It is a common sexually transmitted infection, yet many young people remain unaware of its dangers and boys in Scotland are excluded from vaccination programmes.
Most of us will be exposed to the Human Papillomavirus (HPV) virus at some point in our lives. Most of the time, we won’t have any symptoms and our immune system will get rid of it without the need for treatment.
However, some types of HPV cause genital warts, and other completely different types cause cervical cancer in women, cancer of the penis in men, and anal, mouth/throat (oropharyngeal cancer) in both men and women.
In Scotland, a school-based vaccination programme is offered only to girls aged 12-13 to protect against the most common types that cause cervical cancer. This has led to a reduction in HPV infection amongst women with the potential to protect men too.
Now, as the scientific, financial and ethical issues surrounding this girls-only vaccination policy continue to be debated, new research has explored the views of young people who have previously been excluded from consultation about the HPV vaccine.
The study revealed widespread misunderstanding about the HPV virus and vaccine – a lack of knowledge which could leave young people at greater risk of getting the virus and transmitting it to others.
The young people also wanted information to be made more widely available and vaccination programmes to be extended.
The Scottish Government plans to adopt the advice of the Joint Committee on Vaccination and Immunisation, recommending vaccination for men who have sex with men (MSM) aged 16-45 years and other at-risk groups.
The new study, funded by The Carnegie Trust, was led by researchers from Edinburgh Napier University, Robert Gordon University, King’s College London, the University of Glasgow and the NHS in order to discover the views of specific groups of young people in Scotland.
This included young people with learning disabilities and young people from Black and Minority Ethnic (BME) communities who had not been asked their opinion before.
Groups were held with 59 young people who volunteered for the study, aged 16-26 and from Edinburgh, Glasgow and Fife; 19 young people with learning disabilities (the majority of them young men) and 40 young people from Black African, White-Caribbean, Arab, Indian, Bangladeshi and Pakistani communities.
The main findings of the study indicated that:
l The young men had not been introduced to information about the HPV virus and vaccine at school.
l Most young men and women did not know how HPV affected men.
l They did not know that some other countries such as Australia and Canada offer the vaccination to boys/young men.
l Young people wanted HPV information to be available within secondary school and higher education institutes. They also wanted high-profile public campaigns and information on health websites, and the Scottish vaccination programme to include boys/young men.
The research study also found that HPV appears to have a lower profile than HIV.
Young people made a number of suggestions to improve communication about HPV and the vaccine including adapting information for specific age groups and providing this throughout secondary school; and for young men with learning disabilities and offering face-to-face opportunities to discuss any concerns.
Most young people from BME communities requested that the vaccine be available at colleges, universities and GP surgeries because this would fit better with their age of marriage. Some said that offering the vaccine to men who have sex with men could stigmatise the vaccine.
Participants who had witnessed the Aids epidemic in Africa stressed the need to increase the profile and public understanding of HPV. However, others suggested keeping HPV information and HPV campaigns completely separate from HIV campaigns to avoid stigma being attached to young people who request the HPV vaccine.
Some men suggested peer education from within their community was important instead of relying on outsiders to explain the vaccine. However, some women welcomed the idea of practitioners and “experts” visiting women’s groups conducted within religious or community settings.
In order to make the subject more acceptable, several participants suggested emphasising how common HPV is, likening it to the common cold or linking it to natural milestones such as puberty, rather than sexual activity.
Further consultation with young people from BME communities and those with learning disabilities will be necessary in order to provide more relevant information and accessible vaccination programmes.
l Dr Elaine Carnegie is a lecturer in Edinburgh Napier University’s School of Health & Social Care. On Tuesday, 11 October, Edinburgh Napier University will host an event bringing together research participants, members of the public, practitioners and policymakers to discuss the study findings and their implications. If you would like to attend the event, please contact Dr Carnegie firstname.lastname@example.org