Table 4.

RDS-weighted multinomial logistic regression showing factors associated with being in earlier stages of the cascade compared to having completed human papillomavirus (HPV) vaccination (received all three doses of vaccine) among men from the Engage Study (n = 2433)

Characteristics of interest	Stage 1 vs. Stage 5: unaware of HPV vaccine vs. vaccine completion	Stage 2 vs. Stage 5: undecided/unwilling to get vaccinated vs. vaccine completion	Stage 3 vs. Stage 5: willing to get vaccinated vs. vaccine completion	Stage 4 vs. Stage 5: vaccine initiation (<3 doses) vs. vaccine completion
	aOR (95% CI)	aOR (95% CI)	aOR (95% CI)	aOR (95% CI)
Immigration
Born in Canada	Ref	Ref	Ref	Ref
Immigrated to Canada	1.77 (1.02, 3.05)	0.57 (0.31, 1.04)	0.84 (0.52, 1.37)	0.97 (0.53, 1.77)
Sexual Orientation
Gay	Ref	Ref	Ref	Ref
Bisexual	2.18 (0.63, 7.59)	2.37 (0.71, 7.94)	0.84 (0.25, 2.81)	0.52 (0.12, 2.21)
Queer	0.20 (0.08, 0.52)	1.86 (0.78, 4.45)	0.86 (0.41, 1.80)	1.10 (0.42, 2.84)
Otherb	1.28 (0.32, 5.14)	1.48 (0.31, 7.05)	1.00 (0.25, 3.99)	1.80 (0.41, 7.78)
Prefer to keep same-sex relationships private
Increasing agreement	1.36 (1.11, 1.66)	1.35 (1.11, 1.63)	1.10 (0.93, 1.31)	1.18 (0.96, 1.45)
Received information on sexual health in past 6 months
No	Ref	Ref	Ref	Ref
Yes	0.33 (0.12, 0.94)	0.30 (0.11, 0.84)	0.56 (0.20, 1.62)	1.17 (0.31, 4.46)
Past hepatitis A or B vaccination
No	Ref	Ref	Ref	Ref
Yes	0.16 (0.07, 0.35)	0.17 (0.08, 0.40)	0.36 (0.17, 0.78)	0.93 (0.34, 2.53)
Received poor quality of healthcarec
No	Ref	Ref	Ref	Ref
Yes	0.99 (0.48, 2.06)	1.12 (0.51, 2.48)	0.96 (0.51, 1.80)	1.14 (0.47, 2.77)
Accessing healthcare providerd
No	Ref	Ref	Ref	Ref
Yes	0.45 (0.16, 1.24)	0.32 (0.11, 0.93)	0.49 (0.17, 1.43)	0.81 (0.24, 2.77)
Statistically-significant effect modification by city
Age groupe
Vancouver
≤26 years old	0.40 (0.16, 0.98)	1.07 (0.39, 2.99)	0.61 (0.24, 1.59)	0.99 (0.38, 2.59)
≥27 years old	Ref	Ref	Ref	Ref
Toronto
≤26 years old	0.85 (0.26, 2.75)	1.95 (0.52, 7.25)	0.45 (0.14, 1.41)	0.96 (0.31, 3.02)
≥27 years old	Ref	Ref	Ref	Ref
Montreal
≤26 years old	0.07 (0.03, 0.17)	0.17 (0.06, 0.44)	0.11 (0.05, 0.26)	0.73 (0.25, 2.18)
≥27 years old	Ref	Ref	Ref	Ref
Increasing Financial Strain Index scoree,f
Vancouver	1.27 (1.08, 1.48)	1.44 (1.18, 1.77)	1.14 (0.97, 1.34)	1.07 (0.90, 1.26)
Toronto	0.87 (0.69, 1.10)	0.95 (0.75, 1.20)	0.87 (0.71, 1.04)	0.90 (0.72, 1.14)
Montreal	1.04 (0.85, 1.28)	0.99 (0.81, 1.20)	1.00 (0.83, 1.21)	1.00 (0.79, 1.27)
Educatione
Vancouver
High school or less	Ref	Ref	Ref	Ref
Any post-secondary	0.92 (0.31, 2.72)	1.87 (0.55, 6.34)	2.14 (0.76, 5.99)	0.85 (0.30, 2.45)
Toronto
High school or less	Ref	Ref	Ref	Ref
Any post-secondary	0.43 (0.10, 1.86)	1.30 (0.20, 8.30)	0.32 (0.07, 1.38)	0.50 (0.09, 2.64)
Montreal
High school or less	Ref	Ref	Ref	Ref
Any post-secondary	0.13 (0.05, 0.35)	0.21 (0.07, 0.59)	0.54 (0.19, 1.50)	0.47 (0.12, 1.86)

The first four stages of the cascade (dependent variable) are being compared to the last stage of the cascade, vaccine completion. Modeled using multinomial logistic regression (PROC SURVEYLOGISTIC) and adjusted for the RDS design using RDS-II Volz-Heckathorn weights.⁴¹ Estimates presented as odds ratios with 95% confidence intervals. Missing 2.3% of data in multivariable model.

^aIncludes straight, questioning, asexual, pansexual, two-spirit, and other.

^bPoor health from a doctor, community health center, walk-in clinic, hospital, sexual health clinic, or another hospital clinic (all potential venues for vaccination).

^cMen who currently have at least one of the following: a primary care provider, a sexual health care provider, and among those living with HIV, a HIV care specialist.

^dEffect modification observed by city.

^eScale validated in general population samples measuring lack of ability to meet financial needs. Overall score is computed by adding response value across five questions. Higher score indicates greater financial strain.⁴⁰