Human papillomavirus prevalence among Australian men aged 18-35 years in 2015-2018 according to vaccination status and sexual preference

Prisha Balgovind; Eithandee Aung; Hannah Shilling; Gerald L Murray; Monica Molano; Suzanne M Garland; Christopher K Fairley; Marcus Y Chen; Jane S Hocking; Catriona Ooi; Anna McNulty; Jenny McCloskey; Kathleen McNamee; Deborah Bateson; Louise Owen; Sepehr N Tabrizi; Dorothy A Machalek

doi:10.1093/infdis/jiae412

Human papillomavirus prevalence among Australian men aged 18-35 years in 2015-2018 according to vaccination status and sexual preference

J Infect Dis. 2024 Aug 30:jiae412. doi: 10.1093/infdis/jiae412. Online ahead of print.

Authors

Prisha Balgovind^{1

2}, Eithandee Aung^{1

2}, Hannah Shilling^{1

2}, Gerald L Murray^{1

2

3}, Monica Molano^{1

2}, Suzanne M Garland^{1

2

3}, Christopher K Fairley^{4

5}, Marcus Y Chen^{4

5}, Jane S Hocking⁶, Catriona Ooi^{7

8

9}, Anna McNulty¹⁰, Jenny McCloskey^{11

12}, Kathleen McNamee^{3

13}, Deborah Bateson^{14

15}, Louise Owen¹⁵, Sepehr N Tabrizi^{1

2}, Dorothy A Machalek^{1

16}

Affiliations

¹ Centre for Women's Infectious Diseases, The Royal Women's Hospital, Melbourne, Victoria, Australia.
² Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³ Department of Obstetrics, Gynaecology, and Newborn Health, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
⁵ School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
⁶ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
⁷ Western Sydney Sexual Health Centre, Sydney, New South Wales, Australia.
⁸ Northern Sydney Local Health District Sexual Health Service, Sydney, New South Wales, Australia.
⁹ Northern Clinical School, Faculty of Health and Medicine, University of Sydney, Sydney, New South Wales, Australia.
¹⁰ Sydney Sexual Health Centre, Sydney, New South Wales, Australia.
¹¹ School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia.
¹² Department of Sexual Health, Royal Perth Hospital, Perth, Western Australia, Australia.
¹³ Sexual Health Victoria, Melbourne, Victoria, Australia.
¹⁴ The Daffodil Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
¹⁵ Statewide Sexual Health Service, Hobart, Tasmania, Australia.
¹⁶ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 39213380
DOI: 10.1093/infdis/jiae412

Abstract

Background: Australia introduced a national HPV vaccination program for girls in 2007 and boys in 2013, achieving high coverage in both populations. We assessed HPV prevalence among men who have sex with women (MSW) and men who have sex with men (MSM) aged 18-35 years and examined program effects by vaccination status.

Methods: Men recruited between 2015-2018 self-collected a penile or intra-anal swab for HPV genotyping. HPV vaccination status was confirmed with the National Register. HPV prevalence was examined by age groups and vaccination status.

Results: Of 1,625 men included (median age 27 years; IQR [23-30]), 231 (14.2%) were vaccinated, and 1,370 (84.3%) were unvaccinated. Among 984 MSW, the prevalence of quadrivalent vaccine-targeted HPV types (6,11,16,18) was 10.6% (95%CI: 8.7-12.8) in unvaccinated and 10.7% (5.7-19.3%) in vaccinated men (p=0.96). Prevalence was lowest in the youngest age groups regardless of vaccination status. Among MSM, quadrivalent HPV type prevalence was 40.3% (36.0-44.8%) in unvaccinated and 29.9% (23.1-37.8%) in vaccinated men (p=0.02). In unvaccinated MSM, prevalence was high regardless of age, whereas among vaccinated MSM, prevalence was lowest in the youngest age-group (p=0.001). Among those with confirmed doses, quadrivalent HPV types were detected in 0% (0-7.7%; n=46) of men who had their first dose at 13-19 years and 37.2% (27.5-47.8%; n=94) of those who received their first dose at 20 years or older.

Conclusion: Our data demonstrates the importance of universal adolescent HPV vaccination to ensure MSM receive the same benefits as MSW.

Keywords: Human papillomavirus; herd effect; impacts; infection prevalence; males; universal vaccination.

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