Understanding Vaccination Uptake amongst Gay, Bisexual and other Men who have Sex with Men in UK Sexual Health Services: A Qualitative Interview Study
1National Institute of Health and Care Research Health Protection Research Unit in Evaluation and Behavioural Science at the University of Bristol, Bristol, UK
2National Institute for Health and Care Research Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
3Yuno Sexual Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
4Blood Safety, Hepatitis, STI and HIV Division, UK Health Security Agency, London, UK
5School of Psychological Science, University of Bristol and School of Psychology, University of Southampton
6Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
*Correspondence: t.may@bristol.ac.ukAbstract
Background/Objectives
In England, gay, bisexual and other men-who-have-sex-with-men (GBMSM) are eligible for vaccinations at NHS sexual health services, including human papillomavirus (HPV), hepatitis A virus (HAV), and hepatitis B virus (HBV). However, current research shows limited understanding of the factors influencing vaccination uptake among GBMSM. This study aimed to examine the barriers and facilitators affecting the offer and uptake of these vaccination programmes.
Methods
A qualitative interview study following the Person-Based Approach (a systematic method for developing and optimising health interventions) involving GBMSM and sexual health service staff from two regions of England. Purposive sampling aimed to include GBMSM with diverse backgrounds and engagement with sexual health services. Patient and public involvement shaped the study design and interview topic guides. The interviews were recorded, transcribed, and thematically analysed to identify barriers and facilitators which were interpreted using the COM-B model of behaviour change.
Results
Twenty GBMSM and eleven staff took part. The findings showed that opportunistic delivery of HPV, HAV and HBV vaccination within sexual health services is mostly acceptable and feasible for GBMSM and staff while also highlighting areas for optimization. Despite low knowledge of these viruses and their associated risks, willingness to be vaccinated was high, with healthcare provider recommendations and the convenience of vaccine delivery during routine clinic visits acting as important facilitators. However, the reach of opportunistic models was limited, particularly for individuals underserved by sexual health services or disengaged from GBMSM social networks. System-level barriers such as complex vaccine schedules (particularly when multiple schedules are combined), inconsistent access to vaccination histories and limited system-level follow-up processes (e.g. automated invites and reminders) were also found to act as obstacles to vaccination uptake and delivery.
Conclusions
To improve equitable uptake, sexual health services should explore the feasibility of addressing both individual and structural barriers through additional strategies, including targeted and persuasive communication to increase knowledge, leveraging regular contact with GBMSM to promote uptake and implementing enhanced approaches to support vaccination completion (e.g. prompts or reminders).
Article notes
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
This study was funded by the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol (NIHR200877), in partnership with UK Health Security Agency (UKHSA). The views expressed are those of the author and not necessarily those of the NIHR, the Department of Health and Social Care, or UKHSA
1.Introduction
Gay, bisexual, and other men who have sex with men (GBMSM) are at greater risk of human papillomavirus (HPV), hepatitis A virus (HAV) and hepatitis B virus (HBV) infections which can be transmitted through sexual contact (1). Persistent infection with HPV can lead to the development of anogenital warts and some cancers. HBV infection can become chronic and lead to liver damage, cancer or failure, whilst HAV infection is acute and does not become chronic, but comorbid conditions (including HBV, hepatitis C and HIV) may increase the risk of liver failure following infection (5). Effective vaccines for the prevention of these infections are available (5–8). In England, vaccines are available free of charge through national health service (NHS) specialist sexual health services for those who meet eligibility criteria, including GBMSM (5–8)1. The commissioning and procurement pathways, however, vary for the different vaccines and changes to vaccine schedules, including the addition of new vaccination programmes (such as those against Mpox and gonorrhoea), add complexity to programme delivery.
