Sexual and preventive behaviors associated with HAV, HBV, and HPV vaccine hesitancy among men who have sex with men in France.

Vaccination coverage against hepatitis A virus (HAV), hepatitis B virus (HBV), and human papillomaviruses (HPV) is insufficient among men who have sex with men (MSM), partly because of their high prevalence of vaccine hesitancy (VH) specific to these vaccines. This study aimed to investigate determinants of specific VH in MSM, focusing on characteristics of their sexual activity, propensity to use prevention tools and medical care, disclosure of sexual orientation to health care professionals (HCPs), and perceived stigmatization. A cross-sectional electronic survey (February - August 2022) collected perceptions of HBV, HAV, and HPV, and of their respective vaccines among 3,730 French MSM and enabled the construction of a specific VH variable. Using agglomerative hierarchical cluster analysis, we constructed a typology of MSM sexual and prevention practices. We identified three MSM clusters (low- (C1, 24%), moderate- (C2, 41%), and high- (C3, 35%) "sexual activity/medical engagement") that showed an increasing gradient in the use of medical prevention with regular medical care and exposure to high-risk sexual practices. A multiple ordinal logistic regression showed that overall specific VH was higher in the C1 cluster and in men who had not informed their physician of their sexual orientation. This typology could usefully help to adapt vaccination communication strategies for MSM prevention program according to patients' profiles. HCPs should be encouraged and trained to ask men about their sexual practices and to provide appropriate vaccination recommendations nonjudgmentally.

Gradient of vaccine hesitancy among French men having sex with men: An electronic cross-sectional survey in 2022.

In developed countries, vaccinations against hepatitis B (HBV), hepatitis A (HAV), and human papillomavirus (HPV) are often recommended to men who have sex with men (MSM) because of the risky sexual practices in which some engage. Vaccine coverage against these diseases is not optimal in France, probably due in part to vaccine hesitancy (VH). The overall aim of this survey among MSM was to estimate the prevalence of different grades of VH for these vaccines as well as of general VH (toward any vaccine). The specific objectives were to study the sociodemographic correlates of MSM specific and general VH and its association with vaccine uptake. A cross-sectional electronic survey (February-August 2022) collected information from 3,730 French MSM about their perceptions of HBV, HAV, and HPV and their related vaccines, to construct "specific VH" variables. Information about their past vaccination behaviors for any vaccine was used to construct a "general VH" variable, based on the World Health Organization definition. Almost 90% of MSM showed moderate or high specific VH for HBV, HAV, and/or HPV, and 54% general VH. A higher education level and comfortable financial situation were associated with lower grades of specific and general VH. Younger age was associated with less frequent specific VH and more frequent general VH. Specific VH, versus general, was more strongly associated with frequent self-reported non-vaccination against these three disease. Addressing their concerns about vaccines, improving their knowledge of vaccine-preventable sexually transmitted infections, and motivating them to get vaccinated are public health priorities.

Effectiveness of a French mass-media campaign in raising knowledge of both long-term alcohol-related harms and low-risk drinking guidelines, and in lowering alcohol consumption.

