UK healthcare professionals’ uncertainties, barriers and facilitators to the introduction of targeted HPV vaccination for men who have sex with men: a qualitative analysis

Abstract

Background:  female-only HPV vaccination will fail to protect MSM against HPV and its sequelae i.e. genital warts and anal cancers. In the absence of gender-neutral HPV vaccination, targeted vaccination for MSM at sexual health clinics offers a valuable preventive opportunity. We 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, 3 nurses, 3 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. The lack of political and public support, MSMs’ restricted access to HPV vaccination and disclosure of sexual orientation to HCPs, identification of eligible MSM, 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.

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