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Chow EP, Fairley CK, Atkinson S, Bradshaw CS, Chen MY. Validation of self-reported human papillomavirus vaccination in young adult men who have sex with men. Hum Vaccin Immunother 2024; 20:2371179. [PMID: 38972858 PMCID: PMC11229729 DOI: 10.1080/21645515.2024.2371179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/19/2024] [Indexed: 07/09/2024] Open
Abstract
The Victorian Government introduced a time-limited human papillomavirus (HPV) catch-up program for gay, bisexual, and other men who have sex with men (GBMSM) aged ≤ 26 years in 2017-2019. We conducted a retrospective observational study to examine the accuracy of the self-report of HPV vaccination status using computer-assisted self-interviewing versus their immunization history via electronic health records. We included GBMSM aged 23-30 years visiting the Melbourne Sexual Health Centre (MSHC) in 2020-2021 because they were age-eligible for the HPV catch-up program in Victoria, Australia. Individuals who were unsure about their vaccination status were categorized as 'unvaccinated'. Of the 1,786 eligible men, 1,665 men self-reported their HPV vaccination status: 48.8% (n = 812) vaccinated, 17.4% (n = 289) unvaccinated, and 33.9% (n = 564) unsure. Self-reported HPV vaccination had a sensitivity of 61.3% (95%CI: 58.3 to 64.2%; 661/1079), a specificity of 74.2% (95%CI: 70.5 to 77.7%; 435/586), a positive predictive value of 81.4% (95%CI: 78.6 to 84.0%; 661/812), a negative predictive value of 51.0% (95%CI: 47.6 to 54.4%; 435/853), and an accuracy of 52.6% (95%CI: 50.1 to 55.0%). Our results showed that only half of GBMSM know and report their HPV vaccination status correctly. Novel approaches such as digital vaccine passports may be useful for individuals to accurately report their vaccination status to guide accurate clinical decisions and management.
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Affiliation(s)
- Eric P.F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Sidney Atkinson
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Marcus Y. Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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2
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Guo TY, Halkitis PN, Lewis K, Krause KD. Hepatitis A vaccination in a racially and sexually diverse population of gay, bisexual, and other men who have sex with men: Findings from the QVax study. Int J STD AIDS 2024:9564624241278765. [PMID: 39222969 DOI: 10.1177/09564624241278765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Previous studies found vaccination uptake of vaccine-preventable diseases (VPD) to be associated with race/ethnicity and medical mistrust among key populations, however, few studies examine Hepatitis A vaccination uptake. METHODS This cross-sectional study used online survey data collected from NJ and NY residents identifying as lesbian, gay, bisexual, transgender, queer (LGBTQ+) from October 2021 through November 2022. RESULTS This study used a subsample of 222 gay, bisexual, and other cisgender men, 66.7% White, with mean age 41.22 years (SD = 15.23), and 60% fully vaccinated for Hepatitis A. Overall, average group-based medical mistrust scores did not differ among non-vaccinated participants compared to fully or partially vaccinated participants. However, higher group-based medical mistrust scores were associated with non-White identifying participants, and were highest among Hispanic/Latinx (2.68, sd = 0.43) and Black non-Hispanic (2.58, sd = 0.50) participants (p < .001). Vaccination patterns did not differ among fear or vaccine confidence-based items. CONCLUSIONS Our results contribute to the limited knowledge of differences in Hepatitis A vaccination uptake among men who have sex with men, and support the need for targeted intervention programs that acknowledge the diverse population of LGBTQ + identifying individuals and their associated health behaviors.