AIMS: To evaluate the effectiveness of a French mass-media campaign in raising knowledge of both long-term alcohol-related harms (LTH) and low-risk drinking guidelines (LRDG), as well as in lowering alcohol consumption. DESIGN: An 8-month longitudinal survey from February to October 2019, with three waves of on-line data collection (T0 before the campaign, T1 just after it ended and T2 6 months after it ended). SETTING: France. PARTICIPANTS: A total of 2538 adult drinkers (aged 18-75 years). MEASUREMENTS: The main outcomes' variables were LTH knowledge (cancer, hypertension, brain haemorrhage), LRDG knowledge (two guidelines: 'maximum of two drinks a day' and 'minimum of 2 days without alcohol per week'), intention to reduce alcohol consumption and self-declared consumption with respect to the French LRDG. At T1, exposure to the campaign was measured using self-reported campaign recall. FINDINGS: In T1, we observed significant positive interactions between exposure group based on campaign recall and survey waves on knowledge of (i) the 'maximum two drinks a day' guideline [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.08-1.62, P = 0.008], (ii) brain haemorrhage (aOR = 1.80, 95% CI = 1.44-2.25, P < 0.001) and (iii) hypertension (aOR = 1.41, 95% CI = 1.09-1.81, P = 0.008) risks. Campaign exposure was also associated with a significant decrease in at-risk drinking in women (aOR = 0.67, 95% CI = 0.50-0.88, P = 0.004). No significant interaction was observed at T1 for the knowledge of the 'minimum of 2 days without alcohol a week' guideline, or of cancer risk. At T2, no significant interaction was observed for the main outcomes' variables. CONCLUSIONS: There appears to be an association between exposure to a 2019 French mass-media campaign to raise knowledge of long-term alcohol-related harms and low-risk drinking guidelines and reduce alcohol consumption and (i) improved knowledge of the 'maximum two drinks per day guideline', (ii) knowledge of the risks of hypertension and brain haemorrhage and (iii) a reduction in the proportion of people exceeding low-risk drinking guidelines (in the general population only). These associations were only observed over the short term and, in some cases, only for certain segments of the population.

The practices of French general practitioners regarding screening and counselling pregnant women for tobacco smoking and alcohol drinking.

OBJECTIVES: Our study aims to describe French general practitioners' (GPs') practices toward pregnant patients regarding alcohol consumption and smoking and to highlight factors associated with specific practices. METHODS: In 2015, a representative sample of 1414 French GPs completed a telephone survey based on a stratified random sampling. RESULTS: 61% of GPs declared screening for alcohol use and 82% for smoking at least once with each pregnant patient; quitting was not systematically advised either for alcohol or for smoking. GPs' practices were significantly better among those who had more recent ongoing training. GPs who drank regularly were less likely to screen for alcohol use and GPs' drinking frequency was inversely related to recommending quitting. Current and former smokers were less likely to recommend quitting to pregnant patients smoking over five cigarettes per day. CONCLUSIONS: Screening and counselling practices for substance use during pregnancy are heterogeneous among French GPs and are notably related to their personal consumption. GP's role in preventing substance use during pregnancy could be strengthened by actions regarding their own consumption and by modifications in their initial and ongoing training.

[Determinants of the intention to abstain from or reduce alcohol, tobacco or cannabis use among 15-25 year-olds]. / Déterminants des intentions de rester non-consommateur ou de réduire ses consommations d’alcool, de tabac ou de cannabis chez les 15-25 ans.

OBJECTIVE: This study was designed to identify the sociodemographic and psychosocial factors (based on the theory of planned behaviour) associated with the intentions of young people to remain non-smokers and refrain from experimental cannabis use, and their intentions to reduce drinking during a party, quit smoking and reduce cannabis use among users. METHODS: 3,652 young people aged 15 to 25 years were interviewed by means of an on-line questionnaire. The sample was recruited from an internet access panel and constructed according to the quota method applied to the following variables: gender, age, region, habitat and head of family occupation. RESULTS: Each of the psychosocial determinants {attitudes, norms and control) helped to explain the subject's intention not to smoke and/or use cannabis. The presence of a prohibition norm in the family was also associated with a decreased intention to experiment with cannabis. Among substance users, attitude determined the intention to quit or reduce the use of the three substances {tobacco, alcohol and cannabis) and control was involved in the intention to reduce drinking and quit smoking. Finally, norms only influenced the intention to reduce drinking during parties. CONCLUSION: This study demonstrates the importance of considering psychosocial factors to explain health behaviours and to identify and propose interventions. These results support the priority given to smoking prevention, justify the value of early interventions and confirm the importance of considering social inequalities in health when developing prevention programmes.