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Keywords = male HPV burden

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17 pages, 1726 KiB  
Article
Detection of Human Papillomavirus in Urogenital Swabs from Male Patients in Northern Serbia
by Gordana Kovačević, Vladimir Vuković, Nataša Nikolić, Branka Bašica, Jelena Radovanov, Aleksandra Čolović Popadić, Milica Pejaković Budinski, Tihomir Dugandžija, Zoran Golušin and Aleksandra Patić
Pathogens 2025, 14(6), 558; https://doi.org/10.3390/pathogens14060558 - 3 Jun 2025
Viewed by 903
Abstract
Human papillomavirus (HPV) is one of the most common sexually transmitted infections, affecting both men and women. However, in Serbia, the previous epidemiological and clinical research on HPV has primarily focused on women due to its established role in cervical cancer, while the [...] Read more.
Human papillomavirus (HPV) is one of the most common sexually transmitted infections, affecting both men and women. However, in Serbia, the previous epidemiological and clinical research on HPV has primarily focused on women due to its established role in cervical cancer, while the data on HPV prevalence in men remain scarce. This study analyzed 634 samples from men (mean age: 30 years, SD = 9.98; range: 18–79) from between 2012 and 2024. Overall, 30.76% of the tested men were HPV–positive, with the highest percentage of cases being observed in those aged 25–29 years (32.82%). The most common genotypes were HPV 16 and HPV 31 (22.05% each), followed by HPV6 (20.51%), HPV 56, and HPV 52 (9.23% each). The prevalence of HPV was the highest in the samples from men with genital warts (40.77%). Among the available vaccines, the nonavalent Gardasil 9 provides the broadest protection, covering genotypes found in 82% of the HPV–positive cases identified in this study. Our findings underscore the importance of comprehensive HPV prevention and control measures for the male population, contributing to ongoing research efforts aimed at reducing the burden of HPV–associated diseases in our region. Increasing the vaccination coverage among Serbian men could substantially reduce the overall burden of HPV–related diseases in both sexes. Full article
(This article belongs to the Special Issue Advances in HPV Diagnostic Testing—Improving Access and Accuracy)
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15 pages, 285 KiB  
Review
Overcoming Barriers to Human Papillomavirus Vaccination in Guangdong Province, China
by Shuaijing Zhang, Shiqi Li, Jingtai Ma, Guiyuan Ji, Zhifeng Li, Siyi Chen, Fenglin Zhang, Xingfen Yang, Jianpeng Xiao, Rong Cao, Chenggang Wu and Wei Wu
Vaccines 2025, 13(5), 482; https://doi.org/10.3390/vaccines13050482 - 29 Apr 2025
Cited by 1 | Viewed by 1821
Abstract
Human papillomavirus (HPV) infection remains a critical public health challenge in China, particularly in Guangdong Province, where HPV-52, 16, and 58 genotypes predominate, and male infection rates exceed 40%. Despite the successful implementation of a government-funded school-based program that has achieved 88% HPV [...] Read more.
