Prevalence of human papillomavirus in teenage heterosexual males following the implementation of female and male school-based vaccination in Australia: 2014-2017

Eric P F Chow; Sepehr N Tabrizi; Christopher K Fairley; Rebecca Wigan; Dorothy A Machalek; David G Regan; Jane S Hocking; Suzanne M Garland; Alyssa M Cornall; Steph Atchison; Catriona S Bradshaw; Anna McNulty; Louise Owen; Lewis Marshall; Darren B Russell; John M Kaldor; Marcus Y Chen

doi:10.1016/j.vaccine.2019.09.052

Prevalence of human papillomavirus in teenage heterosexual males following the implementation of female and male school-based vaccination in Australia: 2014-2017

Vaccine. 2019 Oct 31;37(46):6907-6914. doi: 10.1016/j.vaccine.2019.09.052. Epub 2019 Sep 24.

Authors

Eric P F Chow¹, Sepehr N Tabrizi², Christopher K Fairley³, Rebecca Wigan⁴, Dorothy A Machalek⁵, David G Regan⁶, Jane S Hocking⁷, Suzanne M Garland⁸, Alyssa M Cornall⁹, Steph Atchison¹⁰, Catriona S Bradshaw¹¹, Anna McNulty¹², Louise Owen¹³, Lewis Marshall¹⁴, Darren B Russell¹⁵, John M Kaldor¹⁶, Marcus Y Chen¹⁷

Affiliations

¹ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Victoria, Australia. Electronic address: eric.chow@monash.edu.
² Department of Obstetrics Gynaecology, University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia.
³ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Victoria, Australia. Electronic address: CFairley@mshc.org.au.
⁴ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Electronic address: RWigan@mshc.org.au.
⁵ Murdoch Children's Research Institute, Parkville, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia. Electronic address: dorothy.machalek@thewomens.org.au.
⁶ The Kirby Institute, UNSW Sydney, Kensington, New South Wales, Australia. Electronic address: Dregan@kirby.unsw.edu.au.
⁷ Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia. Electronic address: j.hocking@unimelb.edu.au.
⁸ Department of Obstetrics Gynaecology, University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia. Electronic address: Suzanne.Garland@thewomens.org.au.
⁹ Department of Obstetrics Gynaecology, University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia. Electronic address: alyssa.cornall@mcri.edu.au.
¹⁰ Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia. Electronic address: steph.atchison@mcri.edu.au.
¹¹ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Victoria, Australia. Electronic address: catriona.bradshaw@monash.edu.
¹² Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales, Australia; School of Public Health and Community Medicine, UNSW Sydney, Kensington, New South Wales, Australia. Electronic address: Anna.McNulty@health.nsw.gov.au.
¹³ Statewide Sexual Health Service Tasmania, Tasmania, Australia. Electronic address: louise.owen@ths.tas.gov.au.
¹⁴ South Terrace Clinic, Fremantle Hospital, Perth, Western Australia, Australia. Electronic address: Lewis.Marshall@health.wa.gov.au.
¹⁵ Cairns Sexual Health Service, Queensland Health, Cairns, North Queensland, Australia; College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia. Electronic address: Darren.Russell@health.qld.gov.au.
¹⁶ The Kirby Institute, UNSW Sydney, Kensington, New South Wales, Australia. Electronic address: jkaldor@kirby.unsw.edu.au.
¹⁷ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Victoria, Australia. Electronic address: mchen@mshc.org.au.

PMID: 31562001
DOI: 10.1016/j.vaccine.2019.09.052

Abstract

Background: Australia introduced a school-based human papillomavirus (HPV) vaccination program for females aged 12-13 years in 2007, with a three-year catch-up to age 26; and for boys aged 12-13 from 2013, with a two-year catch-up to age 15. This study aimed to compare the prevalence of penile HPV between teenage heterosexual males in cohorts eligible or non-eligible for the school-based male vaccination program.

Methods: Between 2014 and 2017, sexually active heterosexual males aged 17-19 were recruited from sexual health centres and community sources across Australia. Males provided a self-collected penile swab for 37 HPV genotypes using Roche Linear Array and completed a questionnaire. We calculated adjusted prevalence ratios (aPR) of HPV between males in two periods: 2014-2015 (preceding implementation of school-based male vaccination) and 2016-2017 (eligible for school-based male vaccination). Self-reported vaccine doses were confirmed with doses reported to the National HPV Vaccination Program Register.

Results: Overall, 152 males were recruited in 2014-2015 and 146 in 2016-2017. Numbers of female sex partners and condom use did not differ between the two periods. The prevalence of quadrivalent vaccine-preventable [4vHPV] genotypes (6/11/16/18) was low in both periods (2.6% [2014-15] versus 0.7% [2016-17]; p = 0.371; aPR 0.28 [95% CI: 0.03-2.62]). Compared with men in 2014-2015, men in 2016-2017 had a lower prevalence of any of the 37 HPV genotypes tested (21.7% versus 11.6%; aPR 0.62 [95% CI: 0.36-1.07]) and any of the 13 high-risk genotypes tested (15.8% versus 7.5%; aPR 0.59 [95% CI: 0.30-1.19]). Prevalence of low-risk HPV genotypes did not differ between the two periods. Of the males recruited in 2016-2017, 55% had received ≥1 vaccine dose.

Conclusion: The prevalence of 4vHPV genotypes among teenage heterosexual males in both cohorts was low, presumably due to herd protection from the female-only vaccination program. Further studies are required to determine the impact of universal HPV vaccination on HPV prevalence in males.

Keywords: Australia; Control; HPV; Heterosexual; Human papillomavirus; Male; Prevention; Vaccination; Vaccine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Australia
Child
Female
Heterosexuality / statistics & numerical data*
Humans
Immunization Programs / methods
Male
Papillomaviridae / immunology
Papillomaviridae / pathogenicity*
Papillomavirus Infections / epidemiology
Papillomavirus Infections / immunology
Papillomavirus Infections / prevention & control
Papillomavirus Vaccines / immunology
Papillomavirus Vaccines / therapeutic use
Prevalence
Schools / statistics & numerical data
Vaccination / methods
Young Adult

Substances

Papillomavirus Vaccines