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Affiliation(s)
- Tiffany Y Guo
- Center for Health, Identity, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Perry N Halkitis
- Center for Health, Identity, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Kendra Lewis
- Center for Health, Identity, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA
| | - Kristen D Krause
- Center for Health, Identity, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA
- Department of Urban-Global Health, School of Public Health, Rutgers University, Newark, NJ, USA
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3
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Huang F, Fairley CK, Lee DM, Rahman R, Ong JJ, Bradshaw CS, Chen MY, Phillips TR, Chow EPF. Factors Associated With Consenting to Receive an Automated Email Summary After a Sexual Health Clinic Visit. Sex Transm Dis 2023; 50:664-670. [PMID: 37432979 DOI: 10.1097/olq.0000000000001847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND Electronic health records allow for inexpensive communication with patients. In March 2021, the Melbourne Sexual Health Centre implemented an automated email summary ("Sexual Health Automated Visit Email" [SHAVE]) of a client's visit. This study evaluates the proportion of attendees at a sexual health service who opted in or out of SHAVE. METHODS This study was conducted at the Melbourne Sexual Health Centre in Australia between March 2021 and June 2022. Univariable and multivariable logistic regression analyses were used to examine the client characteristics associated with consenting to SHAVE. RESULTS There were 18,528 clients (men, 12,700; women, 5828) included in the final analysis and 55.2% (n = 10,233) consented to receiving SHAVE. Comparing with those who did not have a new sexually transmitted infection diagnosis, clients with a new diagnosis of a sexually transmitted infection, but not HIV, had lower odds of consenting to receiving SHAVE (chlamydia: adjusted odds ratio [aOR], 0.64 [95% confidence interval {CI}, 0.57-0.72]; gonorrhea: aOR, 0.71 [95% CI, 0.62-0.82]; syphilis: aOR, 0.75 [95% CI, 0.59-0.96]). Men had lower odds of consenting when compared with women (men who have sex with women only: aOR, 0.77 [95% CI, 0.71-0.84]; men who have sex with men: aOR, 0.68 [95% CI, 0.62-0.75]). Comparing with those born in Australia or Oceania, clients born in Europe had lower odds of consenting (aOR, 0.81; 95% CI, 0.70-0.94), whereas those born in Latin America or Caribbean had higher odds of consenting (aOR, 1.25; 95% CI, 1.04-1.51). CONCLUSIONS Email summaries may serve as a valuable strategy to improve health communication and record keeping for clients. Understanding the client characteristics associated with consenting SHAVE will allow for the implementation of strategies to better communicate with clients.
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Affiliation(s)
| | | | - David M Lee
- From the Melbourne Sexual Health Centre, Alfred Health
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4
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White P, O'Donnell K, Brennan A, Davoren M, Lyons F, Quinlan M, Foley B, Hurley C, Igoe D, Barrett P. Hepatitis A and B vaccination in gbMSM in Ireland: findings from the European MSM Internet Survey 2017 (EMIS-2017). Sex Transm Infect 2023; 99:337-344. [PMID: 36517220 DOI: 10.1136/sextrans-2022-055580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Gay, bisexual and other men who have sex with men (gbMSM) have a higher risk of acquiring hepatitis A and B viruses (HAV and HBV) than the general population and are recommended for vaccination against both in Ireland. This study aims to determine the prevalence of self-reported HAV and HBV infection and vaccination among gbMSM in Ireland and explore factors associated with self-reported HAV and HBV vaccination among gbMSM. METHODS This study analysed Irish data from the European MSM Internet Survey 2017 (EMIS-2017) to measure the prevalence of self-reported HAV and HBV infection and vaccination among gbMSM in Ireland. Multivariable logistic regression was used to explore the associations between sociodemographic, healthcare-related and behavioural factors and self-reported vaccination. RESULTS There were 2083 EMIS-2017 respondents in Ireland. Among HIV-negative gbMSM, 4.6% and 4.4% reported previous HAV and HBV infection, respectively, and 51% and 57% reported the receipt of one or more vaccine dose for HAV and HBV, respectively. In the multivariable analysis, HIV-negative gbMSM had lower odds of self-reported HAV vaccination if they lived outside the capital, Dublin (aOR 0.61, 95% CI: 0.48 to 0.78), had no third-level education (aOR 0.65, 95% CI: 0.45 to 0.92), were not tested for HIV in the last year (aOR 0.39, 95% CI: 0.31 to 0.50), had never tried to obtain pre-exposure prophylaxis (PrEP, aOR 0.60, 95% CI: 0.38 to 0.96) and had not been diagnosed with a sexually transmitted infection (STI) in the previous year (aOR 0.42, 95% CI: 0.28 to 0.63). Similar associations were observed for self-reported HBV vaccination. CONCLUSIONS Self-reported vaccination against HAV and HBV among gbMSM in Ireland is high, but the level of vaccination remains insufficient to protect against future HAV and HBV infections and outbreaks. Efforts to increase vaccination coverage among gbMSM should focus on men who live outside the capital, have lower educational attainment and do not engage with sexual health services.