Human papillomavirus (HPV) infection remains a critical public health challenge in China, particularly in Guangdong Province, where HPV-52, 16, and 58 genotypes predominate, and male infection rates exceed 40%. Despite the successful implementation of a government-funded school-based program that has achieved 88% HPV vaccine coverage among adolescent girls, several persistent barriers, including genotype mismatch (the free HPV vaccine covers < 50% of high-risk local strains), regional disparities (80% vs. 60% for first-dose coverage), and exclusion of males, thwart progress toward herd immunity. Financial sustainability risks pose an even more significant threat to the expansion of HPV vaccination programs, especially in Guangdong province where annual expenditures exceed CNY 200 million. This review delves into Guangdong’s pioneering efforts and proposes practical solutions: accelerating domestic multivalent HPV vaccine development, adopting gender-neutral vaccination policies, and leveraging mobile clinics for remote populations. These strategies not only provide a roadmap for China but also serve as valuable insight for other LMICs striving to overcome HPV-related inequalities. Full article
(This article belongs to the Special Issue HPV Vaccination Coverage: Problems and Challenges)
22 pages, 3340 KiB  
Article
Vaccination with a Human Papillomavirus L2 Multimer Provides Broad Protection against 17 Human Papillomavirus Types in the Mouse Cervicovaginal Challenge Model
by Zhenwei Han, Shen Wang, Ting Mu, Ping Zhao, Lingli Song, Ying Zhang, Jin Zhao, Wen Yin, Yue Wu, Huan Wang, Bo Gong, Min Ji, Richard B. S. Roden, Yanping Yang, Michel Klein and Ke Wu
Vaccines 2024, 12(6), 689; https://doi.org/10.3390/vaccines12060689 - 20 Jun 2024
Viewed by 5268
Abstract
Human papillomavirus (HPV) is a prevalent cause of mucosal and cutaneous infections and underlying conditions ranging from benign warts to anogenital and oropharyngeal cancers affecting both males and females, notably cervical cancer. Cervical cancer is the fourth leading cause of cancer deaths among [...] Read more.
Human papillomavirus (HPV) is a prevalent cause of mucosal and cutaneous infections and underlying conditions ranging from benign warts to anogenital and oropharyngeal cancers affecting both males and females, notably cervical cancer. Cervical cancer is the fourth leading cause of cancer deaths among women globally and is the most impactful in low- and middle-income countries (LMICs), where the costs of screening and licensed L1-based HPV vaccines pose significant barriers to comprehensive administration. Additionally, the licensed L1-based HPV vaccines fail to protect against all oncogenic HPV types. This study generated three independent lots of an L2-based target antigen (LBTA), which was engineered from conserved linear L2-protective epitopes (aa11–88) from five human alphapapillomavirus genotypes in E. coli under cGMP conditions and adjuvanted with aluminum phosphate. Vaccination of rabbits with LBTA generated high neutralizing antibody titers against all 17 HPV types tested, surpassing the nine types covered by Gardasil®9. Passive transfer of naïve mice with LBTA antiserum revealed its capacity to confer protection against vaginal challenge with all 17 αHPV types tested. LBTA shows stability at room temperature over >1 month. Standard in vitro and in vivo toxicology studies suggest a promising safety profile. These findings suggest LBTA’s promise as a next-generation vaccine with comprehensive coverage aimed at reducing the economic and healthcare burden of cervical and other HPV+ cancers in LMICs, and it has received regulatory approval for a first-in-human clinical study (NCT05672966). Full article
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16 pages, 1136 KiB  
Review
Unveiling the Role of Human Papillomavirus in Urogenital Carcinogenesis a Comprehensive Review
by Beliz Bahar Karaoğlan and Yüksel Ürün
Viruses 2024, 16(5), 667; https://doi.org/10.3390/v16050667 - 25 Apr 2024
Cited by 6 | Viewed by 2742
Abstract
Human papillomavirus (HPV), an oncogenic DNA virus, is the most common sexually transmitted virus and significant public health concern globally. Despite the substantial prevalence of HPV infection among men, routine testing remains elusive due to the lack of approved HPV tests and the [...] Read more.
