Research AppraisalSystematic Review

Strategies implemented to increase HPV vaccine uptake and confidence among men who have sex with men and transgender people: A systematic review

Human vaccines & immunotherapeuticsAvermark, Helena, Tzirita, Sofia, Radix, Erik et al.1 Dec 2026DOI

Clinical Snapshot

55CEBM
Evidence: WeakSystematic Review

PICO Framework

P — PopulationMen who have sex with men (MSM) and transgender persons
I — InterventionStrategies and interventions to increase HPV vaccine confidence and uptake
C — ComparatorStandard care or no intervention (implied)
O — OutcomesHPV vaccine uptake rates and vaccine confidence measures

Bottom Line

This systematic review identifies a critical evidence gap in HPV vaccination strategies for MSM and transgender populations. While only 16 studies were found describing 8 interventions, two main approaches emerged: integrating vaccination into existing health services and using digital platforms to generate demand. The limited evidence base, exclusively from high-income countries, suggests current strategies are insufficiently evaluated. For Australian clinicians, this highlights the need for targeted approaches within existing sexual health services and LGBTI+ friendly practices. Given PBS coverage and RACGP recommendations for HPV vaccination in MSM up to age 26, clinicians should prioritise opportunistic vaccination while advocating for more robust intervention research. The particular lack of transgender-focused studies represents a significant knowledge gap requiring urgent attention.

Evidence: Weak

Key Findings

  • P Value: Not applicable for narrative synthesis

  • Effect Size: Not quantified - narrative synthesis only

  • Primary Outcome: HPV vaccine uptake and confidence among MSM and transgender persons

  • Nnt Or Sensitivity: Not calculated - insufficient data for quantitative analysis

  • Confidence Interval: Not provided

Clinical Application

Limited by small evidence base and lack of specific implementation guidance Relevant to Australian MSM and transgender populations, particularly given PBS coverage of HPV vaccination and RACGP guidelines recommending vaccination for MSM up to age 26 MSM and transgender persons in high-income healthcare settings

Abstract

Men who have sex with men (MSM) and transgender persons are disproportionately affected by HPV-related disease. The HPV vaccine effectively prevents infection, but vaccine uptake remains suboptimal in this group. Thus, this systematic review aimed to synthesize the literature on interventions and strategies implemented to increase HPV vaccine confidence and uptake among MSM and transgender persons. Six databases were searched in May 2025. We assessed risk of bias and extracted and descriptively summarized key data through narrative synthesis and content analysis. Sixteen articles reporting on eight interventions were identified, all implemented in high-income settings. The interventions can be broadly categorized into two types: strategies to integrate HPV vaccination into existing health services and digital interventions aimed at generating vaccine demand. Overall, evidence remains limited on interventions to increase HPV vaccine uptake in these groups, particularly studies focusing on the needs of transgender persons.

References

  1. 1.Avermark, H., Tzirita, S., Radix, E., Sun, S., & Herzig van Wees, S. (2026). Strategies implemented to increase HPV vaccine uptake and confidence among men who have sex with men and transgender people: A systematic review. Human Vaccines & Immunotherapeutics. https://doi.org/10.1080/21645515.2026.2681252
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