HPV infections among young MSM visiting sexual health centers in the Netherlands: Opportunities for targeted HPV vaccination

Petra J Woestenberg; Birgit H B van Benthem; Johannes A Bogaards; Audrey J King; Fiona R M van der Klis; Hella Pasmans; Suzan Leussink; Marianne A B van der Sande; Christian J P A Hoebe; Medical Microbiological Laboratories, the Public Health Services

doi:10.1016/j.vaccine.2020.03.002

HPV infections among young MSM visiting sexual health centers in the Netherlands: Opportunities for targeted HPV vaccination

Vaccine. 2020 Apr 9;38(17):3321-3329. doi: 10.1016/j.vaccine.2020.03.002. Epub 2020 Mar 19.

Authors

Petra J Woestenberg¹, Birgit H B van Benthem², Johannes A Bogaards³, Audrey J King², Fiona R M van der Klis², Hella Pasmans⁴, Suzan Leussink², Marianne A B van der Sande⁵, Christian J P A Hoebe⁶; Medical Microbiological Laboratories, the Public Health Services

Affiliations

¹ Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), 6200 MD Maastricht, the Netherlands. Electronic address: petra.woestenberg@rivm.nl.
² Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, the Netherlands.
³ Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, the Netherlands; Department of Epidemiology & Biostatistics, Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, the Netherlands.
⁴ Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, the Netherlands; Department of Medical Oncology, Leiden University Medical Center, 2333ZA, Leiden, the Netherlands.
⁵ Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium; Julius Center, University Medical Center Utrecht, 3508 GA, Utrecht, the Netherlands.
⁶ Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), 6200 MD Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases and Environment, South Limburg Public Health Service, 6411 TE Heerlen, the Netherlands.

PMID: 32201140
DOI: 10.1016/j.vaccine.2020.03.002

Abstract

Introduction: In 2009, girls-only HPV16/18 vaccination was introduced in the Netherlands which has achieved 46-61% uptake. Heterosexual men have benefitted from herd protection, but it is unknown whether men who have sex with men (MSM) also benefit from herd effects of the girls-only HPV16/18 vaccination program. Because MSM bear a high HPV-related disease burden, countries might consider targeted vaccination for MSM. To study possible herd effects and prior HPV exposure at a potential moment of vaccination, we assessed trends in the HPV prevalence and proportions (sero)negative for the various vaccine types among young MSM visiting sexual health centers (SHCs).

Methods: We used data from MSM included in PASSYON study years 2009-2017. In this biennial cross-sectional study among visitors of SHCs aged 16-24 years, MSM provided a penile and anal swab for HPV DNA testing (including vaccine types HPV6/11/16/18/31/33/45/52/58) and blood for HPV antibody testing (HPV16/18/31/33/45/52/58).

Results: In total 575 MSM were included, with a median of 22 years of age and 15 lifetime sex partners and 3.5% HIV positive. Trends in penile or anal HPV prevalence during 2009-2017 were statistically non-significant for all vaccine types. Of the 455 MSM with a penile and anal swab, 360 (79%), 283 (62%) and 242 (53%) were HPV DNA negative at both anatomical sites for HPV16/18, HPV6/11/16/18 and HPV6/11/16/18/31/33/45/52/58 respectively. Among MSM who were HPV16/18 and HPV16/18/31/33/45/52/58 DNA negative and were tested for serology (n = 335 and 279 respectively), 82% and 71% were also seronegative for the respective types.

Discussion: There were no significant declines in the HPV prevalence among MSM up to eight years after introduction of girls-only HPV16/18 vaccination, indicating that MSM are unlikely to benefit largely from herd effects from girls-only vaccination. Most MSM were vaccine-type DNA negative and seronegative, suggesting that vaccination of young MSM visiting SHCs could still be beneficial.

Keywords: Herd protection; Human papillomavirus (HPV); Men who have sex with men (MSM); Targeted vaccination; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Cross-Sectional Studies
Homosexuality, Male
Human papillomavirus 16
Human papillomavirus 18
Humans
Male
Netherlands / epidemiology
Papillomavirus Infections* / epidemiology
Papillomavirus Infections* / prevention & control
Papillomavirus Vaccines
Prevalence
Sexual Health*
Sexual and Gender Minorities*
Vaccination
Young Adult

Substances

Papillomavirus Vaccines