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Tian Y, Hou Z, Zhu G, Zhang Q, Zhu W, Feng H, Pan W, Li Q, Ge R, Chen Z. Self-reported Infection Status, Knowledge and Associated Factors of Monkeypox Among Men Who Have Sex with Men in Jiaxing, China. BMC Public Health 2024; 24:2250. [PMID: 39160485 PMCID: PMC11334323 DOI: 10.1186/s12889-024-19739-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 08/08/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND As of September 2023, more than 1,000 cases of monkeypox (mpox) have been reported in China. Based on the available evidence, men who have sex with men (MSM) are at high risk for mpox infection. This study aimed to analyses the self-reported infection status, knowledge, attitude and influencing factors of monkeypox among MSM in Jiaxing City, China. METHODS A web-based cross-sectional survey was conducted in September 2023 to gather data on participants' socio-demographic profiles, mpox-related knowledge, sexual behavior characteristics, and other potentially related information to mpox knowledge. Multivariate regression modeling was employed to analyze the factors influencing the level of mpox-related knowledge. RESULTS A total of 562 MSM were recruited; 4.3% self-reported being HIV-positive, 83.3% of respondents had heard of mpox, and 2.3% of them reported having suspected symptoms. 89.7% of respondents were willing to be vaccinated against mpox, but only 24.8% had a high level of knowledge about mpox. The main factors influencing knowledge of mpox were education level, household registration, homosexual anal intercourse in the past 6 months, and taking the HIV pre-exposure prophylaxis (PrEP). CONCLUSIONS Knowledge of mpox among MSM living in the Jiaxing area needs to be enhanced, but willingness to get vaccinated is high. Educational level, household location, sexual behavior and PrEP use have important effects on knowledge of mpox. Individuals exhibiting symptoms indicative of suspected mpox had a diminutive consultation frequency, and it is imperative to augment screening efforts for mpox symptoms within specific demographic groups to prevent the underreporting of mpox cases.
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Affiliation(s)
- Yangyang Tian
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Zhigang Hou
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Guoying Zhu
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Qianqian Zhang
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Wutong Zhu
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Hao Feng
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Weizhe Pan
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Qiang Li
- Zhejiang Firefly Public Welfare Organization, Jiaxing, China
| | - Rui Ge
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China.
| | - Zhongwen Chen
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China.
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Amundsen E, Muller AE, Reierth E, Skogen V, Berg RC. Chemsex Among Men Who Have Sex With Men: A Systematic Scoping Review of Research Methods. JOURNAL OF HOMOSEXUALITY 2024; 71:1392-1418. [PMID: 36939142 DOI: 10.1080/00918369.2023.2170757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Chemsex refers to the use of psychoactive substances with sex. We carried out a systematic scoping review of methodological characteristics of chemsex research among men who have sex with men (MSM), published between 2010 and 2020. For inclusion, chemsex had to be the main focus, and studies had to specify GHB/GBL, stimulant (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine use with sex as a variable. From 7055 titles/abstracts, 108 studies were included, mostly cross-sectional, and from Western countries. About one-third of studies recruited exclusively from clinical settings. A majority of these recruited from sexually transmitted infection (STI) clinics. The included quantitative studies analyzed possible associations between chemsex and STI health (40%), mental health (15%), drug health (12%), sexological health (10%), and post-diagnostic HIV health (7%). Most studies included GHB/GBL and crystal meth in their operationalization of chemsex. Definitions and operationalizations of chemsex vary greatly in the literature, and researchers of chemsex among MSM should consider ways in which this variation impacts the validity of their results. More studies are needed among MSM in non-high income and non-Western countries, and examination of possible links between chemsex and post-diagnostic HIV health, sexological health, and mental health.
