Exploring Perceptions of HPV Risks and Motivations to Vaccination in MSM at a Community-Based HIV Clinic.

Abstract

Anal cancer incidence has risen significantly over the past four decades, with HIV-positive men who have sex with men (HIV + MSM) facing a disproportionately higher disease burden. Although human papillomavirus (HPV) vaccination can prevent most HPV-related cancers, uptake remains low within this population. To explore perceptions of HPV infection and vaccination, this study employed a cross-sectional survey based on the Health Belief Model (HBM). Recruitment took place at a federally qualified health center in Austin, Texas, serving primarily low-income people living with HIV. Biological males over 18 years old, who have sex with men and are HIV-positive, were eligible. A 36-item survey assessed demographics, sexual behavior, and awareness of HPV and the HPV vaccine within the context of the HBM. Among 49 participants, only 22.45% had received at least one dose of the HPV vaccine. Of those who were unvaccinated, only 23.68% planned to receive the HPV vaccine within the next six months. Overall HPV knowledge was low, with fewer than half recognizing HPV's role in anal cancer. Among the vaccine acceptance group (participants who were vaccinated or intended to be vaccinated), there was a higher perceived severity of HPV-related disease, greater perceived benefits of vaccination, fewer perceived barriers, and a stronger response to physician recommendations. Cost was the only barrier notably linked to non-acceptance. These findings highlight an urgent need to address gaps in awareness of HPV's link to anal cancer and underscore how key HBM constructs-particularly high perceived severity and benefits, and low barriers-predict vaccine acceptance. Interventions should focus on informing HIV + MSM about their susceptibility and emphasizing healthcare provider recommendations. Although the small sample size and single-site recruitment limit generalizability, this study offers critical insights into HPV-related perceptions among HIV + MSM, underscoring the importance of targeted strategies to boost vaccination and reduce HPV-related cancer in this underserved group.