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image of Impact of Counselling on the Uptake of STI-Preventive Vaccines Among MSM Using PrEP: A Retrospective Cohort Study in Policlinico Umberto 1, Italy

Abstract

Introduction

The introduction of pre-exposure prophylaxis (PrEP) has significantly improved HIV prevention among men who have sex with men (MSM). Vaccination against hepatitis A (HAV), hepatitis B (HBV), human papillomavirus (HPV), and monkeypox (Mpox) is strongly advised for MSM, yet coverage remains suboptimal. Recent studies suggest moderate effectiveness against gonorrhoea infection from the 4-component MenB vaccine (4CMenB). This study evaluates the impact of targeted counselling strategies on the uptake of STI-preventive vaccines in a cohort of MSM on PrEP at Policlinico Umberto I, Rome.

Methods

This retrospective observational cohort study analysed 511 MSM receiving PrEP between January 2021 and December 2024. Participants were assessed for baseline vaccination status and uptake over an 18-month period. The primary outcome was vaccination coverage at follow-up, while the secondary outcome was STI incidence. Statistical analyses included chi-square tests and t-tests to compare vaccination rates across time points and age groups.

Results

At baseline, vaccination coverage was low for HAV (9.8%), HPV (17.6%), 4CMenB (5.9%), HBV (52.6%), and Mpox (48.9%). After 18 months, significant increases were observed (HAV: 56.4%, HPV: 63.6%, 4CMenB: 20.3%, HBV: 86.1%, and Mpox: 65.6%, <0.05 for all). STI incidence remained high, with syphilis (11.35/100 person-years of follow-up) and Neisseria gonorrhoeae/Chlamydia trachomatis (NG/CT) urethritis (9.35/100 person-years of follow-up) being the most frequent infections.

Discussion

Targeted vaccination counselling integrated with PrEP care significantly increased vaccine uptake among MSM. Structured interventions led to substantial improvements across all age groups. Persistent high STI incidence highlights the need for combined pharmacological and non-pharmacological strategies to optimize STI prevention in this population.

Conclusions

The integration of structured vaccine counselling within PrEP care significantly increased vaccination uptake in MSM.

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2026-01-15
2026-01-29

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Impact of Counselling on the Uptake of STI-Preventive Vaccines Among MSM Using PrEP: A Retrospective Cohort Study in Policlinico Umberto 1, Italy
Bentham Science Publishers ; https://doi.org/10.2174/011570162X411039251119114835
/content/journals/chr/10.2174/011570162X411039251119114835
/content/journals/chr/10.2174/011570162X411039251119114835
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  • Article Type:     Research Article
Keywords: Mpox ; HPV ; HAV ; PrEP ; vaccination uptake ; HBV ; STI prevention ; 4CMenB ; MSM ; targeted counselling

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