Analysis of the willingness and related factors of free HPV vaccination among Men who have Sex with Men (MSM) in Jinan, China.

BACKGROUND

Men who have sex with men (MSM) are at high risk for HPV infection. While economic barriers to vaccination are well documented, factors influencing their decision-making in a cost-free scenario remain unclear. This study aims to explore these core factors.

METHODS

From April to August 2024, MSM aged 18 years and older were recruited in Jinan through social organization networks. A cross-sectional survey was conducted using face-to-face questionnaires to collect information on sociodemographics, sexual behaviors, knowledge about AIDS and HPV, and willingness to receive free HPV vaccination. The sample size was estimated using the formula for cross-sectional studies, with a minimum required sample size of 291 (after adjusting for 10% invalid questionnaires). Data were entered using EpiData 3.1, sorted with Excel, and analyzed with SPSS 22.0. The chi-square test or Fisher’s exact test was used for univariate analysis, and multivariate binary logistic regression was performed for variables that were statistically significant in the univariate analysis. The significance level was set at α = 0.05.

RESULTS

A total of 401 MSM were included, of whom 371 (92.5%) were willing to receive free HPV vaccination. Univariate analysis showed that willingness was significantly higher among those with fixed same-sex partners, those who had heard of PrEP drugs, those who sought partners online, and those who believed that men could be infected with HPV (all P < 0.05). Multivariate analysis revealed that having a fixed partner (aOR = 7.61, 95% CI: 2.38–24.34), awareness of PrEP drugs (aOR = 7.61, 95% CI: 2.65–21.83), and belief in male HPV susceptibility (aOR = 25.85, 95% CI: 8.57–77.96) were positively associated with willingness.

CONCLUSIONS

Fixed same-sex partner relationships, awareness of PrEP drugs, and perception of male susceptibility to HPV are important factors influencing MSM’s willingness to receive free HPV vaccination. It is necessary to further promote free HPV vaccination, reduce the burden of HPV infection and related diseases among MSM, prevent HPV transmission in the general population, and strengthen public health defenses.