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Affiliation(s)
| | | | - Aline Brennan
- Department of Public Health, HSE-South, Cork, Ireland
| | | | - Fiona Lyons
- HSE Sexual Health and Crisis Pregnancy Programme, Dublin, Ireland
| | | | | | - Caroline Hurley
- HSE Sexual Health and Crisis Pregnancy Programme, Dublin, Ireland
| | - Derval Igoe
- Health Protection Surveillance Centre, Dublin, Ireland
| | - Peter Barrett
- Department of Public Health, HSE-South, Cork, Ireland
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5
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Bérot V, Eremin A, Fauchois A, Dechamp J, Schneider L, Chermak A, Faycal A, Sellem B, Orriere T, Favier M, Tubiana R, Valantin MA, Pourcher V, Todesco E, Monsel G, Agher R, Palich R, Katlama C. Hepatitis A, hepatitis B and HPV vaccine needs and coverage in MSM initiating HIV PrEP in a sexual health clinic in Paris. Sex Transm Infect 2023:sextrans-2023-055802. [PMID: 37173130 DOI: 10.1136/sextrans-2023-055802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Affiliation(s)
- Vincent Bérot
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Anton Eremin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Antoine Fauchois
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Jeanne Dechamp
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Luminita Schneider
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Aziza Chermak
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Antoine Faycal
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Baptiste Sellem
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Thibault Orriere
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Marion Favier
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Roland Tubiana
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Marc-Antoine Valantin
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Valerie Pourcher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Eve Todesco
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
- Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Gentiane Monsel
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Rachid Agher
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Romain Palich
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
| | - Christine Katlama
- Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
- INSERM U1136, Pierre Louis Epidemiology and Public Health Research Institute, Paris, Île-de-France, France
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6
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Hui BB, Padeniya TN, Rebuli N, Gray RT, Wood JG, Donovan B, Duan Q, Guy R, Hocking JS, Lahra MM, Lewis DA, Whiley DM, Regan DG, Seib KL. A gonococcal vaccine has the potential to rapidly reduce the incidence of Neisseria gonorrhoeae infection among urban men who have sex with men. J Infect Dis 2021; 225:983-993. [PMID: 34894134 PMCID: PMC8922007 DOI: 10.1093/infdis/jiab581] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background A gonococcal vaccine is urgently needed due to increasing gonorrhea incidence and emerging multidrug-resistant gonococcal strains worldwide. Men who have sex with men (MSM) have among the highest incidences of gonorrhea and may be a key target population for vaccination when available. Methods An individual-based, anatomical site-specific mathematical model was used to simulate Neisseria gonorrhoeae transmission in a population of 10 000 MSM. The impact of vaccination on gonorrhea prevalence was assessed. Results With a gonococcal vaccine of 100% or 50% protective efficacy, gonorrhea prevalence could be reduced by 94% or 62%, respectively, within 2 years if 30% of MSM are vaccinated on presentation for sexually transmitted infection (STI) testing. Elimination of gonorrhea is possible within 8 years with vaccines of ≥ 50% efficacy lasting 2 years, providing a booster vaccination is available every 3 years on average. A vaccine’s impact may be reduced if it is not effective at all anatomical sites. Conclusions Our study indicates that with a vaccine of modest efficacy and an immunization strategy that targets MSM presenting for STI screening, the prevalence of gonorrhea in this population could be rapidly and substantially reduced.
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Affiliation(s)
- Ben B Hui
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | | | - Nic Rebuli
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Richard T Gray
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - James G Wood
- School of Population Health, UNSW Sydney, Sydney, NSW, Australia
| | - Basil Donovan
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Qibin Duan
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rebecca Guy
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Monica M Lahra
- Microbiology Department, New South Wales Health Pathology, The Prince of Wales Hospital, Randwick, NSW, Australia.,School of Medical Sciences, UNSW Sydney, NSW, Australia
| | - David A Lewis
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, NSW, Australia.,Westmead Clinical School, Faculty of Health and Medicine & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, Australia.,Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - David M Whiley
- Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
| | - David G Regan
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Kate L Seib
- Institute for Glycomics, Griffith University, QLD Australia
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7
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Nadarzynski T, Frost M, Miller D, Wheldon CW, Wiernik BM, Zou H, Richardson D, Marlow LAV, Smith H, Jones CJ, Llewellyn C. Vaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework. Vaccine 2021; 39:3565-3581. [PMID: 34034949 DOI: 10.1016/j.vaccine.2021.05.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework. METHODS In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling. RESULTS Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM). CONCLUSION Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.
