title: Impact and Cost-effectiveness of Selective Human Papillomavirus Vaccination of Men Who Have Sex With Men.
abstract: Men who have sex with men (MSM) have a high lifetime risk of anogenital warts and cancers related to infection with human papillomavirus (HPV). They also benefit less from herd protection than heterosexual males in settings with female-only HPV vaccination.
  
  
  
  We evaluated the potential health impact and cost-effectiveness of offering vaccination to MSM who visit genitourinary medicine (GUM) clinics. We used a mathematical model of HPV 6/11/16/18 sexual transmission within an MSM population in England, parameterized with sexual behaviour, GUM attendance, HPV prevalence, HIV prevalence, warts, and cancer incidence data. Interventions considered were offering HPV vaccination to either HIV-positive MSM or MSM regardless of HIV status, for age bands 16-25, 16-30, 16-35, and 16-40 years.
  
  
  
  Substantial declines in anogenital warts and male HPV-related cancer incidence are projected to occur following an offer of vaccination to MSM. MSM not attending GUM clinics will partially benefit from herd protection. Offering vaccination to HIV-positive MSM up to age 40 is likely to be cost-effective if vaccine procurement and administration costs are below £96.50 a dose. At £48 a dose, offering vaccination to all MSM up to age 40 is likely to be cost-effective.
  
  
  
  Quadrivalent HPV vaccination of MSM via GUM clinics is likely to be an effective and cost-effective way of reducing the burden of HPV-related disease in MSM.
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.|Department of Systems Biology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Allen
authors.initials: A
authors.lastname: Lin
authors.affiliation: National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: Koh J
authors.initials: KJ
authors.lastname: Ong
authors.affiliation: National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Hobbelen
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Eleanor
authors.initials: E
authors.lastname: King
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.|National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Mesher
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Pam
authors.initials: P
authors.lastname: Sonnenberg
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Gilson
authors.affiliation: National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: Irenjeet
authors.initials: I
authors.lastname: Bains
authors.affiliation: National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: Yoon H
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Tanton
authors.affiliation: National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Soldan
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.|National Infections Service-Colindale, Public Health England, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Jit
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D004739:England / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D027383:Papillomaviridae / Q000145:classification / Q000276:immunology*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011159:Population Surveillance; D012725:Sexual Behavior; D014611:Vaccination / Q000191:economics; D057188:Workflow; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: human papillomavirus; men who have sex with men.; vaccination