Human papillomavirus (HPV), an oncogenic DNA virus, is the most common sexually transmitted virus and significant public health concern globally. Despite the substantial prevalence of HPV infection among men, routine testing remains elusive due to the lack of approved HPV tests and the complexity of detection methods. Various studies have explored the link between HPV and genitourinary cancers, revealing different associations influenced by geographic variation, histological subtype and methodological differences. These findings underscore the importance of further research to elucidate the role of HPV in male urogenital cancers. This comprehensive review delves into the intricate relationship between HPV and male genitourinary cancers, shedding light on the virus’s oncogenic mechanisms and its reported prevalence. A deeper understanding of HPV’s implications for male health is essential for advancing public health initiatives and reducing the burden of urogenital cancers worldwide. Full article
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11 pages, 578 KiB  
Review
History of Human Papilloma Virus Vaccination with a Focus on Italy
by Giovanni Gabutti and Matilde Ogliastro
Women 2024, 4(1), 42-52; https://doi.org/10.3390/women4010004 - 6 Feb 2024
Cited by 2 | Viewed by 4451
Abstract
The Italian National Immunization Plan (NIP) states that public health today aims at immunizing adolescents of both sexes for maximum protection against all HPV-related vaccine-preventable diseases. Nowadays, the vaccination offer to primary cohorts is reaffirmed with continued free vaccination up to at least [...] Read more.
The Italian National Immunization Plan (NIP) states that public health today aims at immunizing adolescents of both sexes for maximum protection against all HPV-related vaccine-preventable diseases. Nowadays, the vaccination offer to primary cohorts is reaffirmed with continued free vaccination up to at least 26 years of age for females and up to at least 18 years of age for males. The Italian NIP 2023–2025 recommends HPV vaccination for at-risk categories, including individuals with HIV, men who have sex with men (MSM), women treated for intermediate- or high-grade lesions, and travelers. Catch-up vaccination is recommended for women at least up to 26 years of age, also using the appropriate occasion of the call for the first screening for the prevention of cervical cancer as an opportunity for vaccination, and for men at least up to and including 18 years of age if they have not been previously vaccinated or have not completed the vaccination cycle. In summary, the Italian vaccination offer has been extended to additional cohorts in order to reduce the burden of HPV-related diseases and to improve vaccination coverage of the Italian population. Full article
(This article belongs to the Special Issue Feature Papers in Women 2024)
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10 pages, 252 KiB  
Article
HPV Opportunistic Vaccination: A Literature Review and a Single-Center Experience in Northern Italy through the COVID-19 Pandemic
by Francesco Cantatore, Nadia Agrillo, Alessandro Camussi and Massimo Origoni
Vaccines 2023, 11(9), 1435; https://doi.org/10.3390/vaccines11091435 - 31 Aug 2023
Viewed by 2438
Abstract
The World Health Organization (WHO) set the goal of 90% HPV vaccination coverage in the population to eliminate cervical cancer. Opportunistic vaccination is performed outside the free vaccination or catch-up programs. Both free and opportunistic HPV vaccination programs experienced slowdowns during the COVID-19 [...] Read more.
The World Health Organization (WHO) set the goal of 90% HPV vaccination coverage in the population to eliminate cervical cancer. Opportunistic vaccination is performed outside the free vaccination or catch-up programs. Both free and opportunistic HPV vaccination programs experienced slowdowns during the COVID-19 pandemic. In this retrospective study, we aimed to identify the benefits and the obstacles of opportunistic vaccination among male and female individuals who took advantage of the “on-demand” service offered by San Raffaele Hospital in Milan from April 2018 to May 2023. The impact that the COVID-19 pandemic had on vaccination adherence was also analyzed. Data on a total of 527 subjects were collected from an in-house database and through personal interviews. Women in the cohort of older patients (over 25) adhered to the vaccination schedule more than younger women. Opportunistic vaccination request is influenced by the need of a gynecologist, a general practitioner, or public health clinic availability. Women also showed good adherence to screening, demonstrating awareness of the importance of cervical cancer secondary prevention despite vaccination. Opportunistic vaccination offers the possibility of including individuals excluded from the free vaccination campaigns, often already affected by lesions caused by HPV, providing increased viral clearance and faster lesion regression. The main limit remains the economic burden. Full article
(This article belongs to the Special Issue HPV Vaccination: Basic and Clinical Research)
19 pages, 512 KiB  
Article
Factors Associated with College Students’ Human Papillomavirus (HPV) Vaccination and Preferred Strategies for Catch-Up Vaccine Promotion: A Mixed-Methods Study
by Seok Won Jin, Yeonggeul Lee, Sohye Lee, Haeun Jin and Heather M. Brandt
Vaccines 2023, 11(6), 1124; https://doi.org/10.3390/vaccines11061124 - 20 Jun 2023
Cited by 11 | Viewed by 3974
Abstract
Human papillomavirus (HPV) vaccination protects against six types of cancer—cervical, anal, oropharyngeal, penile, vulvar, and vaginal. In the United States (U.S.), HPV vaccination coverage in college students remains low, especially in the Mid-South region, despite the highest risk of HPV infections and disease [...] Read more.
