Does framing human papillomavirus vaccine as preventing cancer in men increase vaccine acceptability?

Background: Human papillomavirus (HPV) vaccine is now approved for use in males in the United States to prevent genital warts. We conducted an experiment to see whether framing HPV vaccination as also preventing cancer in men would increase men's vaccination willingness. Methods: We conducted an online survey in January 2009 with a national sample of men ages 18 to 59 years who self-identified as gay/bisexual (n = 312) or heterosexual (n = 296). In the within-subjects experiment, men read four randomly ordered vignettes that described hypothetical vaccines that prevented either genital warts alone, or genital warts and either anal cancer, oral cancer, or penile cancer. We analyzed data using repeated measures ANOVA and tested whether perceived severity or perceived likelihood mediated the effect of disease outcome framing on men's HPV vaccination willingness. Results: Although only 42% of men were willing to receive HPV vaccine when it was framed as preventing genital warts alone, 60% were willing to get it when it was framed as preventing cancer in addition to genital warts (P <0.001). The effect of outcome framing was the same for heterosexual and gay/bisexual men and for the three cancer types examined. Perceived severity of disease partially mediated the association between disease outcome and HPV vaccination willingness. Conclusions: Men may be more accepting of HPV vaccine when it is framed as preventing cancer, regardless which of the three most common HPV-related cancers in men is described. Impact: Study findings may be useful in developing health communication messages that maximize HPV vaccine acceptability among young men.