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Affiliation(s)
- Eirik Amundsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Eirik Reierth
- Science and Health Library, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vegard Skogen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Infectious Diseases, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Rigmor C Berg
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Huang X, Lin Z, Qin J, Yu D, Zhang F, Fang G, Chen X, He J, Cen P, Li M, Zhang R, Luo T, Jiang J, An S, Liang H, Ye L, Liang B. Willingness to accept monkeypox vaccine and its correlates among men who have sex with men in Southern China: a web-based online cross-sectional study. Front Public Health 2024; 12:1289918. [PMID: 38384873 PMCID: PMC10879393 DOI: 10.3389/fpubh.2024.1289918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Background The May 2022 global outbreak of monkeypox (MPX) poses a threat to the health of men who have sex with men. However, there is limited data on the willingness of MSM to receive monkeypox vaccination in Southern China. This study aimed to assess the knowledge of MPX, concerns regarding MPX, and willingness to receive monkeypox vaccination, as well as their correlates, among MSM in China. Methods We conducted a Web-based online survey of MSM in Southern China from August to September 2022. Data were collected on the socio-demographic characteristics, knowledge, worries, concerns regarding MPX and willingness to receive monkeypox vaccination. Multivariate logistic regression was employed to explore the factors associated with willingness to receive monkeypox vaccination. Results A total of 1903 participants completed the survey. Among them, approximately 69.9% reported being aware of MPX awareness, 94.1% of the participants supported the promotion of monkeypox vaccination. The majority of participants (91.4%) expressed their willingness to receive monkeypox vaccination. Participants who considered monkeypox vaccination safe [adjusted odds ratio (aOR) = 4.82, 95% CI: 1.35-17.18], agreed on the necessity of government promotion of monkeypox vaccination in China (aOR = 6.03, 95% CI: 1.07-33.93), believed in prioritizing monkeypox vaccination for MSM (aOR = 5.01, 95% CI: 1.10-22.71), and had friends or sexual partners who had already received the monkeypox or smallpox vaccination (aOR = 10.37, 95% CI: 2.11-50.99) are more likely to be vaccinated. Conversely, married individuals (aOR = 0.13, 95% CI: 0.03-0.47), those engaging in anal sex 4-6 times per week in the past 3 months (aOR = 0.26, 95% CI: 0.09-0.77) expressed hesitancy toward monkeypox vaccination. Conclusion There was a high willingness to receive monkeypox vaccination among MSM in China. The hesitancy toward the monkeypox vaccine can be effectively mitigated by addressing concerns about its safety and potential adverse reactions. Moreover, increasing acceptance of the monkeypox vaccination among MSM and their peers is crucial, as social influence significantly impacts vaccine attitudes and behaviors.
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Affiliation(s)
- Xinju Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhifeng Lin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiao Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Dee Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Fei Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ganggang Fang
- Kaiyuan Center for Disease Control and Prevention, Kaiyuan, Yunnan, China
| | - Xi Chen
- Sanya Center for Disease Control and Prevention, Sanya, Hainan, China
| | - Jinfeng He
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Mu Li
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Rongjing Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Tong Luo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Sanqi An
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
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Andersen EW, Kulie P, Castel AD, Lucar J, Benator D, Greenberg AE, Monroe A. Mpox Awareness, Risk Reduction, and Vaccine Acceptance among People with HIV in Washington, DC. Pathogens 2024; 13:124. [PMID: 38392862 PMCID: PMC10891655 DOI: 10.3390/pathogens13020124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
People with HIV (PWH) are disproportionally affected by mpox and at risk of severe complications. We assessed mpox knowledge, adoption of preventive behaviors, and vaccination attitudes among PWH enrolled in a longitudinal HIV cohort in Washington, DC, the DC Cohort. We conducted uni- and multivariable analyses comparing participants by vaccination status and HIV risk group, and multinomial regression to identify factors associated with vaccine acceptance. Among 430 PWH, 378 (87.9%) were aware of mpox. Among 373 participants with vaccination status data, 101 (27.1%) were vaccinated, 129 (34.6%) planned to vaccinate, and 143 (38.3%) did not plan to vaccinate. The three vaccination groups differed significantly by age, race, education, HIV risk group, recent STI status, and level of mpox worry (all p < 0.05). A higher proportion of men who have sex with men (MSM) reported limiting their number of sexual partners compared to non-MSM (p < 0.0001). Multinomial regression models comparing vaccinated to unvaccinated PWH found age, education, mode of HIV transmission/gender, and survey period were significantly associated with vaccination status (all p < 0.05). High levels of mpox awareness were observed among this cohort of PWH with more MSM employing risk reduction behaviors and being vaccinated. Ensuring that PWH, regardless of gender, sexual orientation, or age, understand the risks of mpox may improve vaccination uptake.
