Journal Article

SC1 Integrating HPV vaccination promotion into community-based sexual health services: an empowerment approach

Barracchia, M, Sala, A, Vinti, P, Bergomi, A, Stizioli, M, Russo, P

2025

Overview

BackgroundIn September 2024, Lombardy expanded eligibility for HPV vaccination. Now it is available for free to all individuals up to 26 years of age and to all individuals engaging in risky sexual behaviors, although HPV is transmissible beyond traditional risk categories: via skin-to-skin contact, even with condom use.Prevention efforts often remain limited to specific populations, such as gay, bisexual and other men who have sex with men and young adolescents. Lombardy’s policy marks a crucial step in increasing vaccine accessibility for all, especially for sexually active adults of all genders and sexualities.Brescia Checkpoint was established in 2024 and is the first local community-based organization providing comprehensive sexual health services, including HPV vaccination promotion.Material and MethodsBetween November 2024 and February 2025, Brescia Checkpoint offered free and confidential rapid HIV and syphilis testing once a month. During pre-test counselling, all clients completed an anonymous questionnaire and discussed with peer providers about HPV and vaccination benefits.The unvaccinated were informed by peers that the physician conducting the tests could sign a document recommending their eligibility for free HPV vaccination under the new regional guidelines. This initiative leveraged the physician’s authority to facilitate free vaccination at public centers and to empower individuals to get vaccinated. To reinforce support, clients were encouraged to report any barriers encountered.Results61 clients received HIV and syphilis testing, and 36.1% of them were already vaccinated for HPV. Among those vaccinated, 8 (36.4%) had purchased the vaccine out-of-pocket. The majority of clients were not vaccinated for HPV (63.9%), all of them were willing to get vaccinated and received the recommendation from the physician. Demographic data revealed that HPV vaccination rates were higher among gay and bisexual men (45.5%). Significant gaps in vaccination coverage can be seen in all populations, particularly among young people under 26 years of age and those over 30 years, despite the extended eligibility criteria (table 1). No client reported experiencing barriers at vaccination centers.Abstract SC1 Table 1HPV vaccination coverage among HIV/syphilist testing clients, by age, sexual orientation, gender identity, place of residence, employment statusConclusionsThis initiative highlights the crucial role of community-based organizations in bridging gaps in HPV vaccine access through peer-mentorship and collaboration with physicians. We firmly believe that this approach strengthens public health efforts beyond traditional clinical settings. Providing individuals with strong peer and physician support could enable them to effectively prioritize their health.We plan to investigate further the effectiveness of vaccination recommendations issued within our program in increasing vaccination uptake. This experience could serve as a replicable model in other settings and contribute to a more comprehensive HPV prevention strategy.

• Publisher: BMJ Publishing Group LTD
• Subject: Community / Empowerment / Health behavior / Health promotion / Health risks / Health services / Immunization / Physicians / Public health / Sexual health / Syphilis / Vaccines