Prevalence of human papillomavirus in teenage heterosexual males following the implementation of female and male school-based vaccination in Australia: 2014-2017

Chow, Eric P. F., Tabrizi, Sepehr N., Fairley, Christopher K., Wigan, Rebecca, Machalek, Dorothy A., Regan, David G., Hocking, Jane S., Garland, Suzanne M., Cornall, Alyssa M., Atchison, Steph, Bradshaw, Catriona S., McNulty, Anna, Owen, Louise, Marshall, Lewis, Russell, Darren B., Kaldor, John M., and Chen, Marcus Y. (2019) Prevalence of human papillomavirus in teenage heterosexual males following the implementation of female and male school-based vaccination in Australia: 2014-2017. Vaccine, 37 (46). pp. 6907-6914.

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Background: Australia introduced a school-based human papillomavirus (HPV) vaccination program for females aged 12-13 years in 2007, with a three-year catch-up to age 26; and for boys aged 12-13 from 2013, with a two-year catch-up to age 15. This study aimed to compare the prevalence of penile HPV between teenage heterosexual males in cohorts eligible or non-eligible for the school-based male vaccination program.

Methods: Between 2014 and 2017, sexually active heterosexual males aged 17-19 were recruited from sexual health centres and community sources across Australia. Males provided a self-collected penile swab for 37 HPV genotypes using Roche Linear Array and completed a questionnaire. We calculated adjusted prevalence ratios (aPR) of HPV between males in two periods: 2014-2015 (preceding implementation of school-based male vaccination) and 2016-2017 (eligible for school-based male vaccination). Self-reported vaccine doses were confirmed with doses reported to the National HPV Vaccination Program Register.

Results: Overall, 152 males were recruited in 2014-2015 and 146 in 2016-2017. Numbers of female sex partners and condom use did not differ between the two periods. The prevalence of quadrivalent vaccine-preventable [4vHPV] genotypes (6/11/16/18) was low in both periods (2.6% [2014-15] versus 0.7% [2016-17]; p = 0.371; aPR 0.28 [95% CI: 0.03-2.62]). Compared with men in 2014-2015, men in 2016-2017 had a lower prevalence of any of the 37 HPV genotypes tested (21.7% versus 11.6%; aPR 0.62 [95% CI: 0.36-1.07]) and any of the 13 high-risk genotypes tested (15.8% versus 7.5%; aPR 0.59 [95% CI: 0.30-1.19]). Prevalence of low-risk HPV genotypes did not differ between the two periods. Of the males recruited in 2016-2017, 55% had received >= 1 vaccine dose.

Conclusion: The prevalence of 4vHPV genotypes among teenage heterosexual males in both cohorts was low, presumably due to herd protection from the female-only vaccination program. Further studies are required to determine the impact of universal HPV vaccination on HPV prevalence in males.

Item ID: 61086
Item Type: Article (Research - C1)
ISSN: 1873-2518
Keywords: Human papillomavirus, HPV, Vaccine, Vaccination, Heterosexual, Male, Australia, Prevention, Control
Copyright Information: Copyright © 2019 Elsevier Ltd.
Funders: Merck & Co. (MK), Australian Government Department of Health (AGDH), National Health and Medical Research Council (NHMRC), Seqirus Australia, bioCSL, CSL Biotherapies, CSL Limited, Speedx Pty Ltd, Royal Women’s Hospital
Projects and Grants: MK 50939, AGDH HPV Surveillance Fund H1314G010, NHMRC Early Career Fellowships (1091226)
Date Deposited: 27 Nov 2019 07:45
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3204 Immunology > 320499 Immunology not elsewhere classified @ 50%
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