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Affiliation(s)
- Elisabeth W. Andersen
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (E.W.A.); (P.K.); (A.E.G.); (A.M.)
| | - Paige Kulie
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (E.W.A.); (P.K.); (A.E.G.); (A.M.)
| | - Amanda D. Castel
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (E.W.A.); (P.K.); (A.E.G.); (A.M.)
| | - Jose Lucar
- Division of Infectious Diseases, The George Washington School of Medicine and Health Sciences, Washington, DC 20052, USA
| | - Debra Benator
- The Washington DC Veterans Affairs Administration, Washington, DC 20422, USA;
| | - Alan E. Greenberg
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (E.W.A.); (P.K.); (A.E.G.); (A.M.)
| | - Anne Monroe
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA; (E.W.A.); (P.K.); (A.E.G.); (A.M.)
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5
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Wang H, de Paulo KJID, Gültzow T, Zimmermann HML, Jonas KJ. Brief Report: Determinants of Potential Sexual Activity Reduction in the Face of the Mpox Epidemic. Int J Behav Med 2024:10.1007/s12529-023-10252-4. [PMID: 38233626 DOI: 10.1007/s12529-023-10252-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/19/2024]
Abstract
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.
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Affiliation(s)
- Haoyi Wang
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | | | - Thomas Gültzow
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Department of Theory, Methods & Statistics, Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Hanne M L Zimmermann
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands.
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6
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Evers YJ, Schneider F, Widdershoven V, Goense CJD, Peters CMM, van Elsen SG, Hoebe CJPA, Dukers-Muijrers NHTM. Using a theoretical framework of Intervention Mapping to inform public health communication messages designed to increase vaccination uptake; the example of mpox in the Netherlands. BMC Public Health 2023; 23:2373. [PMID: 38037024 PMCID: PMC10688141 DOI: 10.1186/s12889-023-17311-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION During an infectious disease outbreak, primary preventive pre-exposure vaccination (PPV) could substantially increase the potential for its control, if uptake is sufficiently high. An important tool to increase PPV uptake, are communication strategies, with tailored messages targeted to modify determinants for PPV uptake. Here, we take the example of the 2022 mpox multicountry outbreak, as we inform the development of communication strategies by applying a theoretical framework for selecting effective communication strategies. METHODS The theoretical framework Intervention Mapping (IM) was applied during the outbreak to inform communications [program]. Steps included: 1. Creating a logic model of the problem [not accepting PPV] by reviewing available literature, conducting an online survey among people at risk of mpox exposure, and consulting community-members, healthcare-and communication professionals; 2. Creating a matrix of change [from lower to higher PPV acceptance]; and 3. Selecting theory-based methods and practical applications for communication messages to achieve the intended behaviour change (getting vaccinated). RESULTS The program objective was to promote PPV uptake in people at risk of mpox exposure. Important changeable determinants identified included perceived risk and severity of mpox, importance to protect against mpox [attitude], experienced effectiveness of vaccination and side-effects [response efficacy], and social norm. Theory-based communication methods for optimizing these determinants include provision of facts [increasing knowledge], personalized risk and scenario-based risk information [addressing risk perception/severity], elaboration, arguments [stimulating a positive attitude], gain framing [increasing perceived response efficacy], guided practice [increasing skills/self-efficacy in overcoming barriers] and social norm approach [demonstrating positive norm]. Other key important factors include that communication delivery is uniform (across channels), clear, accessible, and with stigma-free messaging, and that is well-timed and repeated. CONCLUSION IM provided a valuable tool in selecting communication methods to promote mpox vaccination uptake. These methods can be used to (more quickly) produce and implement a communication program in the context of possible future, vaccine-preventable, infectious disease outbreaks.
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Affiliation(s)
- Ymke J Evers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Limburg, the Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Francine Schneider
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Veja Widdershoven
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Limburg, the Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Cornelia J D Goense
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Limburg, the Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Charlotte M M Peters
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Limburg, the Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Sjoerd G van Elsen
- Soa Aids Nederland (SANL), National Knowledge Center STIs and HIV/AIDS, Amsterdam, the Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Limburg, the Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, MUMC+), Maastricht, the Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Limburg, the Netherlands.
