Perceptions of targeted sexual healthcare among French MSM based on HPV vaccination policy in France

Human papillomavirus (HPV) vaccination in France is recommended for persons of both sexes up to 19 years of age. This increases to 26 years for men who have sex with men (MSM), as they are considered a high-risk group. Raising the upper age limit for MSM is a targeted sexual healthcare policy because it takes into account the specificities of MSM sexual practices. Assessing MSM's perceptions of targeted sexual healthcare, using HPV vaccination as an example, is crucial for improving public health policy and HPV recommendations. As part of the French mixed-methods study Vaccigay, we conducted a qualitative study-using semi-structured interviews-with MSM selected by age and HPV vaccination status in 2022. Interviews were transcribed verbatim and thematically analysed using NVivo. Some respondents supported targeted sexual healthcare policy for MSM because they recognised the epidemiological factors involved and wanted healthcare workers to have a non-judgmental attitude toward them. Others did not because they felt it stigmatised MSM; they advocated equal sexual healthcare for everyone. Ultimately, uncertainty about one's own sexual orientation and difficulty discussing sexuality with doctors were barriers to accessing targeted sexual health care. We recommend improving training of healthcare workers on the specific needs of sexual and gender minorities, increasing the number of sexual health centres that serve these populations, and extending HPV vaccination to all adults up to the age of 26, irrespective of sexual orientation.