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Affiliation(s)
| | - Miles Frost
- The University of Southampton, Southampton, United Kingdom
| | - Danny Miller
- The University of Westminster, London, United Kingdom
| | | | | | - Huachun Zou
- Sun Yat-sen University, School of Public Health, Shenzhen, China
| | - Daniel Richardson
- Brighton & Sussex University Hospitals NHS Trust, Brighton; Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | | | - Carrie Llewellyn
- Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
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8
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Vodstrcil LA, Fairley CK, Williamson DA, Bradshaw CS, Chen MY, Chow EPF. Immunity to hepatitis A among men who have sex with men attending a large sexual health clinic in Melbourne, Australia, 2012-2018. Sex Transm Infect 2020; 96:265-270. [PMID: 32169881 DOI: 10.1136/sextrans-2019-054327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/24/2020] [Accepted: 02/19/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Outbreaks of hepatitis A are being reported more commonly among men who have sex with men (MSM) globally. Australia has also reported a sharp increase in the number of cases of hepatitis A in 2017. This study aimed to determine the level of immunity to hepatitis A among MSM attending a large urban sexual health clinic in Victoria in the lead up to recent outbreak. METHODS This was a retrospective audit of serological testing data from first-time MSM attendees at Melbourne Sexual Health Centre (MSHC) in Australia from 1 January 2012 to 31 December 2018. We determined the proportion of MSM who were tested and who had serological detection of hepatitis A IgG, stratified by age and calendar year. We used univariable and multivariable logistic regression to investigate factors associated with testing for and detection of hepatitis A IgG. RESULTS There were 16 609 first-time MSM attendees at MSHC over the 7-year period, of which 9718 (59%, 95% CI 58% to 60%) were tested for hepatitis A IgG. There was a 2% annual increase in the proportion of men tested (from 60% in 2012 to 69% in 2018; OR=1.02, 95% CI 1.00 to 1.03, p=0.025). Men born outside of Australia/New Zealand, and younger men <30 years had higher odds of being tested. Of those tested, 44% (n=4304, 95% CI 43% to 45%) had hepatitis A IgG detected at their first visit, with no change over time (OR=1.01, 95% CI 0.99 to 1.03, p=0.210). Detection of hepatitis A IgG was associated with being aged 30 years or older (adjusted OR=2.06, 95% CI 1.89 to 2.24, p<0.001) or being born overseas versus Australia/New Zealand (AOR=1.21, 95% CI 1.11 to 1.31, p<0.001). CONCLUSION Hepatitis A immunity among MSM remains below the estimated 70% required to prevent outbreaks. Measures including increased testing and higher vaccination coverage are needed to prevent outbreaks and to limit the number of cases and deaths.
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Affiliation(s)
- Lenka A Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia .,Central Clinical School, Monash University, Clayton, Victoria, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Clayton, Victoria, Australia
| | - Deborah A Williamson
- Melbourne Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Doherty Applied Microbial Genomics, Department of Microbiology & Immunology, University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Clayton, Victoria, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Clayton, Victoria, Australia
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9
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Martín-Sánchez M, Fairley CK, Bradshaw CS, Chen MY, Chow EPF. Meningococcal vaccine uptake among men who have sex with men in response to an invasive meningococcal C disease outbreak in Melbourne, Australia. Sex Transm Infect 2020; 96:246-250. [DOI: 10.1136/sextrans-2019-054318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/28/2019] [Accepted: 12/12/2019] [Indexed: 11/03/2022] Open
Abstract
ObjectiveIn 2017, there was an outbreak of invasive meningococcal disease (IMD) serogroup C among men who have sex with men (MSM) in Victoria, Australia. A government-funded free meningococcal (MenACWY) vaccination programme targeting all MSM living in Victoria was launched between December 2017 and December 2018. The aim of this study was to examine the vaccine uptake among MSM attending a sexual health clinic in Melbourne.MethodsThis was a retrospective clinical audit of MSM attending the Melbourne Sexual Health Centre (MSHC) during the vaccination programme. We calculated the proportion of MSM who received the meningococcal vaccine on their first visit and at any time during the programme. We performed univariable and multivariable logistic regression to identify the factors associated with the vaccine uptake on the first visit.ResultsOf the 10 370 MSM who attended MSHC, 55.5% received the vaccine on their first visit and 67.4% at any time during the programme. MSM had higher odds of receiving the vaccine on the first visit if they were aged 16–25 years (adjusted OR (aOR) 1.21; 95% CI 1.08 to 1.35) or 26–35 years (aOR 1.17; 95% CI 1.07 to 1.29) in comparison with MSM older than 35 years; were HIV-negative and not on pre-exposure prophylaxis (aOR 1.80; 95% CI 1.56 to 2.09); had more than four male partners in the last 12 months (aOR 1.16; 95% CI 1.06 to 1.27); had male partners only (aOR 2.24; 95% CI 1.96 to 2.55); or were born overseas (aOR 1.11; 95% CI 1.03 to 1.21).ConclusionsTwo-thirds of the MSM attending a sexual health clinic received at least one dose of meningococcal vaccine. The vaccination programme coincided temporally with a dramatic reduction in the incidence of IMD. Vaccination should be further promoted among MSM and men who have sex with both men and women.
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