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
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May T, Towler L, Smith LE, Horwood J, Denford S, Rubin GJ, Hickman M, Amlôt R, Oliver I, Yardley L. Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging. BMC Public Health 2023; 23:2265. [PMID: 37978506 PMCID: PMC10655366 DOI: 10.1186/s12889-023-17196-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to control transmission, multiple public health measures were implemented, including vaccination, contact tracing and isolation. This study examines knowledge, attitudes, and perceptions of mpox among a sample of GBMSM during the 2022-23 outbreak in the UK, including facilitators for and barriers to the uptake of public health measures. METHODS Interviews were conducted with 44 GBMSM between May and December 2022. Data were analysed using reflexive thematic analysis. Positive and negative comments pertaining to public health measures were collated in a modified version of a 'table of changes' to inform optimisations to public health messages and guidance. RESULTS Most interviewees were well informed about mpox transmission mechanisms and were either willing to or currently adhering to public health measures, despite low perceptions of mpox severity. Measures that aligned with existing sexual health practices and norms were considered most acceptable. Connections to GBMSM networks and social media channels were found to increase exposure to sexual health information and norms influencing protective behaviours. Those excluded or marginalized from these networks found some measures challenging to perform or adhere to. Although social media was a key mode of information sharing, there were preferences for timely information from official sources to dispel exaggerated or misleading information. CONCLUSIONS There are differential needs, preferences, and experiences of GBMSM that limit the acceptability of some mitigation and prevention measures. Future public health interventions and campaigns should be co-designed in consultation with key groups and communities to ensure greater acceptability and credibility in different contexts and communities.
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Affiliation(s)
- Tom May
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
- School of Psychological Science, University of Bristol, Bristol, UK.
- Bristol Medical School, University of Bristol, Bristol, UK.
| | - Lauren Towler
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychology, University of Southampton, Southampton, UK
| | - Louise E Smith
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jeremy Horwood
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Sarah Denford
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew Hickman
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- United Kingdom Health Security Agency, Chief Scientific Officer's Group, London, UK
| | - Isabel Oliver
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- United Kingdom Health Security Agency, Chief Scientific Officer's Group, London, UK
| | - Lucy Yardley
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychology, University of Southampton, Southampton, UK
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8
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del Pozo-Herce P, Martínez-Sabater A, Chover-Sierra E, Gea-Caballero V, Satústegui-Dordá PJ, Saus-Ortega C, Tejada-Garrido CI, Sánchez-Barba M, Pérez J, Juárez-Vela R, Santolalla-Arnedo I, Baca-García E. Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex. Healthcare (Basel) 2023; 11:2905. [PMID: 37958049 PMCID: PMC10649857 DOI: 10.3390/healthcare11212905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Chemsex is understood as "the intentional use of stimulant drugs to have sex for an extended time among gay, bisexual, and other men who have sex with men". It is a public health problem because of the increased incidence of cases and because of the consequences on the physical and mental health of those who practice it. AIM This study aimed to analyze, with the help of the Delphi method, the content validity of a new instrument to assess the risk of behaviors associated with the chemsex phenomenon. METHOD First, a bank of items identified from the literature was elaborated. Secondly, 50 experts with knowledge of the chemsex phenomenon at the national level were contacted. A Delphi group was formed with them to carry out two rounds of item evaluation. The linguistic evaluation (comprehension and appropriateness) was assessed using a Likert scale from 1 to 5 for each item. Items that did not reach a mean score of 4 were eliminated. Content assessment was calculated using each item's content validity index (CVI) and Aiken's V (VdA). A minimum CVI and VdA value of 0.6 was established to include the items in the questionnaire. RESULTS A total of 114 items were identified in the literature. In the first round of Delphi evaluation, 36 experts evaluated the items. A total of 58 items were eliminated for obtaining a CVI or VdA of less than 0.6, leaving 56 items. In a second Delphi round, 30 experts re-evaluated the 56 selected items, where 4 items were eliminated for being similar, and 10 items were also eliminated for not being relevant to the topic even though they had values higher than 0.6, leaving the scale finally composed of 52 items. CONCLUSION A questionnaire has been designed to assess the risk of behaviors associated with the chemsex phenomenon. The items that make up the questionnaire have shown adequate content and linguistic validity. The Delphi method proved to be a helpful technique for the proposed objective.
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Affiliation(s)
- Pablo del Pozo-Herce
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (P.d.P.-H.); (E.B.-G.)
