That's a great question, one of my favourite topics to talk about. I'm giving a talk on it Monday.
HPV infection in men is different from HPV infection in women. It's not the same thing. Men tend to get less disease from HPV; women tend more to get disease. I'm not talking about the gay population; I'm just talking in general. Women tend more to get disease from it, but women clear the virus better. Men do not clear the virus very well, so the virus keeps hanging around. There have been great studies on this. Men up to their fifties and sixties have persistent staph oropharyngeal HPV infections that they don't clear. Men don't form good antibodies naturally to HPV infection.
Coming back to your question about the vaccine, what is the recommendation? Well, definitely boys should get it, because it's probably the only vaccine that prevents cancer. The vaccine is really about cancer prevention. The argument for young boys and girls is that it's not a sexualized vaccine; it's a cancer-preventing vaccine that everybody should get. In the MSM population, we highly recommend it because of what I told you about anal cancer rates. Those are important things, even though it's post-exposure, as I said. In the general population it's a question mark.