Human Papillomavirus (HPV) and Oropharyngeal Cancer in the LGBT Population

Purpose: In 2015, HPV-positive oropharyngeal squamous cell carcinoma (oropharyngeal SCC) became the most prevalent HPV-associated cancer in the United States. Oral HPV infection disproportionately affects gay and bisexual males, with men who have sex with men almost twice as likely to have a high-risk oral HPV infection than men with predominantly female sex partners. Despite the rise of HPV-positive oropharyngeal SCC, the rate of HPV vaccination among male adolescents in Texas lags behind the national rate of vaccine uptake. This review examines the barriers to vaccination uptake in gay and bisexual males. Methods: The databases used for this review were PubMed Central, UpToDate, and the Center for Disease Control. Key words searched included HPV rates in LGBT, HPV Oropharyngeal cancer, HPV vaccine barriers, and HPV vaccination rates in LGBT. Results: Three main barriers to vaccination were identified in the LGBT population. These barriers included lack of recommendation from a healthcare provider, lack of funding for new age of majority individuals, and outdated marketing strategies. Conclusion: The most important factor that determines whether a LGBT adolescent receives the HPV vaccine is a recommendation from a healthcare provider. Additionally, when the HPV vaccine is marketed as preventing anal, penile, and oral cancer in males versus just preventing genital warts, the intent of an LGBT patient to initiate the vaccination series is greater. Further research should be done to determine which educational methods and marketing materials used by a healthcare provider impact a patient's decision to vaccinate most significantly.