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Antonio Martínez-Sabater
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain; (A.M.-S.); (E.C.-S.)
- Care Research Group (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Elena Chover-Sierra
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain; (A.M.-S.); (E.C.-S.)
- Internal Medicine, Consorci Hospital University of Valencia, 46014 Valencia, Spain
| | - Vicente Gea-Caballero
- Research Group Community Health and Care, International University of Valencia, 46002 Valencia, Spain;
- Faculty of Health Sciences, International University of Valencia, 46002 Valencia, Spain
| | - Pedro José Satústegui-Dordá
- SAPIENF (B53_23R) Research Group, Faculty of Health Sciences, University of Zaragoza, 50018 Zaragoza, Spain;
| | - Carles Saus-Ortega
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain;
- Research Group GREIACC, Health Research Institute La Fe, 46016 Valencia, Spain
| | - Clara Isabel Tejada-Garrido
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; (C.I.T.-G.); (I.S.-A.)
| | | | - Jesús Pérez
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (M.S.-B.); (J.P.)
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK
- Prevention and Early Intervention in Mental Health (PRINT), Biomedical Institute of Salamanca, 37008 Salamanca, Spain
| | - Raúl Juárez-Vela
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; (C.I.T.-G.); (I.S.-A.)
- Prevention and Early Intervention in Mental Health (PRINT), Biomedical Institute of Salamanca, 37008 Salamanca, Spain
| | - Iván Santolalla-Arnedo
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; (C.I.T.-G.); (I.S.-A.)
| | - Enrique Baca-García
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (P.d.P.-H.); (E.B.-G.)
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
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9
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Chow EPF, Samra RS, Bradshaw CS, Chen MY, Williamson DA, Towns JM, Maddaford K, Mercury F, Fairley CK. Mpox knowledge, vaccination and intention to reduce sexual risk practices among men who have sex with men and transgender people in response to the 2022 mpox outbreak: a cross-sectional study in Victoria, Australia. Sex Health 2023; 20:390-402. [PMID: 37423606 DOI: 10.1071/sh23075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The first mpox case was reported in May 2022 in Australia. Most cases have been diagnosed in men who have sex with men (MSM). This study aimed to examine community understanding of mpox, attitudes towards vaccination, and potential changes in sexual practices surrounding the mpox outbreak among MSM and transgender people in Victoria, Australia. METHODS Participants were recruited from sexual health clinics and communities in Victoria, Australia, in August-October 2022. Participants were asked about their understanding and knowledge of mpox, vaccination uptake and intentions to change sexual practices. Univariable and multivariable logistic regression was performed to examine the factors associated with mpox vaccine uptake. RESULTS Most participants (97.8%, 525/537) had heard about mpox and 10.5% (55/525) knew someone who had had mpox. Of the 12 mpox knowledge questions, the median score of correct answers was 10 (IQR=8-11) out of a maximum of 12. More than a third (36.6%, 191/522) had been vaccinated against mpox. MSM who had a good knowledge of mpox had the highest odds of receiving mpox vaccine compared with those who had poor knowledge (aOR=4.05; 95% CI: 1.54-10.61). To prevent mpox, half reported they would reduce having sex with casual partners, stop having chemsex (used drugs for the purpose of sex), stop attending sex-on-premises-venues, and stop having group sex. A quarter reported they would increase condom use for anal sex. CONCLUSIONS One-third of high-risk participants and a substantial proportion of participants intended to reduce or stop certain practices, which may explain the large reduction in mpox cases.
