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Original Research

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HPV vaccination among gay, bisexual and other men who have sex with men in Canada's three largest cities: a person-centred approach

  • Ramandip Grewal1
  • Shelley L Deeks2,3
  • Trevor A Hart2,4
  • Joseph Cox5,6
  • Alexandra De Pokomandy7
  • Troy Grennan8,9
  • Gilles Lambert6
  • David Moore9,10
  • Mark Gaspar2
  • Clemon George11
  • Jennifer Gillis12
  • Daniel Grace2
  • Jody Jollimore13
  • Nathan J Lachowsky10,14
  • Rosane Nisenbaum1,2
  • Gina Ogilvie8,9
  • Chantal Sauvageau15
  • Darrell HS Tan1,16
  • Anna Yeung1
  • Ann N Burchell1,2,17,*,

1St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1T8, Canada

2Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada

3Department of Health and Wellness, Halifax, NS B3J 2R8, Canada

4Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada

5Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC H3A 1Y7, Canada

6Direction régionale de santé publique, Montréal, QC H2L 2W5, Canada

7Department of Family Medicine, McGill University, Montréal, QC H3S 1Z1, Canada

8BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada

9Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada

10BC Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada

11Health, Nutrition, and Dietetics, SUNY Buffalo State University, Buffalo, NY 14222, USA

12Canadian Cancer Society, Vancouver, BC V5Z 4J4, Canada

13Community-Based Research Centre, Vancouver, BC V6Z 2H2, Canada

14School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada

15Institut national de santé publique du Québec, Québec, QC G1V 5B3, Canada

16Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada

17Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada

DOI: 10.22514/jomh.2023.097 Vol.19,Issue 10,October 2023 pp.22-33

Submitted: 23 March 2023 Accepted: 09 June 2023

Published: 30 October 2023

*Corresponding Author(s): Ann N Burchell E-mail:


Starting in 2015, many Canadian provinces and territories introduced publicly-funded human papillomavirus (HPV) vaccination programs targeted to gay, bisexual and other men who have sex with men (GBM) 9–26 years old. Using baseline data from the Engage study, a sexual health study of GBM from three Canadian cities, we explored how social and programmatic factors intersect and affect stages of HPV vaccination (Stage 1: unaware of HPV vaccine, Stage 2: undecided/unwilling to get vaccinated, Stage 3: willing to get vaccinated, Stage 4: vaccinated with at least one dose). First, by city, we created subgroups of GBM ≤26 years old (N Vancouver = 178; Toronto = 123; Montreal = 249) using latent class analysis. Next, by latent class, we estimated the probability of being in the four HPV vaccination stages using the Bolck, Croon and Hagenaar method. Latent class membership was associated with HPV vaccination stage in Vancouver (p = 0.003) and Montreal (p = 0.048) but not Toronto (p = 0.642). In Vancouver and Montreal, membership in the “no barriers” latent class had the highest probability of vaccination (56–58%). In Vancouver, the “racialized, GBM privacy, immigration and healthcare access barriers” class had a 75% probability of being vaccine unaware. In Montreal, the “immigration and past vaccines barriers” and “socio-economic, GBM privacy and healthcare access barriers” classes had the highest probabilities of being vaccine unaware (43% and 46%) and of being undecided or unwilling to get vaccinated (40% and 25%). In conclusion, our person-centred findings suggest tailored interventions by locale may help to increase HPV vaccine uptake among GBM in Canada’s three largest cities.


Vaccination; Human papillomavirus; Gay, bisexual and other men who have sex with men; Vaccine hesitancy

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Ramandip Grewal,Shelley L Deeks,Trevor A Hart,Joseph Cox,Alexandra De Pokomandy,Troy Grennan,Gilles Lambert,David Moore,Mark Gaspar,Clemon George,Jennifer Gillis,Daniel Grace,Jody Jollimore,Nathan J Lachowsky,Rosane Nisenbaum,Gina Ogilvie,Chantal Sauvageau,Darrell HS Tan,Anna Yeung,Ann N Burchell. HPV vaccination among gay, bisexual and other men who have sex with men in Canada's three largest cities: a person-centred approach. Journal of Men's Health. 2023. 19(10);22-33.


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