Integrating HPV Vaccination Within PrEP care Delivery for Underserved Populations: A Mixed Methods Feasibility Study

Area of Science:

• Public Health
• Vaccinology
• Cancer Prevention

Background:

• Anal cancer disproportionately affects gay/bisexual men (GBM) and transgender women (TGW).
• Human Papillomavirus (HPV) vaccination is effective but coverage is insufficient in these populations.
• Federally Qualified Health Centers (FQHCs) can improve vaccine uptake by integrating services.

Purpose of the Study:

• To assess the feasibility and potential impact of integrating HPV vaccination with Pre-exposure Prophylaxis (PrEP) care.
• To identify barriers and facilitators to HPV vaccination implementation within PrEP services.

Main Methods:

• Mixed-methods study involving qualitative interviews with PrEP providers/staff (N=9) and a quantitative survey of PrEP patients (N=88).
• Qualitative analysis used the Exploration, Preparation, Implementation, Sustainment (EPIS) framework.
• Quantitative analysis utilized the Information-Motivation-Behavioral Skills Model.

Main Results:

• Barriers to HPV vaccination in PrEP care include lack of guideline focus, mandated metrics, and EMR template limitations.
• Both patients and providers/staff reported a lack of specific knowledge and motivation regarding anal cancer and HPV vaccination.
• Integrating HPV vaccination into routine PrEP visits was highly acceptable to both patients and providers.

Conclusions:

• Integrating HPV vaccination into PrEP services is a feasible and acceptable strategy to increase vaccine uptake.
• Multi-level strategies are recommended to address identified barriers and enhance HPV vaccine uptake among PrEP patients.
• This approach holds promise for reducing anal cancer disparities in GBM and TGW populations.