Application of the Ecological Model Concept to Promote Male Access to The HPV Vaccine in Thailand

Abstract

Human papillomavirus (HPV) infection is common among men in Thailand and is associated with several HPV-related cancers. However, HPV vaccination services in Thailand have predominantly targeted females, and male vaccination remains limited, leaving gaps in prevention and increasing long- term health risks. This article proposes strategies to improve male access to HPV vaccination in Thailand using the Social Ecological Model as an organizing framework. A literature review was conducted using ThaiJo, Google Scholar, and PubMed, covering studies published from 2014 to the present. Relevant evidence was synthesized through content analysis by extracting and categorizing factors related to HPV vaccine access among men and mapping them onto five ecological levels:intrapersonal, interpersonal, organizational, community, and policy. Improving vaccination uptake among men requires coordinated multi-level actions, including: strengthening knowledge, risk perception, and vaccine confidence (individual level); leveraging family, peers, and healthcare-provider recommendations (interpersonal level); establishing proactive and convenient vaccination services in schools, universities, and workplaces (organizational level); implementing community and mass-media communication to correct misconceptions and create supportive social norms (community level); and expanding policy and financing mechanisms to reduce cost barriers and increase coverage for males (policy level). Applying the Social Ecological Model highlights that male HPV vaccination is shaped by interacting personal, social, organizational, and policy determinants. A multi-level approach can inform the design of health-service interventions and policies to increase vaccination coverage among men and reduce HPV-related morbidity and mortality in the long term.