We currently have vaccinations against hepatitis A and B, causes of liver disease, and against human papillomavirus (HPV), the viruses that cause genital or anal warts and which can lead to certain cancers.
Getting vaccinated is a personal decision which should be discussed with your doctor.
Hepatitis A and B
Hepatitis A and B can be contracted by penetrating or licking the ass of an infected person. HPV can be transmitted through simple skin-to-skin contact or during penetration or a blowjob, even when there are no warts.
Since 2008, all children in Grade 4 receive the combination vaccine against hepatitis A and B. This vaccine is known to be effective for life. Talk to your doctor if you have not had the vaccine or if you are not sure if you’ve had it. With a blood sample, your doctor can check if you’ve had it and if it’s still effective.
The effectiveness of the vaccine against hepatitis A and B can vary if you are living with HIV. It’s possible that you may need to be re-vaccinated. To know if this is the case, talk to your doctor.
Since January 1st, 2016, gay men, men who have sex with men (MSM), bisexual and trans men 26 years old or younger can get vaccinated against human papillomavirus (HPV) for free.
The following information has been put together by the Portail VIH/sida du Québec, which can help you make your choice.
What are HPVs?
- HPVs are very common viruses which are transmitted during sexual activity involving the genitals, anus, mouth or fingers through direct or intermediate contact, even without penetration.
- There are more than 200 different strains (genotypes) of the virus, about fifty of which involve infections of the anus and genitals, which can be classified into two large categories according to their risk of developing cancer:
- “Low risk” types may lead to more or less annoying condylomas (external benign anal and genital warts). The most common are types 6 and 11.
- “High risk” types may lead to pre-cancerous and cancerous lesions. Types 16 and 18 are the most often cited.
Why is HPV a particular concern for MSM?
- Generally speaking, men produce fewer antibodies than women after being infected by a strain of HPV and are at risk of contracting the same strain of HPV more than once.
- As opposed to men who have sex with women, MSM generally do not benefit from the indirect protection provided by the vaccine for girls.
- Sex between men greatly increases the risk of developing anal cancer, and condylomas are 2 to 3 times more common among MSM than in a group of heterosexual men of the same age.
- In Quebec, the MSM population is overrepresented in HIV statistics. In addition, co-infections of HIV and HPV increase the prevalence of cancer.
Are there effective treatments for treating the different HPV strains for men?
- No treatment can guarantee that an HPV infection has been removed from the body.
- In most cases, the symptoms will go away on their own, but they can also be treated (liquid nitrogen, silver nitrate, laser).
- Type 16 and 18 HPV infections (highest carcinogenic risk) can last for several months or years and lead to pre-cancerous or cancerous lesions for which treatments also exist.
- There is currently no reliable and widely accessible means of testing for HPV or detecting pre-cancerous lesions for men.
What is the objective of the new free vaccination program for MSM?
- The objective is to prevent and reduce the incidence, morbidity and mortality of cancers of the anus, penis and throat, pre-cancerous lesions and other diseases related to HPV among MSM, as is already the case for women.
- The vaccine approved in Quebec protects against the 4 most common types of HPV : 6, 11, 16 and 18.
What brought about this decision in 2016? What motivated it?
- There are not many studies on how HPV negatively affects men, but the vaccine has been approved following the recent publication of data demonstrating its effectiveness and safety in this population.
- This decision has also been backed by recent studies on the serious consequences of HPV infections among MSM (as mentioned above).
Are people who have already been in contact with HPV eligible?
- The HPV vaccine is most effective when it is administered before a man has been exposed to the virus, in other words, before he begins his sexual life. This is, however, not the only option.
- The vaccine does not protect men against the types of HPV that they have already been in contact with, but does protect them against those that they have not yet been exposed to.
- It is rare for someone to be infected with the four HPV strains contained in the vaccine (6, 11, 16 and 18).
Why is the vaccine free for men between 9 and 26 years old? What can MSM older than 26 do if they want to get vaccinated, in particular people living with HIV?
- The risk for HPV infections generally peaks in the first five to ten years following the first sexual experience. Since the vaccine remains effective for a number of years, it is recommended to get it before or at the beginning of sexual life in order to cover the so-called “active” period.
- The HPV vaccine is only approved for the vaccination of men between the ages of 9 and 26 because there is no significant data available for men older than 26.
- MSM older than 26 and people living with HIV in particular can still get vaccinated if they cover the costs themselves.
- Exploratory studies of HIV positive and HIV negative MSM older than 26 appear to also show that the vaccine is effective for this age group.
What does an MSM 26 years or younger need to do to get vaccinated for free?
- The vaccine must be offered to all men 26 years old or younger who say that they have or think they will be having sexual sex with men.
- Men making the request to get vaccinated are not required to prove that they are having sexual sex with men.
- Eligible men can get vaccinated for free at a local community service centre (CLSC), at youth clinics and at some medical clinics.
Gardasil (quadrivalent vaccine used in Canada) protects against 2 high-risk strains, but there are 25 strains in all that are considered oncogenic. What is its true effectiveness?
- The majority of pre-cancerous and cancerous anal lesions are caused by strains 16 and 18, which are contained in the vaccine.
- The vaccine is 90% effective in preventing condylomas.
- It is 79% effective in reducing anogenital lesions related to the HPV types included in the vaccine. Its effectiveness in specifically preventing pre-cancerous and cancerous anal lesions is similar.
- The vaccine is less effective for men who have already been infected at the time of vaccination. Recent data indicate that the vaccine can also be effective in preventing the reappearance of anal lesions for men already infected with the types of HPV included in the vaccine.
Gardasil has been the subject of debates around the world and in Quebec regarding its safety in view of a number of reported cases of serious side effects such as death, neurological disorders and paralysis. What about these discussions?
- The World Health Organization, on the basis of a number of studies in different countries on the vaccine’s safety, remains assured of the vaccine’s safety and recommends vaccination against HPV, as do all public health authorities (American, European and Canadian).
- The majority of possible reactions to the vaccine are minor and short-term (pain in the area of injection, rash, itching).
- Rarer reactions have been reported, but have not been linked to the vaccine. Up until now, no study has been able to establish a link between the HPV vaccine and the serious diseases mentioned in the question.
For more information
HPV Vaccine for men age 26 or under who have sex with men. Pamphlets (MSSS, PDF, January 2016)
Vaccination contre les VPH – Nouveautés et mise à jour des connaissances (MSSS, PDF, Décembre 2015)
Virus du Papillome Humain (MSSS, 2015)
Information taken March 17, 2016, from the site: http://pvsq.org/2016/02/harsah-ce-quil-vous-faut-savoir-sur-la-vaccination-vph-pour-un-consentement-eclaire/