Faible couverture vaccinale contre les papillomavirus chez les hommes ayant des relations sexuelles avec des hommes : un manque de proposition du vaccin par les médecins

Abstract : Background: In France, it is currently recommended to immunize against HPV only girls, with two exceptions: males under 20 years in case of immunodepression (since 2014); and male under 27 years in cases of sexual intercourses with men (since 2016). We aimed to determine whether men having sex with men (MSM) were immunized in France, and to what extent this resulted from an opposition to vaccine, or a lack of offer. Materials/methods: We electronically diffused on various social medias between October 7th 2018 and January 6th 2019 an anonymous questionnaire targeting MSM in France. Apart from sociodemographic data, we explored perceptions of vaccination in general, vaccinal status for HPV and hepatitis A, and past vaccine offer by physicians. Results: 2094 participants completed the questionnaire (age 35.4±11 years). 93.5% declared having only male partners, and the others mostly male or mostly female partners. The use of pre-exposure prophylaxis (PrEP) was reported by 16.3%. 39.2% were aware of the HPV vaccine recommendation; 8.0% had received this vaccine. Among those who were concerned by the age-based vaccine recommendation (being 26 or younger in 2016), 17.9% were vaccinated ; in this age class, this proportion was higher among those under PrEP (52.5% vs 15.0%, p<0.01). 82.6% had a general practitioner. 90.1% of those having a general practitioner declared that he/she had never evoked the vaccine (with no difference between those in the targeted age class and the others). When asked whether they would accept to receive the vaccine, 79.9% of the unvaccinated participants answered “yes, absolutely” or “rather yes”. Concerning their perceptions of vaccines in general, on a 1-10 scale, the medians of answer were 10 for “being in favor of vaccine”, 10 for “vaccines are useful” 10 and 2 for “vaccine are dangerous”; there was a negligible difference in these scores according to vaccine status. 49.4% had received the anti-hepatitis A vaccine. Conclusions: The vaccine coverage against HPV is low in MSM, even in those concerned by the age-based recommendation. This appears to result more from a lack of offer than an opposition to vaccine.
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Master Thesis
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Benoit Petit. Faible couverture vaccinale contre les papillomavirus chez les hommes ayant des relations sexuelles avec des hommes : un manque de proposition du vaccin par les médecins. Médecine humaine et pathologie. 2019. ⟨dumas-02171646⟩

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