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- W2275063690 abstract "Whether boys should receive the human papilloma virus (HPV) vaccination is now a very live health policy issue in the United Kingdom. The government's advisory body, the Joint Committee on Vaccination and Immunisation (JCVI), is currently looking at whether all adolescent boys should be included in the national vaccination programme which has been vaccinating girls aged 12-13 years since 2008.HPV, a very common sexually transmitted infection, is estimated to be responsible for 5% of all cancers. It is a major cause of cancers of the cervix, vagina, vulva, anus, penis, tonsils, base of tongue and oropharynx and contributes to cancer of the larynx. HPV also causes genital warts and a rare but often disabling breathing condition known as recurrent respiratory papillomatosis. Overall, the disease burden caused by HPV is equally shared by both sexes.The key issue is whether the United Kingdom's very successful HPV vaccination programme, which now reaches 90% of females, actually protects males too. If both sexes are protected by a girls-only programme, then it could be argued that it is not necessary to extend the programme to boys.Men who have sex with men (MSM) constitute a significant group that remains entirely unprotected by a girlsonly programme. While anal cancer occurs most often in women, the incidence of anal cancer is highest in MSM. In fact, the incidence in MSM is estimated to be equivalent to that of cervical cancer in an unscreened population and is even higher in HIVpositive MSM.1 MSM also have a higher risk of developing genital warts than men who have sex with women (MSW).HPV vaccinations for adult MSM (aged 16-40 years), offered at sexual health and HIV clinics, has been suggested by JCVI as a possible solution for this group. While this would undoubtedly benefit the individuals who do receive the vaccine, it cannot be seen as the most effective intervention for MSM as a whole. This is because* Many MSM will already have been infected with HPV before they attend a clinic.2,3 MSM who attend genitourinary medicine (GUM) clinics often do not do so until their late 20s.4* The Stonewall health survey5 found that 44% of gay and bisexual men had never discussed sexually transmitted infections with a healthcare professional, suggesting they may have never used a sexual health service.* Vaccination in adolescence produces a much greater immune response providing a higher level of protection against infection in the future.It is best practice to vaccinate before 'sexual debut' and exposure to HPV. But it would, of course, be neither ethical nor practical to try to identify and vaccinate adolescent boys who might later become MSM. The best way of protecting MSM is therefore to vaccinate all boys.But what about MSW? Are they adequately protected by a girls-only HPV vaccination programme?* In countries with female vaccination coverage of at least 50%, the reduction in genital warts in young men aged * Men who have sex with unvaccinated women continue to be at risk. In total, 20% of men in Britain aged 16-24 years have had 10 or more female sexual partners.7 Given a 90% vaccination rate in girls, this means that these men are likely to have had at least one unvaccinated partner.* MSW in those areas of the United Kingdom where vaccination rates for girls are much lower than the national average, such as East Sussex, Cornwall and several London boroughs, are at greater risk of HPV infection.8* Men may have sexual contact with unvaccinated women from other countries with limited or no HPV vaccination programmes. In total, 13% of 16- to 24-year olds and 15% of 25- to 34-year olds are thought to have had at least one sexual partner from outside the United Kingdom in the past five years. …" @default.
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- W2275063690 date "2015-12-23" @default.
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- W2275063690 title "Jabs for the boys: the case for gender-neutral HPV vaccination" @default.
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- W2275063690 doi "https://doi.org/10.1177/1757913915616729" @default.
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