Human papillomavirus (HPV) vaccination protects against six types of cancer—cervical, anal, oropharyngeal, penile, vulvar, and vaginal. In the United States (U.S.), HPV vaccination coverage in college students remains low, especially in the Mid-South region, despite the highest risk of HPV infections and disease burden. However, few studies have assessed HPV vaccination among college students here. This study examined factors associated with HPV vaccination among college students in the Mid-South and explored preferred strategies for promoting vaccination. A mixed-methods design comprising a cross-sectional, self-report online survey and dyadic virtual interviews was conducted. Simple random sampling was performed to recruit a total of 417 undergraduate students aged 18–26 from March to May 2021; convenience sampling was performed to recruit three sex-matched dyads of a total of six (four female and two male) undergraduates from survey respondents who had not completed the HPV vaccine series in May 2021. Binary logistic regression analyses showed HPV vaccine knowledge and perceived barriers to vaccination were factors contributing to coverage for both female and male students, while perceived risks of HPV and vaccine hesitancy were factors only among female students. Findings from the qualitative content analysis identified college students’ perceived barriers to the vaccination at multiple levels and preferred strategies for vaccination promotion, corroborating the findings from the survey study. The findings provide implications that benefit the development of tailored interventions aimed at facilitating catch-up vaccination among college students in the Mid-South region. There is an urgent need for further research and the implementation of effective strategies that address the identified barriers and improve HPV vaccine uptake in this population. Full article
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12 pages, 396 KiB  
Article
Awareness of Human Papillomavirus among Male and Female University Students in Saudi Arabia
by Esraa Aldawood, Lama Alzamil, Layla Faqih, Deemah Dabbagh, Sarah Alharbi, Taghreed A. Hafiz, Hassan H. Alshurafa, Wajd F. Altukhais and Rufaidah Dabbagh
Healthcare 2023, 11(5), 649; https://doi.org/10.3390/healthcare11050649 - 23 Feb 2023
Cited by 20 | Viewed by 3915
Abstract
Background: Human papillomavirus (HPV) is a common sexually transmitted infection globally. Investigating HPV awareness can reduce the burden of HPV-related cancers. Aims: (1) Assessing HPV awareness and knowledge among health college students at King Saud University, (2) comparing these outcomes across sociodemographic characteristics. [...] Read more.
Background: Human papillomavirus (HPV) is a common sexually transmitted infection globally. Investigating HPV awareness can reduce the burden of HPV-related cancers. Aims: (1) Assessing HPV awareness and knowledge among health college students at King Saud University, (2) comparing these outcomes across sociodemographic characteristics. Methods: A cross-sectional survey study was conducted from November to December 2022 and included 403 health college students. Associations of HPV awareness and knowledge with sociodemographic characteristics were assessed using logistic regression analysis and linear regression analysis, respectively. Results: Only 60% of students were aware of HPV, with awareness higher among females, although their knowledge scores were comparable to males. The odds of awareness of HPV were greater among medical students compared to other colleges and among students belonging to older age groups compared to the younger age group (18–20). The odds of HPV awareness among hepatitis B vaccinated students were 2.10 times that among unvaccinated students (AOR = 2.10; 95% CI = 1.21, 3.64). Conclusions: The low level of HPV awareness among college students warrants the need for HPV educational campaigns to improve HPV awareness and to promote HPV vaccination in the community. Full article
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10 pages, 621 KiB  
Article
Economic Burden of Cervical and Head and Neck Cancer in Taiwan from a Societal Perspective
by Ying-Hui Wu, Chyong-Huey Lai, Ling Chien, Yun-Chung Pan, Yu-Jr Lin, Casey Feng and Chee-Jen Chang
Int. J. Environ. Res. Public Health 2023, 20(4), 3717; https://doi.org/10.3390/ijerph20043717 - 20 Feb 2023
Cited by 6 | Viewed by 4279
Abstract
Background: Head and neck cancers (HNC) are increasingly recognized as important human papillomavirus (HPV)-related malignancies in addition to cervical cancer (CC). However, data on the socioeconomic impact of HNC and CC in Taiwan are limited. Methods: A retrospective cohort study was conducted to [...] Read more.
