Mathematical model shows targeted vaccine beneficial for men who have sex with men
Friday, November 5, 2010 (Last Updated: 11/08/2010)
FRIDAY, Nov. 5 (HealthDay News) -- Targeted human papillomavirus (HPV) vaccination of young men who have sex with men (MSM) is cost-effective for prevention of some anal cancers, according to research published online Nov. 3 in The Lancet Infectious Diseases.
Jane J. Kim, Ph.D., of the Harvard School of Public Health in Boston, used mathematical modeling to estimate the direct health and economic outcomes of HPV vaccination for prevention of HPV-related anal cancer and genital warts in MSM, using varied age-at-vaccination parameters.
The researchers found that HPV vaccination at age 12, with the assumption of no prior HPV exposure, cost $15,290 per quality-adjusted life-year (QALY) gained. Vaccination at age 20 or 26, with assumption of prior HPV exposure, cost more, but most scenarios were less than $50,000 per QALY. The modeling process was most sensitive to the accuracy of assumptions of anal cancer incidence, duration of vaccine protection, and HIV prevalence in MSM.
"Several obstacles challenge early uptake in this high-risk subgroup, including age at which people self-identify as MSM, willingness to disclose sexual identity to others, acceptability of the vaccine, and social stigma of vaccination against a sexually-transmitted infection (especially if vaccination is targeted to a subgroup with a specific sexual orientation)," the author writes.
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