Research suggests GBMSM generally hold positive views about vaccination (9). However, estimates of uptake rates vary considerably. For example, a UK community survey found self-reported uptake rates of 68-73% (10), but levels of HPV vaccine uptake reported using clinical electronic patient record data were much lower at 45- 49% (11, 12). More recent data for England indicates that cumulative HPV vaccine uptake to the end of 2024 was 32–49% (13). Known issues with under-reporting in clinical records, under-representation in younger age groups and non-white ethnicities in the survey sample and difficulties in reliably confirming immunity from verbal vaccine history, particularly when vaccinations received in different settings are not recorded within sexual health service records to protect confidentiality, also means there is still uncertainty about the true levels of vaccine coverage. Similar issues persist for HBV vaccination coverage among GBMSM, where incomplete coding of immunity or vaccination in sexual health services may contribute to inaccurately low estimates of vaccination coverage (14). In addition, while the Joint Committee on Vaccination and Immunisation (JCVI) recommends targeting vaccination to GBMSM attending sexual health services due to their higher risk, reliance on opportunistic delivery within these settings may limit broader coverage, given that only 33% of GBMSM reported attending a sexual health clinic in the last year (15).
Previous research has found that multiple interacting factors influence GBMSM vaccination uptake in sexual health services, relating to the individual, healthcare provider, organisational setting, and community and policy environments (9). Further, HPV vaccine uptake amongst GBMSM was found to be influenced by the limited perceived relevancy of HPV, often due to lack of information and the feminisation of HPV (e.g. promotion of the link between HPV and cervical cancer), as well as sociocultural contexts and healthcare experiences. The latter encompassed the influence of the healthcare provider recommendations of vaccination and the role of disclosure of GBMSM identity to indicate eligibility for vaccination (16). For healthcare professionals, time pressure in consultations, difficulty identifying eligible GBMSM and not feeling sufficiently informed were identified as barriers to vaccine delivery (17–19).
Interventions found to be successful in increasing uptake amongst GBMSM include the provision of information combined with motivational messaging, and interaction with or recommendation by healthcare professionals (16). In addition, the use of telephone contact, text messaging and online communication were all found to be acceptable ways to receive information (20–25). Outreach health promotion activities such as offering vaccinations at annual LGBTQ+ Pride events were found to be effective at targeting populations who may not access sexual health services, as well as GBMSM who are engaged in high-risk sexual behaviours (26, 27).
However, the existing literature has limitations as most studies focus on uptake of single vaccines rather than considering them in combination, and the majority were conducted prior to the COVID-19 pandemic. As a result, it is important to explore whether COVID-19–related vaccine fatigue (28) may exist among GBMSM, and how this might influence acceptance of current vaccination programmes. This is particularly important in the context of recent shifts towards the online delivery of some sexual health services in England - such as self-sampling testing for sexually transmitted infections (STIs) - which may reduce the need for in-person clinic attendance. Although previous research has indicated both GBMSM and healthcare professionals would welcome more information or training on HPV, HAV and HBV infections and vaccines (19, 29), framing findings with reference to behaviour change theories would also help to better understand how information provision can be used most effectively to increase vaccination uptake and identify any additional interventions required.
Study Aims and Objectives
The overall aim of this study was to explore ways to increase the uptake of HPV, HAV and HBV vaccination programmes amongst GBMSM, informed by behaviour change theory. The specific objectives were to:
- Explore the attitudes amongst GBMSM from diverse backgrounds towards HPV, HAV and HBV infections and vaccines, and identify barriers and facilitators to vaccine uptake.
- Explore the views of sexual health service staff and commissioners on the delivery of vaccines to GBMSM and identify barriers and facilitators to vaccine programme delivery post COVID-19 pandemic.
- Develop recommendations based on the study’s findings to optimise service delivery and improve information provision to staff and GBMSM with the aim of increasing the offer and uptake of HPV/HAV/HBV vaccination programmes.
2.Materials and Methods
2.1.Design
A qualitative study, employing semi-structured interviews by telephone or online. The study methodology was informed by the Person-Based Approach (PBA) (30), which focuses on developing and optimizing interventions to ensure they are tailored to the views, needs and experiences of individuals who use them. PBA uses an iterative approach to intervention planning and optimisation, incorporating input from patient and public involvement and qualitative research.
PBA has two broad areas of activity: 1) Gathering evidence about user context and experience, and 2) Programme theory and intervention development (31). This manuscript reports a qualitative study conducted within the first of these two areas of activity, which supports the second by identifying likely intervention mechanisms to inform programme theory. This process also included conducting a review of relevant literature, scoping conversations with GBMSM public contributors and sexual health clinicians, and systematically recording qualitative findings, including barriers and facilitators to target behaviours (intervention uptake and delivery) in an Intervention Planning Table2. Findings were also discussed iteratively throughout the data collection and analysis period with the study team, consisting of Blood Safety, Hepatitis, STI and HIV Division colleagues from the UK Health Security Agency (UKHSA), a sexual health consultant and behavioural science experts.
