HPV Vaccine

A reference guide for Physicians providing care to gay and bisexual men

  • Human papillomavirus (HPV) infections are the most common sexually transmitted infections (4).
  • In men, HPV is associated with squamous cell carcinomas of the anus, penis and oropharynx.
  • The prevalence of HPV-associated cancers is increasing in the general population as well as among gay and bisexual men (2).
  • Gay, bisexual, and other men who have sex with men are 20 times more likely to get anal cancer compared to heterosexual men (2).
  • HIV-positive gay and bisexual men are 80-100 times more likely to get anal cancer compared to heterosexual men (2).
HPV Prevention

The best way to prevent HPV infections is to be vaccinated. The HPV vaccine is safe and effective, and has demonstrated strong immunogenicity (4). The Gardasil-9 vaccine protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 which includes those causing genital warts and the most prevalent HPV types causing cancer (3).

The Canadian National Advisory Committee on Immunizations states Gardasil should be considered for all men who have sex with men regardless of age (4). In Ontario, Gardasil-9 is recommended and publicly funded for gay and bisexual men under 27 at no cost. For men 27 and over, Gardasil-9 is available for a fee or may be covered by patient’s health insurance. The Canadian Cancer Society estimates that it costs around $600 for three doses of the Gardasil-9 vaccine.

Gardasil Dosage

For patients 15 years and older, 3 doses are recommended (4).


  • First dose today
  • Second dose in 2 months
  • Third dose in 6 months

For more information regarding the HPV vaccination, visit the National Advisory Committee on Immunization (NACI) website (4).