vaccination, 377 (62.4%) accepted vaccination (defined as already vaccinated (N = 204) or intending to get vaccinated (N = 173), and 223 (36.9%) participants were hesitant. Main reasons for hesitancy included a lack of information and no mandatory reimbursement of adult HPV vaccination costs. For MSM who intended to get vaccinated, payment out of pocket and missing physician recommendations were the main reasons for not being vaccinated yet. Among all analyzed MSM (N = 929), 127 (13.7%) completed a full vaccination schedule (21% within those aware of HPV vaccination).

Conclusion: Despite almost 80% participants being aware of HPV, vaccination uptake was low among all participants. More information about HPV, i.e., through physicians and social networks, might support informed decision-making. Further, facilitating access by offering reimbursement options for vaccination could potentially be a factor to help increase HPV vaccination uptake among MSM in Germany.

Keywords: HPV knowledge; HPV vaccination acceptance; HPV vaccination uptake; MSM.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the Declaration of Helsinki. An ethics vote for this study was obtained in accordance with local legal requirements for non-interventional studies in Germany prior to the start of data collection. The study protocol was reviewed and initially approved on 18th September 2023 by the ethics committee Ärztekammer Berlin, Berlin, Germany (central ethics committee), and was then submitted to all local ethics committees. Any amendments to the study protocol were submitted to the central as well as local ethics committees of each participating site. All Ethics Committees involved are listed in the supplement, table B1. Participants were informed about this study and asked if they are willing to participate by their treating physician. The participant received a patient information sheet in electronic form including the informed consent form (ICF) and the Data Protection Regulations. Written informed consent, as appropriate in accordance with local regulations (pursuant to Article 6 and Article 7 of the European General Data Protection Regulation (GDPR)), was obtained before any study-related procedure (i.e., before the screening interview). Consent was documented by the participant’s dated signature on the ICF along with the dated signature of the physician conducting the consent discussion. The participant received a copy of the signed document via e-mail before participating in the study. Consent for publication: Not applicable. Competing interests: CW, LL and AL are employees of MSD Sharp & Dohme GmbH, Germany, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. MA is an employee at the University Medical Center Hamburg-Eppendorf. He received honoraria for lecturing and/or travel expenses from GSK/ViiV Healthcare, MSD Sharp & Dohme GmbH Germany, Gilead Sciences, Inc., Janssen, Octapharma, and Biogen Inc.DB is an employee at Praxis/Labor of Dr. Knechten, Aachen, Germany. He received honoraria from Amgen, Gilead Sciences, Inc., MSD Sharp & Dohme GmbH Germany, Johnson & Johnson, and GSK/ViiV Healthcare as a speaker; institutional grant support from Gilead Sciences, Inc., Johnson & Johnson, and GSK/ViiV Healthcare; travel expenses from Gilead Sciences, Inc.SE received institutional research funding from Gilead Sciences, ViiV Healthcare, Janssen and MSD Sharp & Dohme GmbH Germany, and honoraria, consulting fees and, lecturer fees from Gilead Sciences, Glaxo Smith Kline, ViiV Healthcare, Janssen and MSD Sharp & Dohme GmbH Germany.MCM received consulting fees and support for congress attendance from Gilead Sciences.NP received research funding, congress and travel support and consultancy fees from TAD, Hexal, MSD Sharp & Dohme GmbH Germany, ViiV/GSK, Gilead, Heidelberg Immunotherapeutics, Astra Zeneca, Janssen.AP received honoraria for lectures from GSK and participated in a GSK advisory board and has received support for attending meetings from Gilead. AP holds stock of HALEON.SSc is an employee at Praxis Hohenstaufenring, Cologne, Germany. He received honoraria from MSD Sharp & Dohme GmbH Germany and GSK/ViiV Healthcare as a speaker. Institutional research funding MSD Sharp & Dohme GmbH Germany, Gilead Sciences and GSK/ViiV Healthcare; travel expenses from Gilead Sciences, Inc, Johnson and Johnson and GSK/VIIV Healthcare.SVS received institutional research funding from Gilead Sciences, ViiV Healthcare, MSD Sharp & Dohme GmbH Germany, Glaxo Smith Kline and honoraria, consulting fees and lecturer fees from Gilead Sciences, Glaxo Smith Kline, Abbvie, Biontech, Thera Therapeuticals, Astrazeneca, Bavarian Nordic, ViiV Healthcare, Janssen and MSD Sharp & Dohme GmbH Germany.

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
Knowledge sum scores
See this image and copyright information in PMC

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