Background: Head and neck cancers (HNC) are increasingly recognized as important human papillomavirus (HPV)-related malignancies in addition to cervical cancer (CC). However, data on the socioeconomic impact of HNC and CC in Taiwan are limited. Methods: A retrospective cohort study was conducted to estimate the total direct medical cost and indirect productivity loss from CC and HNC between 2014 and 2015. Patient data from the Taiwan National Cancer Registry were analyzed, with matched non-cancer controls from the Taiwan National Healthcare Reimbursement Database. Indirect costs due to premature deaths were calculated using public data from Taiwanese government reports. Results: In the direct cost analysis, 2083 patients with newly diagnosed CC and 11,078 with newly diagnosed HNC (10,036 males) were identified between 2014 and 2015 and followed up through the end of 2016 or until death. The total direct medical costs incurred in 2014 and 2015 due to HNC were 11.54 times higher in males than in females, and 4.55 times higher than CC. Indirect cost analysis showed the total annual productivity loss was New Taiwan Dollar (NTD) $12 billion in 2019, and 79.99% was attributed to male HNC. Conclusion: In Taiwan, the socioeconomic burden associated with male HNC is high and greater than that seen with CC. While not all HNCs are attributable to HPV infection, prevention of HNC through HPV vaccination should be considered for both sexes. Full article
(This article belongs to the Section Health Economics)
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13 pages, 311 KiB  
Review
Genomic Immune Evasion: Diagnostic and Therapeutic Opportunities in Head and Neck Squamous Cell Carcinomas
by Kedar Kirtane, Maie St. John, Harry Fuentes-Bayne, Sandip P. Patel, Armen Mardiros, Han Xu, Eric W. Ng, William Y. Go, Deborah J. Wong, John B. Sunwoo and John S. Welch
J. Clin. Med. 2022, 11(24), 7259; https://doi.org/10.3390/jcm11247259 - 7 Dec 2022
Cited by 5 | Viewed by 3198
Abstract
Head and neck squamous cell cancers (HNSCCs) represent a diverse group of tumors emerging within different mucosal surfaces of the oral cavity, nasopharynx, oropharynx, larynx, and hypopharynx. HNSCCs share common clinical risk factors and genomic features, including smoking, alcohol, age, male sex, aneuploidy, [...] Read more.