2.2.Setting
The study took place in South-West and North-West England between August 2024 and February 2025 and was supported by two sexual health services operating in these regions. At the time of the study, the new national vaccination programmes for Mpox and 4CMenB for gonorrhoea were not yet available in these services.
2.3.Participants, Recruitment and data collection procedures
GBMSM participants were recruited either through the two participating sexual health services or by using wider community recruitment strategies. In the sexual health services, eligible GBMSM were given verbal information and printed participant information sheets by a member of the healthcare team during a clinical consultation. Recruitment posters were also displayed in the waiting rooms. To ensure the study included the perspectives of GBMSM who were not currently engaging with sexual health services, the study information and a recruitment poster were promoted by local community organisations and representatives who work with GBMSM. This included distribution through local community WhatsApp groups and social media. Inclusion criteria were: GBMSM, based in either of the two study locations, 18 years old or above, and able to provide informed consent.
Individuals expressed their interest in taking part on an online sign-up page which recorded contact details and basic demographic information. Recruitment was purposive, based on age, vaccination status, ethnicity, socioeconomic background, and engagement (or not) with sexual health services. A sample size of approximately 25 GBMSM participants was planned, based on our previous experience of undertaking qualitative studies (32) and a pragmatic assessment of the numbers required to obtain sufficient data according to the concept of information power (33).
Sexual health service commissioners and staff with different job roles (e.g. doctors, nurses, public health practitioners and data managers) and levels of experience involved in the delivery of the HPV, HAV and HBV vaccination programmes were recruited from the two participating sexual health services and through existing connections with commissioning organisations. The lead clinician in each service facilitated invitation distribution by sharing information sheets and consent forms with their colleagues, who then contacted the research team if they wished to participate. All participants were made aware of the incentive for participating (£30 shopping e-voucher).
GBMSM and staff who expressed interest in taking part were contacted by the research team to discuss what participation would involve, re-provide the participant information sheet, and agree a convenient time for the interview. The interviews were semi-structured, guided by topic guides which covered knowledge of the vaccination programme and the diseases protected against, barriers and facilitators to uptake and delivery and suggestions for ways to improve provision (see supplementary information). The topic guides were developed with reference to scoping conversations between the research team and GBMSM public contributors and sexual health clinicians. The interviews took place either on Microsoft Teams or by telephone. Follow-up telephone calls, texts or email to non-responders were used up to three times as required. Written consent was provided by participants ahead of the interview using an online form via a link which was emailed or texted to them, along with an invitation to email with questions or talk through the form on a call. Before the interview started, participants were briefed again on the purpose for the interview and key information about the study and the right to withdraw, before giving verbal consent for the interview recording to begin. Interviews were audio recorded using a digital encrypted Dictaphone, or the record function in Microsoft Teams. At the end of the interview, participants were thanked and provided with a £30 shopping e-voucher.
2.4.Data Analysis
The interviews were transcribed verbatim and then analysed inductively and deductively to identify barriers and facilitators to the offer and uptake of vaccination. TM and HEF analysed the GBMSM data and JK analysed the staff data. We used the Intervention Planning Table to detail the barriers and facilitators to the target behaviours (GBMSM taking up vaccination offer & sexual health services offering vaccinations) identified in the interviews. The interview analyses were reviewed across staff and GBMSM transcripts and interpreted using the Capability, Opportunity, Motivation - Behaviour (COM-B) (34) model of behaviour change to create a “behavioural diagnosis” of the barriers and facilitators to the target behaviours. The model proposes that in order for a behaviour to occur, an individual must have three things: (1) capability to carry out the behaviour, including physical capability (e.g. skills) and psychological capability (e.g. knowledge, memory); (2) opportunity to carry out the behaviour including social opportunity (e.g. the behaviour fits with social norms) and physical opportunity (e.g. the person has the time, resources and can access what is needed to carry out the behaviour); and (3) motivation to undertake the behaviour including automatic motivation (which is influenced by emotional responses or habit) and reflective motivation (confidence they can carry out the behaviour, belief that the behaviour will be beneficial for them). The COM-B behavioural diagnosis can then be used to facilitate selection of evidence-based behaviour change techniques to enhance facilitators and address barriers. Although factors could fit within multiple COM-B components, we have primarily categorised them based on how they functioned to drive behaviour, for example, by facilitating opportunities for action, increasing motivation or supporting capabilities to perform a behaviour (35).
