Awareness, perceptions and knowledge of human papillomavirus (HPV) infection and vaccine in a cohort of men who have sex with men (MSM)

Background: MSM are at higher risk for acquiring an HPV genital infection. A prophylactic HPV vaccine is currently in clinical trials in males.

Objective: To examine the awareness, perception of risk, and knowledge of HPV disease and vaccine among MSM.

Design/Methods: Voluntary, anonymous survey administered to male students from medical and law schools in Chicago, IL. MSM were identified by personal history. The maximum HPV knowledge score was 6.

Results: 1,195 male students completed the survey; 55 MSM were identified. 72.7% were Caucasian, 20% Asian, 1.8% Black and 5.5% other races. 16.5% smoked. 98.2% were sexually active; 74.6% became sexually active between 16 and 20 years of age. 8.2% had 4-6, 24.5% 7-10, and 40.8% had >10 partners. 20.8% rarely/never used condoms. Forty percent saw their PCP annually; 27.3% rarely/never sought routine medical care.

Mean HPV knowledge score was 4.61 vs. 3.92 for non-MSM males, p<0.0001. 100% identified HPV as cause of cervical cancer; only 66% knew HPV caused genital warts with 28.3% identifying HSV-1 as the cause. Eighty-nine percent knew of HPV vaccine, 83% would consider receiving it. Primary barriers to receiving vaccine included: believing not at risk (33.3%), cost (25%), and already infected (13.9%).

Conclusions: This MSM cohort demonstrated greater HPV knowledge compared to non-MSM; however, they lacked knowledge regarding HPV as cause of genital warts. The biggest barrier to receiving vaccine was perceived lack of risk for disease. Intensive education regarding prevalence, risk factors and consequences of male HPV disease is needed to increase vaccine acceptance.