Falling Short of Clinical Recommendations: Low Uptake of the Human Papillomavirus Vaccine Among Gay, Bisexual, and Other Men Who Have Sex with Men in Ontario, Canada—Results from the Ontario Gay Men’s Health Survey
Bibliographic record
Abstract
Abstract Introduction Despite the high prevalence of human papillomavirus (HPV) infection and incidence of associated anal cancer among men who have sex with men (MSM) and the recommendation that all MSM in Canada receive the HPV vaccine, uptake of the vaccine remains low. The objective of this study was to identify correlates of HPV vaccination among MSM to expose gaps and better inform vaccination strategies and policies. Methods Data were collected from an anonymous, online, self-administered survey of MSM in Ontario, Canada’s most populous province. Participants were recruited by network and snowball sampling from June 2018 to March 2019. Results Of 1788 survey respondents, only 27.3% reported having received the HPV vaccine. Those who were vaccinated tended to be ≤ 30 years of age, live in an urban center, have more sexual partners, and more frequently access sexual health services. Having a primary care provider was not associated with HPV vaccination. Conclusion These data mandate increased efforts to deliver the HPV vaccine to MSM. Policy Implications Our data suggest at least four areas for policy reform to help increase HPV vaccine uptake among MSM. First, public funding of the HPV vaccine should be aligned with clinical recommendations and the vaccine should be available free of charge to MSM irrespective of age. Second, sexual health clinics, as clinics of choice for sexual minorities, should be supported and the HPV vaccine should be bundled with other sexual health services. Third, innovative strategies should be developed and funded to better deliver the HPV vaccine to older MSM and those living in rural areas. Finally, policymakers must remember the MSM population is diverse, and data acquired from MSM living in large metropolitan centers should not be the sole source of information used to inform health policies for this population. More awareness of and data from men living outside urban settings is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".