3.Results
We interviewed 20 GBMSM, with equal numbers across our study sites in the South-West and North-West of England. Participants ranged in age from 20 to 64 years. Eight participants identified as non-white. Four participants self-reported that they had not received any of the three vaccines. Sixteen participants reported that they had received at least one of the three vaccines, whilst eight participants reported that they had all three vaccines. There was also variation in the setting these vaccines had been received, including as part of the universal schools-based HPV vaccination programme and vaccination for HAV from travel clinics.
Some participants expressed uncertainty about which vaccines they had previously received. This uncertainty partly reflected the absence of a consolidated vaccination record and the inability to view sexual health vaccination history via the NHS App, as sexual health services maintain separate records to protect patient confidentiality across services (36).
11 staff completed interviews from the participating sexual health services, five from the service in South-West England and six from the service in North-West England. Staff had diverse roles including clinical, data management and public health commissioning.
Further information about participant characteristics is provided in Table 1.
Analysis of the interview data identified the facilitators and barriers to vaccine offer and uptake presented below, firstly from the perspective of GBMSM and secondly from the sexual health service provider perspective. These are categorised according to the constructs of the COM-B model of behaviour change (see Figure 1).
4.Discussion
This study highlights the factors influencing the opportunistic offer and uptake of HAV, HBV and HPV vaccination among GBMSM within sexual health services. Consistent with earlier research demonstrating the acceptability of the HPV vaccine in this population (37, 38), our findings show that co-administered, opportunistic vaccines were generally acceptable to GBMSM, even among those with limited knowledge of HAV, HBV and HPV, or those unaware that vaccination is recommended. Vaccine delivery was also perceived as acceptable by staff working in clinical settings, although several system-level barriers limited optimal coverage. Additionally, the programme had limited reach beyond sexual health service settings, particularly among populations underserved by current opportunistic delivery models.
GBMSM appeared to have low knowledge of the three viruses, including symptom recognition, long-term health complications and the availability of vaccines through sexual health services. Previous research has documented that low knowledge and awareness of HPV, as well as vaccination as a method of prevention, is common among GBMSM (29, 37). Our findings extend this by highlighting similar gaps for HAV and HBV, including knowledge about vaccine entitlement and eligibility (psychological capability). Nevertheless, limited knowledge did not reduce willingness (reflective motivation) to receive these vaccinations, which was often supported by discussions with healthcare providers (facilitating psychological capability) and the convenience (physical opportunity) of receiving vaccines during routine sexual health visits. This aligns with previous work emphasizing the importance of healthcare provider recommendations and reminders (enhancing psychological capability), as attitudes (reflective motivation) toward vaccines are often influenced by the clinical environment and reassurance from trusted professionals (37, 38, 40). Hence, integrating vaccination within routine sexual health services should be viewed as an efficient and convenient (physical opportunity) strategy for GBMSM with regular engagement with sexual health services.
Such an approach, however, is only likely to be effective if vaccines are equitably accessible through these settings. Commonly, individuals received vaccines only after attending clinics for other healthcare appointments (e.g. PrEP), rather than actively seeking them (see also (37)). This was often due to limited awareness of vaccine eligibility (psychological capability barrier) and low perceived severity of the viruses (reflective motivation barrier). With increasing reliance on digital and remote service provision, opportunities for opportunistic vaccine delivery during in-person visits may decline (physical opportunity barrier), particularly for those individuals in this study with low severity perceptions of the viruses, potentially leading to suboptimal uptake (29). Additional efforts are therefore needed to increase knowledge of HPV, HAV and HBV, as well as awareness of vaccine eligibility. This includes addressing psychological barriers - such as beliefs that HPV is “treatable” or perceptions that vaccination is unnecessary - which reflect deficits in reflexive motivation and capability. Such efforts are particularly important among populations with lower levels of clinical engagement, including minoritized ethnic groups, young people and bisexual or straight-identifying MSM (10, 41).
