Correlates of Mpox Vaccination among Sexual Minority Men in the United States: Sexual Behavior, Substance Use, and Main Partner Relationships

Psychosocial and Behavioral Impacts of the Mpox Outbreak among People with and without HIV in the United States

Over 32,000 mpox cases were identified in the United States (US) within one year of the start of the global outbreak in 2022. Research on how the mpox outbreak affected individuals' lives is limited. We analyzed qualitative and quantitative cross-sectional survey data collected from 60 participants in August 2022 to (1) describe mpox-related psychosocial and behavioral impacts among adults in the US and (2) explore differences in mpox-related impacts by HIV status. Results indicate that the outbreak affected both people with HIV (PWH) and people without HIV (PWOH) in our sample, while also highlighting the unique experience of PWH. The majority of participants reported that they felt at risk, experienced negative impacts across multiple life domains, changed aspects of their behavior, and anticipated mpox-related stigma. These findings can be used to inform the public health response in the event of future mpox outbreaks.

Preventive behavior intention for a viral outbreak among college students: The case of Mpox

OBJECTIVE

Examine college students' behavior intention to reduce viral outbreak transmission in the context of Mpox, and what preventive messaging strategies would be most effective in future transmissible disease outbreaks based on the Reasoned Action Approach (RAA).

PARTICIPANTS

Undergraduates at a mid-Atlantic U.S. University.

METHODS

An online survey (n = 266) conducted at the height of the recent Mpox outbreak in the U.S., asked about five target behaviors to reduce Mpox transmission, including RAA determinants for each behavior.

RESULTS

Highest intention was safe sex practices, lowest were vaccination and sexual abstinence, and sharing dishes and fabrics were in between. RAA determinants differed by target behavior, although attitudes were significantly positively associated with intention for all five behaviors.

CONCLUSIONS

College students are potentially open to preventative behaviors to reduce viral transmission during an outbreak. However, specific target behavior matters and messaging should focus on differing RAA determinants depending on target behavior.

Drug use during the second year of the COVID-19 pandemic: observations from repeated cross-sectional surveys of sexual minority men in the US active on social networking applications

Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (n = 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (OR = 1.249, p < .001), 3 (OR = 1.668, p < .001), and 4 (OR = 1.674, p < .001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (OR = 0.361, p < .001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications.

Influences of mpox disease perceptions, sources and contents of information exposure on mpox vaccine uptake among gay, bisexual, and other men who have sex with men in Hong Kong, China

BACKGROUND

Following the global mpox outbreak in 2022, multiple regions in Asia have been reporting ongoing mpox cases within high-risk groups, including gay, bisexual, and other men who have sex with men (GBMSM). An optimal level of vaccination rate is essential to prevent further mpox outbreaks. However, no existing studies have examined mpox vaccine uptake among GBMSM in East Asia.

METHODS

A cross-sectional survey was conducted among a sample of 531 GBMSM in Hong Kong, China, between March and October 2023. The study used multivariable logistic regression models to investigate the associations between mpox-related disease perceptions, exposures to sources and contents of mpox-related information, and mpox vaccine uptake.

RESULTS

The prevalence of mpox vaccine uptake among GBMSM in Hong Kong was 21.7%, with 7.7% completing one dose and 13.9% completing two doses. GBMSM who were younger or earning less monthly income were less likely to have been vaccinated. After adjusting for confounding variables, participants who perceived more negative impacts on their lives if they were to contract mpox, more severe symptoms, and a more coherent understanding of mpox were positively associated with mpox vaccine uptake. In addition, more frequent exposure to information through the following sources: TV, newspaper, radio and posters, government websites, news websites or apps, other people's social media, and communication over the phone or face-to-face was positively associated with mpox vaccine uptake. Finally, more frequent exposure to the following information contents: mpox statistics from other countries, the Hong Kong government's responses to mpox cases, negative information about patients with mpox, and information on prevention and treatment of mpox were positively associated with mpox vaccine uptake.

CONCLUSIONS

This study provides timely and evidence-based implications to address health communication and messaging needs in promoting mpox vaccination among GBMSM in Hong Kong, relevant to regions with similar sociocultural contexts.

Brief Report: Determinants of Potential Sexual Activity Reduction in the Face of the Mpox Epidemic

BACKGROUND

The current mpox epidemic is most prevalent among men-who-have-sex-with-men (MSM). Vaccination programs are being rolled-out to curb the epidemic. Behavioural measures have been called for as well, for example, by the WHO and national public health authorities to reduce the number of sexual partners and sexual activity. We investigated intentions and determinants among Dutch MSM to follow such behavioural measures.

METHODS

Early in July 2022, in the context of a dynamic ongoing epidemic, 394 MSM answered an online questionnaire investigating concepts such as perceived mpox risk, vaccination and behavioural change intentions and collecting socio-demographic and sexual behaviour information.

RESULTS

The overall intentions to reduce number of partners and sexual activity were high, but only a minority had developed definite intentions. Determinant analysis revealed that dating/open relationship status was a positive predictor; vaccination intentions did not predict sexual behaviour change; those not on PrEP were more likely to change their sexual behaviour. Mpox infection concern was the main predictor for behaviour change intentions.

CONCLUSIONS

Our results show that behavioural measures to avoid an mpox infection are present in majority of participants in our survey, but high intentions are held by a minority. Taking the historic complexity of behavioural change pleas among MSM into account sensitive, additional public health measures are necessary to reach and to inform MSM about potential benefits of sexual behaviour change.