UK healthcare professionals’ uncertainties, barriers and facilitators to the introduction of targeted human papillomavirus vaccination for men who have sex with men
Tom Nadarzynski A E , Carrie Llewellyn B , Daniel Richardson B C , Alex Pollard B and Helen Smith B DA Department of Psychology, Room 44/3016, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
B Department of Primary Care & Public Health (PCPH), Brighton & Sussex Medical School Mayfield House, Falmer, Brighton, BN1 9PH, UK.
C Brighton & Sussex University NHS Trust/Brighton & Sussex Medical School Claude Nicol Centre, Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK.
D Lee Kong Chian School of Medicine, 308232, 11 Mandalay Road, Singapore.
E Corresponding author. Email: T.Nadarzynski@soton.ac.uk
Sexual Health 14(4) 372-377 https://doi.org/10.1071/SH17026
Submitted: 14 February 2017 Accepted: 3 April 2017 Published: 8 June 2017
Abstract
Background: Female-only human papillomavirus (HPV) vaccination will fail to protect men who have sex with men (MSM) against HPV and its sequelae (i.e. genital warts and anal cancers). In the absence of gender-neutral HPV vaccination, targeted vaccination at sexual health clinics for MSM offers a valuable preventive opportunity. This study aimed to identify sexual healthcare professionals’ (HCPs) perceived barriers and facilitators for MSM-targeted HPV vaccination. Methods: Nineteen telephone interviews with UK-based self-referred HCPs (13 doctors, three nurses, three health advisers) were conducted in October and November 2014. The interviews were recorded and transcribed verbatim. Data were analysed thematically by two researchers. Results: HCPs were unsure about selection criteria, acceptable healthcare settings and the source of vaccination funding for the introduction of MSM-targeted HPV vaccination. Lack of political and public support, MSMs’ limited access to HPV vaccination and disclosure of sexual orientation to HCPs, identification of eligible MSM, patients’ poor HPV awareness and motivation to complete HPV vaccination were perceived as significant barriers. HCPs believed that the introduction of official guidelines on HPV vaccination for MSM, awareness campaigns and integrated clinic procedures could improve vaccination coverage. Conclusion: HCPs recognised a need to protect MSM against HPV. However, several challenges and obstacles associated with the introduction of MSM-targeted HPV vaccination in the UK were reported. HCPs’ perspectives and concerns need to be addressed when developing policies and guidelines for a potential MSM-targeted HPV vaccination. Future research needs to examine whether negative views of HCPs towards MSM-targeted HPV vaccination are associated with lower HPV vaccine uptake and completion rates in MSM.
Additional keywords: acceptability, attitudes, decision-making, hesitancy, views.
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