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This study evaluates how effective counselling is at increasing STI-preventive vaccine uptake among MSM on PrEP.

January 27, 2026

Impact of Counselling on the Uptake of STI-Preventive Vaccines Among MSM Using PrEP: A Retrospective Cohort Study in Policlinico Umberto 1, Italy

MRMarco RidolfiPoliclinico Umberto I LBLuca BortolaniPoliclinico Umberto I RARaissa AronicaSapienza University of Rome

Key Points

This study evaluates how effective counselling is at increasing STI-preventive vaccine uptake among MSM on PrEP.
Retrospective observational cohort design
Analysed 511 MSM receiving PrEP over 18 months
Assessed baseline vaccination status and uptake
Employed chi-square tests and t-tests for statistical analysis
Initial vaccination coverage was low for all vaccines assessed: HAV (9.8%), HPV (17.6%), 4CMenB (5.9%), HBV (52.6%), Mpox (48.9%)
After 18 months, significant increases were seen: HAV (56.4%), HPV (63.6%), 4CMenB (20.3%), HBV (86.1%), Mpox (65.6%)
STI incidence remained high, with syphilis (11.35/100 person-years) and NG/CT infections (9.35/100 person-years) prevalent.

Abstract

Introduction: The introduction of pre-exposure prophylaxis (PrEP) has significantly improved HIV prevention among men who have sex with men (MSM). Vaccination against hep-atitis A (HAV), hepatitis B (HBV), human papillomavirus (HPV), and monkeypox (Mpox) is strongly advised for MSM, yet coverage remains suboptimal. Recent studies suggest moderate effectiveness against gonorrhoea infection from the 4-component MenB vaccine (4CMenB). This study evaluates the impact of targeted counselling strategies on the uptake of STI-preventive vac-cines in a cohort of MSM on PrEP at Policlinico Umberto I, Rome. Methods: This retrospective observational cohort study analysed 511 MSM receiving PrEP be-tween January 2021 and December 2024. Participants were assessed for baseline vaccination sta-tus and uptake over an 18-month period. The primary outcome was vaccination coverage at fol-low-up, while the secondary outcome was STI incidence. Statistical analyses included chi-square tests and t-tests to compare vaccination rates across time points and age groups. Results: At baseline, vaccination coverage was low for HAV (9.8%), HPV (17.6%), 4CMenB (5.9%), HBV (52.6%), and Mpox (48.9%). After 18 months, significant increases were observed (HAV: 56.4%, HPV: 63.6%, 4CMenB: 20.3%, HBV: 86.1%, and Mpox: 65.6%, p<0.05 for all). STI incidence remained high, with syphilis (11.35/100 person-years of follow-up) and Neisseria gonorrhoeae/Chlamydia trachomatis (NG/CT) urethritis (9.35/100 person-years of follow-up) be-ing the most frequent infections. Discussion: Targeted vaccination counselling integrated with PrEP care significantly increased vaccine uptake among MSM. Structured interventions led to substantial improvements across all age groups. Persistent high STI incidence highlights the need for combined pharmacological and non-pharmacological strategies to optimize STI prevention in this population. Conclusions: The integration of structured vaccine counselling within PrEP care significantly increased vaccination uptake in MSM.

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