Grant: Catalyst Grant: HPV Screening & Vaccination in Underserved Populations

Human papillomavirus (HPV) is the most common sexually transmitted infection, so much so that ¾ people will get this infection at least once. This is concerning because certain HPV types cause cervical, anal, and oral cancers. Two important high-risk populations for HPV prevention are gay, bisexual and other men who have sex with men (gbMSM) and men and women living with human immunodeficiency virus (HIV) infection. Besides women, gbMSM are most likely to directly benefit from HPV vaccination. HPV is very common among gbMSM impacting ~78% of HIV- and ~88-98% of HIV+ men. Most concerning are HPV types causing anogenital cancers, including the cervix and anus, as well as head and neck cancers. Although several Canadian jurisdictions, including Ontario, have targeted HPV vaccine policy for gbMSM aged 9-26, this requires a young male be aware of his sexual orientation and disclose potentially stigmatizing behaviour to a provider. HPV-related cancer screening is also important among men and women living with HIV. The rate of anal cancer among HIV+ gbMSM is 131 per 100,000, which is 100 times higher than in the general population. Cervical cancers are preventable among women living with HIV but only half undergo regular cervical cancer screening in Ontario. Our goal is to bring together emerging knowledge about HPV-related vaccination and screening among gbMSM and men and women living with HIV in Ontario to identify and recommend best approaches for vaccination and screening. To do so, we will work with data already being collected in Ontario by our team. Using information from many studies, we will gain a more thorough picture of the challenges and opportunities for vaccination and screening in these populations than one could ever do with one study alone. Next we will share these findings with community members and government stakeholders in face-to-face meetings, and brainstorm together on the best ways to address gaps in vaccination and screening delivery.