Attendance of MSM at Genitourinary Medicine services in England: implications for selective HPV vaccination programme (a short communication)

BackgroundHuman papillomaviruses (HPV) immunisation programmes for female adolescents in the UK offer relatively little benefit to men who have sex with men (MSM). Targeted HPV vaccination for MSM may reduce the high incidence of HPV-related disease among MSM. We used national data from sexual health clinics to calculate the number of MSM attending these clinics throughout England from 2009 to 2014 and to identify their characteristics, to inform the implementation of a targeted HPV vaccination programme in MSM.MethodsWe used the Genitourinary Medicine Clinic Activity Dataset (GUMCADv2) to obtain data for men aged 15–70 years who had attended a GUM clinic in England from 2009 to 2014. We analysed both numbers of MSM attending and number of GUM attendances, age at first attendance, ethnicity and geographical area of the clinic in England.ResultsA total of 374 983 MSM attended sexual health services in England between 2009 and 2014. Median age of presentation was 32 years (IQR 25–41) and showed regional geographical variation. Of all men attending sexual health clinics in England, the highest proportion of those identifying as MSM was in London (21%). Excluding visits within 1 month of an initial attendance, 49% of all MSM re-attended within 12 months and 58% within 24 months. MSM aged ≥36 years reattended more frequently than younger MSM. 51% reattended at least twice within 24 months of initial visit.ConclusionsThe majority of MSM reattend clinic at least once within a 24-month period, potentially facilitating the delivery of a three-dose HPV vaccination programme. This would reduce the burden on sexual health clinics and cost to local authorities due to extra visits if HPV vaccination were to be delivered through these services.

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Men who have sex with men who do not access sexual health clinics nor disclose sexual orientation are unlikely to receive the HPV vaccine in the UK

Vaccine ◽

10.1016/j.vaccine.2018.06.075 ◽

2018 ◽

Vol 36 (33) ◽

pp. 5065-5070 ◽

Cited By ~ 6

Author(s):

Tom Nadarzynski ◽

Helen Smith ◽

Daniel Richardson ◽

Stephen Bremner ◽

Carrie Llewellyn

Keyword(s):

Sexual Orientation ◽

Sexual Health ◽

Hpv Vaccine ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics ◽

The Uk ◽

To Receive

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HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054726 ◽

2020 ◽

pp. sextrans-2020-054726

Author(s):

Eleanor M King ◽

David Mesher ◽

Pam Sonnenberg ◽

Ezra Linley ◽

Kavita Panwar ◽

...

Keyword(s):

Sexual Health ◽

Hpv Vaccination ◽

Hpv Infection ◽

Cross Sectional Study ◽

Health Clinic ◽

Cross Sectional ◽

Hpv Dna ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics

ObjectivesMen who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection and related diseases compared with men who have sex exclusively with women. From April 2018, there has been a phased roll-out of HPV vaccination offered to MSM aged up to 45 years old who are attending sexual health clinics and HIV clinics in England. The vaccine is most effective if delivered prior to HPV infection. We estimated the proportion of MSM with no current vaccine-type infection and no serological evidence of prior infection, in a study undertaken prior to vaccine introduction.MethodsWe conducted a cross-sectional study among 484 MSM aged 18–40 years old who attended a sexual health clinic in London between 2010 and 2012. We estimated the prevalence of current and past infection by testing for HPV DNA in anogenital samples and for serum antibodies to HPV16 and HPV18.ResultsThe median age was 30 years (IQR 25–35). The prevalence of HPV16 and HPV18 DNA was 13.2% and 6.2%, respectively. Seropositivity for HPV16 and HPV18 was 28.5% and 17.1%, respectively, with 11.4% seropositive for both types. Seropositivity for the same HPV type was strongly associated with anogenital DNA detection. 279 MSM (57.6%) tested negative for both HPV16 and HPV18 serology and were DNA negative for these two types; only 5 MSM (1.0%) were seropositive and DNA positive for both HPV types.ConclusionsThis is the first study to determine both the prevalence of HPV DNA in anogenital samples and HPV seroprevalence among MSM attending a sexual health clinic in the UK. Over half of MSM in this study had no evidence of a previous or current infection with either of the high-risk HPV types included in the quadrivalent vaccine, which supports the rationale for opportunistic HPV vaccination of MSM attending sexual health clinics.

