PrEP patient attitudes, beliefs and perceived barriers surrounding HPV vaccination: a qualitative study of semistructured interviews with PrEP patients in primary care clinics in Kansas and Missouri

• Published in: BMJ open Vol. 12; no. 4; p. e058510
• Main Authors: Sullivan-Blum, Zoe C, Brophy, Margaret, Didde, Ryan, Nagireddy, Radha, Swagerty, Hannah, Weir, Sumiko, Sykes, Kevin J, Dietz, Craig, Alt, Marcus, Ramaswamy, Megha, Rotert, Paul
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 04.04.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Adult; Age; Cervical cancer; Clinics; COVID-19; Demographics; Disease prevention; Ethnicity; FDA approval; Female; Gays & lesbians; Health care policy; Health insurance; Health Knowledge, Attitudes, Practice; HIV; HIV & AIDS; Homosexuality, Male; Human immunodeficiency virus; Human papillomavirus; Humans; Immunization; Infections; Interviews; Kansas; Male; Males; Mens health; Middle Aged; Missouri; Papillomavirus Infections; Papillomavirus Vaccines - therapeutic use; Patient Acceptance of Health Care; Patients; Perceptions; Physicians; Population; preventive medicine; Primary care; Primary Health Care; Public Health; Qualitative research; Sexual and Gender Minorities; sexual medicine; Sexual orientation; Vaccination; Vaccines; Womens health; Missouri; Kansas; United States > US; qualitative research; HIV & AIDS; public health; sexual medicine; preventive medicine
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-058510

ObjectivesMen who have sex with men who use pre-exposure prophylaxis (PrEP) have not traditionally been targets for human papillomavirus (HPV) vaccine programmes, despite their high risk for HPV-related cancers and HPV vaccine being approved by the U.S. Food and Drug Administration (FDA) for people up to age 45. The objective of this study was to assess attitudes and barriers towards HPV vaccine for adult PrEP users in the primary care context.MethodsSemistructured phone interviews of 16 primary care patients taking PrEP in the Kansas City metropolitan area were conducted, with interviews assessing HPV vaccination status, and attitudes, beliefs and perceived barriers surrounding HPV vaccine. Interview notes were open-coded by student authors, and themes were generated through code review and consensus. Data were then analysed using thematic analysis.ResultsThe results showed that most patients believed that preventative health was important and felt the HPV vaccine was important. Most patients were open to vaccination if recommended by their primary care physician and covered by insurance. Most participants believed HPV infection to be far worse in women, and there were gaps in knowledge surrounding HPV and its effects in men.ConclusionsWhile more research is needed to better understand facilitators of a linkage between PrEP and HPV vaccine in clinical settings for groups at high risk for HPV-related cancers, getting primary care providers involved in educating high-risk patients about the importance of HPV vaccination and actively recommending the vaccine to those patients has the potential to prevent HPV-related cancers.