Background

Globally, human papillomavirus (HPV) vaccine uptake rates have declined within a wider context of vaccine hesitancy. Gender-neutral vaccine programmes are increasing and recommended for the prevention of cervical, anogenital, and oropharyngeal cancers affecting both women and men. To address the problem of suboptimal HPV uptake rates for boys and men, we aimed to understand young men’s communication needs for HPV messages in a cross-cultural analysis.

Methods

Qualitative methods consisting of 14 focus group discussions were conducted with young men (18–26 years) about the HPV vaccine in three countries with varying HPV vaccine implementation policies at the time. A total of 55 participants were included from Scotland (n=14), Spain (n=25), single-gendered programmes, and the USA (n=16), gender-neutral programme. Analysis was informed by reflexive thematic analysis.

Findings

Four themes were identified: (1) the ‘Girl vaccine’: primarily seen as a vaccine for girls, despite varying vaccine knowledge and awareness across contexts; (2) vaccine ambivalence: perceptions of men’s HPV risks were low and some vaccine worries were evident from US contexts; (3) altruism: a pervasive theme related to young men’s roles and responsibilities for HPV transmission within relationships; (4) trusted sources: messages from health care providers/authorities were persistently valued but direct opportunities were often absent.

Conclusion

Public health messaging to increase HPV vaccination for young men should focus on direct appeal to young men’s health through specific and targeted HPV messages for cancer and sexual health benefits to increase the personal relevance of the vaccine. It should also focus on indirect appeal through incorporating messages about safe sex in relationships and for herd immunity. Healthcare providers and authorities are trusted sources of information and can influence men’s confidence for the HPV vaccine; opportunities for interactions should be optimised.