Gay and bisexual men have high rates of human papillomavirus (HPV) infection and HPV-related disease, such as anal cancer. Despite these existing disparities, no known interventions have been developed to increase HPV vaccination among young gay and bisexual men (YGBM) in the United States. We developed and pilot tested an online intervention, Outsmart HPV, to promote HPV vaccination among YGBM.
In 2016, we used social media to recruit a national sample of YGBM ages 18-25 in the United States who had not received any does of HPV vaccine (n=150). Participants were randomized to receive either standard information about HPV vaccination (control group) or population-targeted, individually-tailored content about HPV vaccination (intervention group). Participants in both study arms completed a baseline survey before viewing their study materials and a follow-up survey immediately afterwards. We used multiple linear regression to assess between-group differences in attitudes and beliefs about HPV vaccination.
Most participants were ages 22-25 (59%), gay (83%), non-Hispanic white (57%), and not married or living with a partner (80%). There were no differences in HPV vaccination attitudes and beliefs between study arms at baseline. Compared to participants in the control group, participants in the intervention group reported on their follow-up surveys: greater perception of increased risk for anal cancer among men who have sex with men compared to other men (b=0.30), fewer perceived harms of HPV vaccine (b=-0.34), and greater self-efficacy to get HPV vaccine (b=0.18) (all p<0.05). Results also suggest a trend toward higher intent to get HPV vaccine among participants in the intervention group compared to those in the control group (b=0.21, p=0.09). Participants in the intervention group reported high levels of acceptability and satisfaction with their viewed study materials about HPV vaccination (all means >4.40 on a 5-point scale). Further, participants in the intervention group more strongly endorsed that their materials were easy to understand than did the control group (means: 4.72 vs. 4.42, p<0.05).
Findings from this pilot randomized controlled trial provide preliminary support for an online HPV vaccination intervention being highly acceptable to YGBM and improving their attitudes and beliefs about HPV vaccination. Taken together, these results suggest that Outsmart HPV may be a promising tool for promoting HPV vaccination among YGBM. An important next step is to determine the efficacy of the intervention on increasing HPV vaccine uptake among this population.