The BMA has called for the HPV immunisation programme to be widened to include gay men, in an effort to tackle ‘alarming’ rates of HPV-related disease.
Colm O’Mahony, chair of the BMA’s dermatology and venereology subcommittee and BMA public health committee co-chair Penelope Toff have written to health minister Anna Soubry supporting offering the Gardasil vaccine to gay men.
In July, Government advisers decided to evaluate an expansion of the current vaccination strategy, but HPA officials told Pulse that the results of the work were not likely to be published before 2013.
While the current vaccination of all girls aged between 12 and 13 years of age protects heterosexual men, Australian data has shown that the same protection is not afforded to men who have sex with men.
The BMA letter said that although it would be difficult to identify young gay men for a vaccine programme, the HPV vaccine could be administered at genitourinary medicine clinics or community sexual health clinics, perhaps as an add-on vaccination for patients receiving a hepatitis B vaccination.
The letter said: ‘The increasing incidence of HPV and development of anal lesions in gay men, particularly HIV positive gay men, is alarming.
‘As doctors of this cohort, we need to be sensitive to any factors that could impact on individuals being able to protect themselves and work towards protecting them from acquiring infections at an early age.
‘We believe that a vaccination programme with Gardasil which included this group would be of enormous benefit in reducing the increasing incidences of anal warts, anal pre-cancers and cancers, as has been borne out in Australia.’
A HPA spokesperson told Pulse: ‘JCVI concluded that this should be further investigated by Health Protection Agency. The results of this work are not likely to conclude before late 2013 at the earliest.’
A Department of Health spokesperson said: ‘The JCVI keeps the eligibility criteria of all vaccination programmes under review, and research is underway to support a future assessment of vaccinating men who have sex with men against HPV. However, there are currently no plans to extend HPV vaccination to males, based on an assessment of available scientific evidence.’
Dr Richard Ma, a GP in north London and a member of the RCGP’s Sex, Drugs and HIV taskgroup said: ‘I would support the BMA on principle. Gay men are at a higher risk of developing anal cancer, and will not be protected by the herd immunity conferred from vaccinating girls. But we do need evidence to show its cost effective when we use Gardasil so I fully understand there’s a bit of work to do before the DH can fully a mass programme.’
He added: ‘Delivery is contentious. I accept it could be added to the hep b vaccination at sexual health clinics. It should also be offered in general practice. I know many GPs ask about sexual orientation, however we can see from the Stonewall survey last yea that there was still anxiety about gay men revealing their sexuality to health practitioners. There was alleged homophobia and discrimination. This needs to be tackled otherwise it will be difficult to implement widely. It’s important men who are at risk hear about this campaign and feel empowered to come ans ask for the vaccine if they want it.’