Head and neck squamous cell cancers (HNSCCs) represent a diverse group of tumors emerging within different mucosal surfaces of the oral cavity, nasopharynx, oropharynx, larynx, and hypopharynx. HNSCCs share common clinical risk factors and genomic features, including smoking, alcohol, age, male sex, aneuploidy, and TP53 mutations. Viral initiating and contributing events are increasingly recognized in HNSCCs. While both Epstein–Barr Virus (EBV) and human papilloma virus (HPV) are observed, EBV is more frequently associated with nasopharyngeal cancers whereas HPV is associated with oropharyngeal cancers. HNSCCs are associated with high tumor mutational burden and loss of tumor suppressor gene function, especially in TP53 and X-linked genes. Multiple lines of evidence suggest that HNSCCs are subject to immunologic surveillance and immune-induced evolutionary pressure that correlate with negative clinical outcomes. This review will discuss genomic mechanisms related to immune-mediated pressures and propose prognostic and therapeutic implications of detectable immune escape mechanisms that drive tumorigenesis and disease progression. Full article
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18 pages, 1445 KiB  
Review
Novel Vaccine Strategies and Factors to Consider in Addressing Health Disparities of HPV Infection and Cervical Cancer Development among Native American Women
by Crystal G. Morales, Nicole R. Jimenez, Melissa M. Herbst-Kralovetz and Naomi R. Lee
Med. Sci. 2022, 10(3), 52; https://doi.org/10.3390/medsci10030052 - 13 Sep 2022
Cited by 3 | Viewed by 5443
Abstract
Cervical cancer is the 4th most common type of cancer in women world-wide. Many factors play a role in cervical cancer development/progression that include genetics, social behaviors, social determinants of health, and even the microbiome. The prevalence of HPV infections and cervical cancer [...] Read more.
Cervical cancer is the 4th most common type of cancer in women world-wide. Many factors play a role in cervical cancer development/progression that include genetics, social behaviors, social determinants of health, and even the microbiome. The prevalence of HPV infections and cervical cancer is high and often understudied among Native American communities. While effective HPV vaccines exist, less than 60% of 13- to 17-year-olds in the general population are up to date on their HPV vaccination as of 2020. Vaccination rates are higher among Native American adolescents, approximately 85% for females and 60% for males in the same age group. Unfortunately, the burden of cervical cancer remains high in many Native American populations. In this paper, we will discuss HPV infection, vaccination and the cervicovaginal microbiome with a Native American perspective. We will also provide insight into new strategies for developing novel methods and therapeutics to prevent HPV infections and limit HPV persistence and progression to cervical cancer in all populations. Full article
(This article belongs to the Special Issue Gynecologic Oncology – Old Controversies and New Strategies)
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11 pages, 1506 KiB  
Article
HPV Vaccination during the COVID-19 Pandemic in Italy: Opportunity Loss or Incremental Cost
by Francesco Saverio Mennini, Andrea Silenzi, Andrea Marcellusi, Michele Conversano, Andrea Siddu and Giovanni Rezza
Vaccines 2022, 10(7), 1133; https://doi.org/10.3390/vaccines10071133 - 16 Jul 2022
Cited by 10 | Viewed by 2941
Abstract
Objectives: Italy was the first European country to introduce universal vaccination of adolescents, for both males and females, against Human Papilloma Virus (HPV) starting in 2017 with the NIP 2017–2019′s release. However, vaccine coverage rates (VCRs) among adolescents have shown a precarious take-off [...] Read more.