Opportunities to obtain vaccine-related information varied depending on individuals’ engagement with both social and community networks and sexual health services. For many participants, exposure to information - including awareness that vaccines were available through sexual health services - occurred primarily through social connections to online and offline GBMSM networks (social opportunities facilitating increased psychological capability). These included informal conversations with peers, as well as sexual networking apps where vaccination status was sometimes displayed. Being socially connected within GBMSM communities has been associated with higher vaccination uptake in other contexts, such as during the 2022 mpox outbreak (42, 43), likely facilitated by the sharing of information about vaccination within social networks (39). In contrast, uptake of HPV, HBV and HCV vaccines appears to be lower among GBMSM with lower markers of social capital (10). Studies on HIV self-testing (44) and PrEP uptake (45) have similarly found that social and geographical marginalization from GBMSM networks can reduce individuals’ exposure to information about these interventions. Future vaccination campaigns should therefore target individuals marginalized from these networks to avoid reinforcing existing disparities in awareness, access and uptake. Here, targeted messaging emphasizing personal relevance and the benefits of vaccination should be used to improve awareness of personal risk and support informed decision-making (39), whilst community-led outreach and vaccination delivery through alternative routes - such as pharmacies or outreach vans - can help to reduce structural barriers to uptake (46–48).
A novel feature of this work was the inclusion of participants who had actively declined vaccination or had no intention of accepting it if offered. Some reported that their decisions were influenced by what they perceived to be side effects experienced following COVID-19 vaccination, leading them to avoid additional vaccines for viruses they perceived as ‘low risk’ (reflective motivation barriers). While this suggests a potential disconnect between perceived and actual risk among some GBMSM, it also reflects broader post-COVID skepticism toward vaccination, where concerns about side effects and exposure to multiple vaccines are shaping decision making around uptake (49). It should be noted that, in the broader GBMSM population, COVID-19 vaccination uptake has been reported as high (50), suggesting that these concerns may be concentrated in a small subgroup of the GBMSM population. Given the recent introduction of routine Mpox and gonorrhoea vaccination programmes for GBMSM in the UK, it is important to consider how additional vaccines may influence uptake of other vaccines targeting infections perceived as ‘low risk’ among GBMSM, including HAV, HBV and HPV (38), particularly if concerns about side effects or reactogenicity may affect willingness to complete vaccination schedules. Such insights can help guide the design and roll-out of future vaccination programmes by highlighting the factors that influence engagement and uptake within GBMSM communities.
Clinic staff were generally knowledgeable and confident in identifying eligible patients and promoting vaccines, supported by training and electronic record prompts. However, logistical and structural challenges - including complex vaccine schedules, inconsistent access to verified vaccination histories, high workload and reliance on patients to self-initiate return visits for follow-up doses - limited the consistency of vaccine delivery and course completion.
Given that clinician recommendations and clear guidance on follow-up doses are strong (motivational) facilitators of vaccine course completion (29, 38), additional measures are needed to optimize clinicians’ role in delivery and mitigate these system-level (physical opportunity) barriers. These include implementing more robust, joined up and consistent systems for patient vaccination status record access and patient follow-up, particularly when patients are unsure of their vaccination status or report receiving vaccines elsewhere at first offer. Systems to support course completion - such as contacting patients or using reminder mechanisms or prompts, ideally automated - would help ensure timely dosing. Introducing prompts for healthcare professionals (to address psychological capability barriers) could further support opportunistic vaccine completion during clinic visits for other reasons. Enhanced integration of vaccination within existing successful services could also be leveraged (supporting both psychological capability and physical opportunity): for example, aligning vaccine schedules with routine PrEP monitoring appointments may streamline delivery and reduce missed opportunities for follow-up doses, though differences in PrEP prescribing intervals, including 6 monthly reviews for some individuals, may limit this in practice. Finally, providing more feedback on service performance based on surveillance data reporting, (to support reflective motivation) and to allow services to check that what is reported is accurate (to facilitate psychological capability), could help optimise vaccination programme delivery.
