The systematic review of HPV vaccine acceptability among males

Abstract

Introduction: Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) disease nowadays in the world and it actually infects in both sexes. HPV prevalence in men was reported to be over 20% in most studies, and the number is much higher among men having sex with men (MSM) either HIV positive or negative. Food and Drug Administration (FDA) approved the Gardasil-one of the HPV vaccines brand-in the USA in 2009 for use on males’ aged 9-26 years and it is proved to be effective in preventing genital warts and anal cancer. However, little study has been conducted to demonstrate a better situation of the acceptability on HPV vaccination among males.

Objectives: To explore the acceptability of HPV vaccine among males by combining acceptability and attitude analyses targeted adult males and adolescent boys’ parents.

Methodology: A systematic review was conducted to search for literatures that demonstrate acceptability analyses of HPV vaccination that contains males, by searching in MEDLINE, Google Scholar and CNKI using relevant keywords. English and Chinese articles published from 2009 to 2015 that talking about men ages over 9 years old were selected.

Results: Twelve qualified articles, 7 were conducted in the United States, 1 in Hong Kong, 2 in mainland China, 1 in Korea and 1 in Canada were selected in this systematic review. The acceptability of HPV vaccination was not the same among these articles; the different acceptance level might be due to region, age, price and sexual preference.

Three of the twelve articles were targeted local population; and compared to other countries, vaccine acceptability is generally lower in Hong Kong and Mainland China. Four of the twelve articles targeted parents’ attitude on HPV vaccination of their adolescent sons; parents would be more willing to get their son’s vaccinated if the vaccine were cheaper. The other eight articles targeted adult males showed that MSM group has a lower acceptance than the general society.

Discussion: The two factors mentioned most among the 12 studies were sexually and financially related. The group of men having sex with men has a relatively high prevalence of HPV infection in anus leading to anal cancer. Due to MSM group’s high prevalence of HPV infection, sexual preference might be a major factor for vaccine acceptability. However, research shows a rare acceptability among them. Price has a significant impact in HPV vaccination acceptance in all articles despite of region, ethnic, age or sexual preference since the vaccine is expensive. Several cost-effective analyses indicate that HPV vaccine for males might not be cost-effective, but more investigations are needed.