Objectives: Italy was the first European country to introduce universal vaccination of adolescents, for both males and females, against Human Papilloma Virus (HPV) starting in 2017 with the NIP 2017–2019′s release. However, vaccine coverage rates (VCRs) among adolescents have shown a precarious take-off since the NIP’s release, and this situation worsened due to the impact of the COVID-19 pandemic in 2020. The aim of this work is to estimate the epidemiological and economic impact of drops in VCRs due to the pandemic on those generations that missed the vaccination appointment and to discuss alternative scenarios in light of the national data. Methods: Through an analysis of the official ministerial HPV vaccination reports, a model was developed to estimate the number of 12-year-old males and females who were not vaccinated against HPV during the period 2017–2021. Based on previously published models that estimate the incidence and the economic impact of HPV-related diseases in Italy, a new model was developed to estimate the impact of the aggregated HPV VCRs achieved in Italy between 2017 and 2021. Results: Overall, in 2021, 723,375 girls and 1,011,906 boys born between 2005 and 2009 were not vaccinated against HPV in Italy (42% and 52% of these cohorts, respectively). As compared with the 95% target provided by the Italian NIP, between 505,000 and 634,000 girls will not be protected against a large number of HPV-related diseases. For boys, the number of the unvaccinated population compared to the applicable target is over 615,000 in the ‘best case scenario’ and over 749,000 in the ‘worst case scenario’. Overall, between 1.1 and 1.3 million young adolescents born between 2005 and 2009 will not be protected against HPV-related diseases over their lifetime with expected lifetime costs of non-vaccination that will be over EUR 905 million. If the 95% optimal VCRs were achieved, the model estimates a cost reduction equal to EUR 529 million, the net of the costs incurred to implement the vaccination program. Conclusion: Suboptimal vaccination coverage represents a missed opportunity, not only because of the increased burden of HPV-related diseases, but also in terms of economic loss. Thus, reaching national HPV immunization goals is a public health priority. Full article
(This article belongs to the Special Issue Latest National HPV Vaccine Programs and Outcomes in the World)
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13 pages, 883 KiB  
Article
Factors Influencing Men’s Attitudes toward HPV Vaccination in Males Included in the Chinese National Immunization Program
by Yi Tao, Huarui Shao, Ting Zhang, Junliang Pu and Chengyong Tang
Vaccines 2022, 10(7), 1054; https://doi.org/10.3390/vaccines10071054 - 30 Jun 2022
Cited by 7 | Viewed by 2857
Abstract
Background: Human papillomavirus (HPV) infection is the most common sexually transmitted disease, and it is associated with anogenital warts and oropharyngeal and anogenital cancers. Among female malignant tumors in China, the incidence of cervical cancer ranks second, with only breast cancer being more [...] Read more.
Background: Human papillomavirus (HPV) infection is the most common sexually transmitted disease, and it is associated with anogenital warts and oropharyngeal and anogenital cancers. Among female malignant tumors in China, the incidence of cervical cancer ranks second, with only breast cancer being more prevalent. HPV infection and related diseases affects both women and men. HPV vaccination is an optimal prevention strategy in preventing HPV infection and related diseases. The inclusion of the HPV vaccine in the national immunization program is an effective way to increase immunization coverage, reduce the burden of HPV related diseases, and increase national life expectancy. Objective: This study aimed to explore the factors influencing the attitudes of Chinese men toward the inclusion of the HPV vaccine in males included in the national immunization program, thus providing reference for launching the national immunization program policy. Methods: We invited men aged 20 to 45 to participate in an online survey. The participants were requested to complete a questionnaire, including sociodemographic characteristics, sexual behavior characteristics, knowledge of HPV and the HPV vaccine, and attitudes toward the HPV vaccine. A logistic regression model was constructed to analyze the influencing factors of attitudes. Results: A total of 660 males in China participated in this survey, and 80.45% supported the inclusion of HPV vaccines in national immunization programs. Participants earning CNY 100,000–200,000 (dds ratio (OR): 0.63, 95% confidence interval (CI): 0.39–1.00) or ≥200,000 (OR: 0.34, 95% CI: 0.17–0.68) were more likely to disapprove this strategy. Compared with people without a history of HPV infection, those with a history of HPV infection (OR: 1.84, 95% CI: 1.17–2.90) were more likely to approve. Men who had better knowledge of HPV were more likely to approve than men with less knowledge about HPV (OR: 1.44, 95% CI: 1.17–1.79). Compared with participants who did not know when the HPV vaccine should be given, those who knew that the ideal time of vaccination is before an individual becomes sexually active (OR: 1.75, 95% CI: 1.04–2.95) were more likely to approve. Conclusion: One in five men did not support the inclusion of HPV vaccines in national immunization programs, and they are likely to be from higher socioeconomic background and have poor knowledge of HPV. In order to implement comprehensive immunity, targeted actions need to be taken at national and public levels. In addition, when implementing measures, more attention needs to be paid to lower income men, men without a history of HPV infection and with poor knowledge of HPV, as well as young men. Full article
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