Is it Necessary to Design a “Bivalent Genital Wart Vaccine” for Young Men?—— A Cross-Sectional Survey on Male College Students with Different Sexual Orientations

Condyloma acuminata (CA) is a prevalent sexually transmitted infection caused by low-risk human papillomavirus (HPV) types, such as HPV 6 and HPV 11. The HPV vaccine, which includes the L1 protein for HPV types 6 and 11, effectively prevents CA. In China, the primary vaccination strategy targets the prevention of cervical cancer caused by high-risk HPV, and HPV vaccination is not routinely recommended for men. Most men face a lower risk of high-risk HPV-related cancers; however, sexually active adolescent males are at a notable risk of CA due to low-risk HPV infection. Additionally, CA significantly facilitates the spread of HIV, underscoring the need for vigilance. This cross-sectional study was conducted in Guangzhou in March 2017, recruited 350 men who had engaged in sexual activity, comprising 161 young men who have sex with women (YMSW) and 189 young men who have sex with men (YMSM). Participants completed an online survey to assess their knowledge, attitudes, and behaviors related to HPV vaccination. Among the participants, 133 (38.0%) were aware of the HPV vaccine, and 53 (15.1%) reported receiving at least one dose. HPV vaccine uptake was higher among YMSM (24.9%) than YMSW (3.7%) (P < 0.001). Approximately 65.4% (229/350) expressed willingness to receive the HPV vaccine for CA prevention. YMSM showed greater willingness to vaccinate (72.5%) compared to YMSW (57.1%) (P = 0.003). HPV vaccine coverage was higher among YMSM compared to YMSW. Predictors of vaccination intention included knowledge and attitudes toward CA vaccination. Barriers to HPV vaccine uptake for CA prevention were people’s lack of knowledge about the vaccine’s preventive effect, adverse reactions after vaccination and the high cost of the vaccine. The study revealed that there is higher acceptance of the more affordable HPV vaccine for CA prevention among younger male college students. However, there are significant differences in attitudes toward the HPV vaccine for CA among male college students of different sexual orientations. Future interventions should focus on the health education of HPV vaccination intentions in adolescent males, particularly YMSW. This survey provides foundational data on HPV vaccination for CA and emphasizes the importance of promoting HPV vaccines in the male population in China. Expanding vaccination efforts may help reduce the spread of both HPV and HIV.