HPV vaccine acceptability among men: a systematic review and meta-analysis

OBJECTIVE: To understand rates of human papillomavirus (HPV) vaccine acceptability and factors correlated with HPV vaccine acceptability. DESIGN: Meta-analyses of cross-sectional studies. DATA SOURCES: We used a comprehensive search strategy across multiple electronic databases with no date or language restrictions to locate studies that examined rates and/or correlates of HPV vaccine acceptability. Search keywords included vaccine, acceptability and all terms for HPV. REVIEW METHODS: We calculated mean HPV vaccine acceptability across studies. We conducted meta-analysis using a random effects model on studies reporting correlates of HPV vaccine acceptability. All studies were assessed for risk of bias. RESULTS: Of 301 identified studies, 29 were included. Across 22 studies (n=8360), weighted mean HPV vaccine acceptability=50.4 (SD 21.5) (100-point scale). Among 16 studies (n=5048) included in meta-analyses, perceived HPV vaccine benefits, anticipatory regret, partner thinks one should get vaccine and healthcare provider recommendation had medium effect sizes, and the following factors had small effect sizes on HPV vaccine acceptability: perceived HPV vaccine effectiveness, need for multiple shots, fear of needles, fear of side effects, supportive/accepting social environment, perceived risk/susceptibility to HPV, perceived HPV severity, number of lifetime sexual partners, having a current sex partner, non-receipt of hepatitis B vaccine, smoking cigarettes, history of sexually transmitted infection, HPV awareness, HPV knowledge, cost, logistical barriers, being employed and non-white ethnicity. CONCLUSIONS: Public health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men. Future investigations employing rigorous designs, including intervention studies, are needed to support effective HPV vaccine promotion among men.