HPV vaccine is recommended for men who have sex with men (MSM) of any age who have not previously been vaccinated. The number of doses and the interval between doses should follow the recommendations in Table. Recommended doses and intervals between doses for human papillomavirus (HPV) vaccines, by age group at the start of the course.
The decision to vaccinate should consider:
- the likelihood of previous exposure to HPV
- the person’s future risk of HPV exposure and HPV disease
MSM have a higher risk of repeated and persistent HPV infection and associated diseases, such as genital warts and anal cancer, at all ages and regardless of HIV status or other immunocompromising conditions.6,8 Patterns of HPV infection and disease in MSM are markedly different from those of heterosexual men and women. Men have stable incidence and prevalence throughout life, but rates of HPV infection in heterosexual men are much lower compared with MSM.9 HPV infection incidence among women is highest in young adulthood, shortly after sexual debut, and then declines.10,11 MSM are also less likely to benefit from herd protection attained from HPV vaccination of females.