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Anogenital warts

Oxford Handbook of Genitourinary Medicine, HIV, and Sexual Health ◽

10.1093/med/9780198783497.003.0023 ◽

2019 ◽

pp. 291-304

Keyword(s):

Natural History ◽

Young Women ◽

Hpv Vaccination ◽

Anogenital Warts ◽

National Guidelines ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics ◽

The Uk ◽

In Pregnancy

Warts are caused by human papilloma viruses (HPV) and remain one of the most common STIs, accounting for 16% of new diagnoses in UK GUM clinics in 2015. Introduction of the quadrivalent HPV vaccine for girls has seen a steady decline of warts in young women and heterosexual men. Currently in the UK, HPV vaccination is offered to men who have sex with men <46 years old who access sexual health clinics, but national guidelines recommend routine vaccination to all boys as well as girls. Some countries such as Australia have already introduced vaccination for girls and boys, and there is hope that the UK will follow suite. This chapter details epidemiology, natural history, diagnosis, and principles of management of anogenital warts, including management in pregnancy and

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How can we increase offer rates of human papillomavirus (HPV) vaccination among men who have sex with men (MSM) in routine sexual health clinics?

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053505 ◽

2018 ◽

Vol 94 (4) ◽

pp. 247-247 ◽

Cited By ~ 1

Author(s):

Alex Parr ◽

Nicolas Pinto-Sander ◽

Daniel Richardson

Keyword(s):

Human Papillomavirus ◽

Sexual Health ◽

Hpv Vaccination ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics

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Is it time to move to nucleic acid amplification tests screening for pharyngeal and rectal gonorrhoea in men who have sex with men to improve gonorrhoea control?

Sexual Health ◽

10.1071/sh10134 ◽

2011 ◽

Vol 8 (1) ◽

pp. 9 ◽

Cited By ~ 20

Author(s):

Christopher K. Fairley ◽

Marcus Y. Chen ◽

Catriona S. Bradshaw ◽

Sepehr N. Tabrizi

Keyword(s):

Nucleic Acid ◽

Antimicrobial Resistance ◽

Sexual Health ◽

Nucleic Acid Amplification ◽

Nucleic Acid Amplification Tests ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics

The use of nucleic acid amplification tests (NAAT), as well as or in preference to culture for non-genital sites is now recommended both in Australia and overseas because of their greater sensitivity and improved specificity. A survey of 22 Australian sexual health clinics who each year test over 14 500 men who have sex with men (MSM) show that culture remains the predominate method for detecting gonorrhoea at pharyngeal (64%) and rectal (73%) sites. This editorial discusses the potential disadvantages of using culture over NAAT in relation to optimal gonorrhoea control among MSM and advocates that significantly improved control would be achieved by moving to NAAT with the proviso that culture samples are taken wherever possible on NAAT-positive samples and from clients with urethritis to ensure continued surveillance for antimicrobial resistance.

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Carriage of Neisseria meningitidis in men who have sex with men presenting to public sexual health clinics, New York City

Sexually Transmitted Diseases ◽

10.1097/olq.0000000000001205 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Stephanie Ngai ◽

Don Weiss ◽

Julie Anne Bell ◽

Difaa Majrud ◽

Greicy Zayas ◽

...

Keyword(s):

New York ◽

New York City ◽

Sexual Health ◽

Neisseria Meningitidis ◽

York City ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics

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Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)?

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.25.30553 ◽

2017 ◽

Vol 22 (25) ◽

Cited By ~ 53

Author(s):

Alison E Brown ◽

Hamish Mohammed ◽

Dana Ogaz ◽

Peter D Kirwan ◽

Mandy Yung ◽

...

Keyword(s):

High Risk ◽

Sexual Health ◽

Hiv Testing ◽

Health Clinics ◽

High Risk Populations ◽

Sex With Men ◽

Sexual Health Clinics ◽

Exposure Prophylaxis

Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014–September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable.

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