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; Med Microbiological Labs; Public Hlth Serv

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

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
, Med Microbiological Labs
, Public Hlth Serv

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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. (C) 2020 The Author(s). Published by Elsevier Ltd.

Original language	English
Pages (from-to)	3321-3329
Number of pages	9
Journal	Vaccine
Volume	38
Issue number	17
DOIs	https://doi.org/10.1016/j.vaccine.2020.03.002
Publication status	Published - 9 Apr 2020

Keywords

Human papillomavirus (HPV)
Vaccination
Herd protection
Men who have sex with men (MSM)
Targeted vaccination
HUMAN-PAPILLOMAVIRUS VACCINATION
ANAL HUMAN-PAPILLOMAVIRUS
GENITAL WARTS
MEN
PREVALENCE
EFFICACY
WOMEN
CANCER
GAY

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Woestenberg, P. J., van Benthem, B. H. B., Bogaards, J. A., King, A. J., van der Klis, F. R. M., Pasmans, H., Leussink, S., van der Sande, M. A. B., Hoebe, C. J. P. A., Med Microbiological Labs, & Public Hlth Serv (2020). HPV infections among young MSM visiting sexual health centers in the Netherlands: Opportunities for targeted HPV vaccination. Vaccine, 38(17), 3321-3329. https://doi.org/10.1016/j.vaccine.2020.03.002

@article{182dbbc563b245a78b9c3ce68954beca,

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

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. (C) 2020 The Author(s). Published by Elsevier Ltd.",

keywords = "Human papillomavirus (HPV), Vaccination, Herd protection, Men who have sex with men (MSM), Targeted vaccination, HUMAN-PAPILLOMAVIRUS VACCINATION, ANAL HUMAN-PAPILLOMAVIRUS, GENITAL WARTS, MEN, PREVALENCE, EFFICACY, WOMEN, CANCER, GAY",

author = "Woestenberg, \{Petra J.\} and \{van Benthem\}, \{Birgit H. B.\} and Bogaards, \{Johannes A.\} and King, \{Audrey J.\} and \{van der Klis\}, \{Fiona R. M.\} and Hella Pasmans and Suzan Leussink and \{van der Sande\}, \{Marianne A. B.\} and Hoebe, \{Christian J. P. A.\} and \{Med Microbiological Labs\} and \{Public Hlth Serv\}",

note = "Funding Information: This work was supported by the Ministry of Health, Welfare and Sport , the Netherlands. The funders had no role in study design, data collection and analysis, interpretation of data, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2020 The Author(s)",

year = "2020",

month = apr,

day = "9",

doi = "10.1016/j.vaccine.2020.03.002",

language = "English",

volume = "38",

pages = "3321--3329",

journal = "Vaccine",

issn = "0264-410X",

publisher = "Elsevier Ltd",

number = "17",

}

Woestenberg, PJ, van Benthem, BHB, Bogaards, JA, King, AJ, van der Klis, FRM, Pasmans, H, Leussink, S, van der Sande, MAB, Hoebe, CJPA, Med Microbiological Labs & Public Hlth Serv 2020, 'HPV infections among young MSM visiting sexual health centers in the Netherlands: Opportunities for targeted HPV vaccination', Vaccine, vol. 38, no. 17, pp. 3321-3329. https://doi.org/10.1016/j.vaccine.2020.03.002

TY - JOUR

T1 - HPV infections among young MSM visiting sexual health centers in the Netherlands

T2 - Opportunities for targeted HPV vaccination

AU - Woestenberg, Petra J.

AU - van Benthem, Birgit H. B.

AU - Bogaards, Johannes A.

AU - King, Audrey J.

AU - van der Klis, Fiona R. M.

AU - Pasmans, Hella

AU - Leussink, Suzan

AU - van der Sande, Marianne A. B.

AU - Hoebe, Christian J. P. A.

AU - Med Microbiological Labs

AU - Public Hlth Serv

N1 - Funding Information: This work was supported by the Ministry of Health, Welfare and Sport , the Netherlands. The funders had no role in study design, data collection and analysis, interpretation of data, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2020 The Author(s)

PY - 2020/4/9

Y1 - 2020/4/9

N2 - 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. (C) 2020 The Author(s). Published by Elsevier Ltd.

AB - 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. (C) 2020 The Author(s). Published by Elsevier Ltd.

KW - Human papillomavirus (HPV)

KW - Vaccination

KW - Herd protection

KW - Men who have sex with men (MSM)

KW - Targeted vaccination

KW - HUMAN-PAPILLOMAVIRUS VACCINATION

KW - ANAL HUMAN-PAPILLOMAVIRUS

KW - GENITAL WARTS

KW - MEN

KW - PREVALENCE

KW - EFFICACY

KW - WOMEN

KW - CANCER

KW - GAY

U2 - 10.1016/j.vaccine.2020.03.002

DO - 10.1016/j.vaccine.2020.03.002

M3 - Article

C2 - 32201140

SN - 0264-410X

VL - 38

SP - 3321

EP - 3329

JO - Vaccine

JF - Vaccine

IS - 17

ER -

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

Abstract

Keywords

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