Vaccine Effectiveness Against 12-Month Incident and Persistent Anal Human Papillomavirus Infection Among Gay, Bisexual, and Other Men Who Have Sex With Men

• Published in: The Journal of infectious diseases Vol. 228; no. 1; pp. 89 - 100
• Main Authors: Chambers, Catharine, Deeks, Shelley L, Sutradhar, Rinku, Cox, Joseph, de Pokomandy, Alexandra, Grennan, Troy, Hart, Trevor A, Lambert, Gilles, Moore, David M, Grace, Daniel, Grewal, Ramandip, Jollimore, Jody, Lachowsky, Nathan, Nisenbaum, Rosane, Ogilvie, Gina, Sauvageau, Chantal, Tan, Darrell H S, Coutlée, François, Burchell, Ann N
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 28-06-2023
• Subjects: Adult; Anus Diseases - epidemiology; Anus Diseases - prevention & control; Anus Diseases - virology; Bisexuality; Cohort Studies; Gays & lesbians; Human papillomavirus; Human Papillomavirus Viruses; Humans; Immunization; Incidence; Major; Male; Mens health; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - standards; Sexual and Gender Minorities; Vaccine Efficacy; Vaccines; Young Adult; vaccine effectiveness; persistent infection; incidence; men who have sex with men; human papillomavirus; vaccination
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiad005

Abstract
Background
Real-world evidence of human papillomavirus (HPV) vaccine effectiveness (VE) against longitudinal outcomes is lacking among gay, bisexual, and other men who have sex with men (GBM). We compared 12-month incidence and persistence of anal HPV infection between vaccinated and unvaccinated GBM.
Methods
We recruited GBM aged 16–30 years in Montreal, Toronto, and Vancouver, Canada, from 2017 to 2019. Participants were followed over a median of 12 months (interquartile range, 12–13 months). Participants self-reported HPV vaccination and self-collected anal specimens for HPV DNA testing. We calculated prevalence ratios (PR) for 12-month cumulative incidence and persistence with ≥1 quadrivalent vaccine type (HPV 6/11/16/18) between vaccinated (≥1 dose at baseline) and unvaccinated participants using a propensity score-weighted, modified Poisson regression.
Results
Among 248 participants, 109 (44.0%) were vaccinated at baseline, of whom 62.6% received 3 doses. PRs for HPV 6/11/16/18 were 0.56 (95% confidence interval [CI], .24–1.31) for cumulative incidence and 0.53 (95% CI, .25–1.14) for persistence. PRs were 0.23 (95% CI, .05–1.03) and 0.08 (95% CI, .01–.59) for incidence and persistence, respectively, among participants who received their first dose at age ≤23 years and 0.15 (95% CI, .03–.68) and 0.12 (95% CI, .03–.54) among participants who were sexually active for ≤5 years before vaccination.
Conclusions
Findings support national recommendations for HPV vaccination at younger ages or soon after sexual debut.
Among sexually active men who have sex with men aged 16–30 years, human papillomavirus (HPV) vaccine was significantly protective against 12-month anal HPV cumulative incidence and persistence when vaccination was initiated at younger ages or soon after sexual debut.