[Abstract] Behavioural factors associated with HPV vaccine acceptability amongst men who have sex with men in the United Kingdom

Background: Men who have sex with men (MSM) are selected for Human Papillomavirus (HPV) vaccination due to their higher risk of genital warts and anal cancer. Aim: To examine HPV vaccine acceptability amongst MSM in the UK. Methods: Using Facebook advertisements, MSM were recruited for an online survey measuring motivations for HPV vaccination. Logistic regression was performed to identify predictors of HPV vaccine acceptability at baseline, after receiving information about HPV vaccination, and four weeks later. Results: Out of 1508 MSM (median age = 22, range: 15–63) 19% knew about HPV. While only 55% of MSM would be willing to ask for the HPV vaccine, 89% would accept it if offered by a healthcare professional (HCP). Access to sexual health clinics [OR = 1.82, 95% CI 1.29–2.89], the disclosure of sexual orientation to an HCP [OR = 2.02, CI 1.39–3.14] and HIV-positive status [OR = 1.96, CI 1.09–3.53] positively predicted HPV vaccine acceptability. After receiving the information, perceptions of HPV risk [OR = 1.31, CI 1.05–1.63], HPV infection severity [OR = 1.89, CI 1.16 3.01), HPV vaccination benefits [OR = 1.61, CI 1.14–3.01], HPV vaccine effectiveness [OR = 1.54, CI 1.14–2.08], and the lack of perceived barriers to HPV vaccination [OR = 4.46, CI 2.95–6.73] were also associated with acceptability. Discussion: Although nearly half of MSM would not actively pursue HPV vaccination, the vast majority would accept the vaccine if recommended by HCPs. MSM need to be informed about HPV to appraise the benefits of HPV vaccination for their health. In order to achieve optimal uptake, vaccine promotion campaigns need to focus on MSM that do not access sexual health clinics and those unwilling to disclose their sexual orientation