James Diemert remembers when a young gay man came into The AIDS Network last year, concerned about his sexual health. He wanted more information about the human papillomavirus (HPV), which Diemert was happy to provide. But when the young man wanted the HPV vaccine, Diemert was at an impasse: there were no publicly funded vaccination programs available at the time and the young man wasn’t able to come out to his family, so jumping on his parents’ insurance wasn’t an option. This left Diemert and his client with little recourse.
“It broke my heart,” Diemert says in an email. “Here was a young guy who was really invested in making good choices about his sexual health, and there was nothing I could offer him.”
Diemert, a gay men’s HIV prevention worker at The AIDS Network, says that this story is one of the reasons he was so enthusiastic about incorporating HPV vaccinations into the work his Men4Men clinics do. The clinics are a partnership between The AIDS Network and two of the region’s public health units (Hamilton and Halton Public Health Services) with a goal of offering sexual health clinics targeting men who have sex with men.
“We not only make HIV testing available in spaces where gay men already feel comfortable such as bathhouses, clubs and campgrounds, but are able to offer special men’s clinics in traditional clinic spaces,” he says.
Since 2010, these services have primarily focused on HIV testing. But this year, they’re finally offering HPV vaccinations to queer men, and those under 26 can get vaccinated for free.
“We are very proud to be among the first outreach programs in Ontario to be promoting this vaccination’s availability, and we are fortunate to work in partnership with regional Public Health units that share our excitement and enthusiasm for promoting better sexual health among gay men,” Diemert says.
Historically, HPV vaccinations were only made available to young girls, due to the correlation between HPV and cervical cancer. Policy makers at the time hoped that vaccinating young women would be enough to prevent the spread of the virus. However, as Diemert points out, that policy approach neglected the experience of men who have sex with men.
“This thinking unfortunately ignored the existence of queer men, and the vaccines are prohibitively expensive to many guys who could benefit from the protection they offer.”
Some strains of HPV can lead to genital warts, anal warts, throat cancers and anal cancers — all easily preventable through vaccination, which is why Diemert and his team are actively trying to spread the word about the vaccine.
“Men who have sex with men are vastly overrepresented in cases of cancers linked to HPV,” he says.
“Most types of HPV are harmless and your body clears them on its own, but there are a few strains that can be very dangerous, especially to gay men,”
Type 16 and 18 are known to cause cancer, including anal, oral, and penile cancer among men. Among cancers affecting men, it is estimated that HPV infection is associated with 80–90 percent of anal cancers, 40–50 percent of penile cancers, 35 percent of throat cancers and 25 percent of mouth cancers.
Despite the current emphasis on HPV, the Men4Men clinics will still continue to offer other types of sexual health services.
“As an AIDS service organization, our priority is HIV testing (which as always we will be offering at these clinics) but the pieces of our sexual health are interconnected,” Diemert says. “We hope to engage gay, bi and other men who have sex with men in considering their overall sexual health — which includes knowledge of HIV — but so many other important pieces as well.”