The strengths of this research include exploring barriers and facilitators to all vaccines in the programme rather than focusing on individual vaccines in isolation, conducting interviews in two geographical areas with a diverse sample of GBMSM and staff holding a range of roles. Contextual differences at the clinic and system level between the two areas were identified which supported or restricted vaccination delivery. For instance, one area’s data system supported monitoring of vaccination through automated coding. Examining differences and similarities between GBMSM and staff perspectives illuminated areas for improvement with the programme. Without interviewing staff we would not have identified that course completion is a major issue or illuminated other clinic and system level issues. A limitation of the study was that despite employing a multi-pronged recruitment strategy including inside and outside clinics, our sample included only a small number of GBMSM with limited experience of sexual health services or those expressing vaccine hesitancy. However, we were able to indirectly capture these perspectives via staff accounts and GBMSM reflecting on their peers’ behaviour.
5.Conclusion
This study demonstrates that opportunistic delivery of HAV, HBV and HPV vaccines within sexual health services is mostly acceptable and feasible for GBMSM and for the staff responsible for administering vaccines. Despite low knowledge of these viruses and their associated risks, willingness to be vaccinated remained high, with healthcare provider recommendations and the convenience of vaccine delivery during routine clinic visits acting as important facilitators. However, the reach of opportunistic models was limited, particularly for individuals underserved by sexual health services or socially disengaged from GBMSM networks. System-level barriers such as complex vaccine schedules, inconsistent access to vaccination histories and reliance on patients to self-initiate follow-up doses were also found to contribute to sub-optimal vaccine coverage within services.
To improve equitable uptake, sexual health services should explore the feasibility of addressing both individual and structural barriers through additional strategies, including targeted and persuasive communication to increase knowledge, leveraging of regular contacts with patients and enhanced approaches to support vaccination completion (e.g. digital vaccine apps and prompts or reminders to support completion). Ensuring interventions are also attentive to the diverse needs, experiences and preferences of GBMSM - particularly those less connected to clinical or social networks - while promoting vaccination as a core component of sexual health care rather than an optional add-on, will also be key to enhancing acceptability, accessibility and equitable coverage.
As sexual health services now offer an increasing number of vaccines for GBMSM, the value and impact of these programmes will depend on achieving high and equitable coverage. The findings from this study, along with future work on the acceptability of new vaccination programmes, can help towards optimizing their delivery and coverage.
Supporting information
Supplementary Materials
The interview topic guides can be downloaded at: https://www.mdpi.com/article/doi/s1
Funding
This study was funded by the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol (NIHR200877), in partnership with UK Health Security Agency (UKHSA). The views expressed are those of the author and not necessarily those of the NIHR, the Department of Health and Social Care, or UKHSA
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the UK National Health Service (NHS) Research Ethics Committee (REC reference: 23/YH/0159 dated: 14/9/2023) and the Health Research Authority (IRAS: 328525) prior to the study commencing.
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
Interview data will be available from the University of Bristol data repository, data.bris. Data access is restricted to bona fide researchers for ethically approved research and subject to approval by the University’s Data Access Committee.
Acknowledgments
JMK, CT, HEF and JH are partly funded by NIHR Health Protection Research Unit in Evaluation and Behavioural Science at University of Bristol and NIHR Applied Research Collaboration West (NIHR ARC West). LY is an NIHR Senior Investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West and NIHR Health Protection Research Unit (HPRU) in Evaluation and Behavioural Science.
We are grateful for the contributions of GBMSM public contributors and study participants and participating sexual health service staff for their contribution to this study.
Conflicts of Interest
The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
Abbreviations
The following abbreviations are used in this manuscript:
- GBMSM
- Gay, Bisexual or other Men who have Sex with Men
- GP
- General Practitioner
- HAV
- Hepatitis A Virus
- HBV
- Hepatitis B Virus
- HIV
- Human Immunodeficiency Virus
- HPV
- Human Papillomavirus
- LGBTQ+
- Lesbian, Gay, Bisexual, Transgender, Queer, plus
- NHS
- National Health Service
- NIHR
- National Institute of Health and Care Research
- PBA
- Person Based Approach
- PrEP
- Pre-exposure Prophylaxis
- STI
- Sexually Transmitted Infection
- UK
- United Kingdom
- UKHSA
- UK Health Security Agency
Disclaimer/Publisher’s Note
The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.