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Affiliation(s)
- Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Ranjit S Samra
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Deborah A Williamson
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia; and Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia; and Walter and Eliza Hall Institute, Melbourne, Vic., Australia
| | - Janet M Towns
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Finn Mercury
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
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10
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Zimmermann HML, Gültzow T, Marcos TA, Wang H, Jonas KJ, Stutterheim SE. Mpox stigma among men who have sex with men in the Netherlands: Underlying beliefs and comparisons across other commonly stigmatized infections. J Med Virol 2023; 95:e29091. [PMID: 37752803 DOI: 10.1002/jmv.29091] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
People with or at risk for mpox are likely to be stigmatized because of analogies to other sexually transmitted infections. Stigma is driven by beliefs about the perceived severity of the condition and perceived responsibility for acquiring the condition, both in broader society and individual responsibility. We explored these beliefs and compared them across mpox, human immunodeficiency virus (HIV), syphilis, gonorrhoea, and chlamydia in an online survey, conducted in July 2022, with 394 men-who-have-sex-with-men in the Netherlands. We compared mean scores between infections using repeated measures analysis of variance and conducted hierarchical regression analyses to identify determinants of both mpox perceived responsibility endpoints. Results showed that participants expected that mpox would be seen as a "gay disease" and will be used to blame gay men. Compared to other infections, mpox was considered less severe than HIV, but more severe than syphilis, gonorrhoea, and chlamydia. Perceived responsibility was comparable across infections, but, for each infection, participants perceived attributed responsibility to be higher in society than individual responsibility. Both perceived responsibility endpoints were highly correlated with each other and with other stigma beliefs. These results provide insight on the underlying determinants of mpox stigma and demonstrate that anticipated mpox stigma is present in the Netherlands.
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Affiliation(s)
- Hanne M L Zimmermann
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Thomas Gültzow
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Department of Theory, Methods and Statistics, Open University of the Netherlands, Heerlen, The Netherlands
| | - Tamika A Marcos
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Haoyi Wang
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Viroscience Department, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Sarah E Stutterheim
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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11
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Jiao K, Xu Y, Huang S, Zhang Y, Zhou J, Li Y, Xiao Y, Ma W, He L, Ren X, Dai Z, Sun J, Li Q, Cheng F, Liang W, Luo S. Mpox risk perception and associated factors among Chinese young men who have sex with men: Results from a large cross-sectional survey. J Med Virol 2023; 95:e29057. [PMID: 37635623 DOI: 10.1002/jmv.29057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
The mpox outbreak since 2022 had attacked the community of men who have sex with men (MSM) heavily. This large cross-sectional study investigated the levels and associated factors of mpox risk perception among young MSM (YMSM) aged 18-29 years in six provincial regions of China in September 2022. The participants were recruited via facility-based sampling. Mpox risk perception was measured by perceived susceptibility and perceived severity of mpox. Geodetector was used to measure stratified heterogeneity of mpox risk perception. Univariate and multivariable linear regressions were used to examine the factors associated with mpox risk perception. A total of 2493 participants were included with a mean age of 24.6 years. The proportion of perceiving a susceptibility of mpox under different scenarios ranged 3.7%-17.0% and that of perceiving a severity of mpox ranged 81.6%-83.2%. Stratified heterogeneity of perceived susceptibility, perceived severity, and overall perceived risk of mpox were observed in several characteristics such as study sites, monthly income, risk behaviors, and psychosocial factors. Multivariable regression showed the level of mpox risk perception was positively associated with having in-person gathering activities (ba = 0.457, 95% CI: 0.208, 0.705), history of HIV infection (ba = 0.431, 95% CI: 0.028, 0.834), depressive symptoms (ba = 0.069, 95% CI: 0.049, 0.090), and self-stigma to MSM identity (ba = 0.047, 95% CI: 0.024, 0.071). The Chinese YMSM showed a high level of perceived severity of mpox but a low level of perceived susceptibility. It is warranted to strengthen targeted risk communication of mpox, develop comprehensive and unstigmatized health messages, and provide mental health support for YMSM.
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Affiliation(s)
- Kedi Jiao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yutong Xu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Siwen Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhang Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jingtao Zhou
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yongkang Xiao
- Department of Acute Infectious Diseases Control and Prevention, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lin He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xianlong Ren
- Department of AIDS/STD Control and Prevention, Beijing Center for Disease Control and Prevention, Beijing, China
| | - Zhen Dai
- Department of AIDS/STD Control and Prevention, Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jiaruo Sun
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Qingyu Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Feng Cheng
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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12
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Starks TJ, Scales D, Castiblanco J, Gorman J, Cain D. Correlates of Mpox Vaccination among Sexual Minority Men in the United States: Sexual Behavior, Substance Use, and Main Partner Relationships. JOURNAL OF SEX RESEARCH 2023; 60:634-644. [PMID: 36920105 PMCID: PMC10175215 DOI: 10.1080/00224499.2023.2188443] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Sexual minority men (SMM) have accounted for the majority of infections during the 2022 outbreak of the orthopox virus known as mpox (previously "monkeypox") in the US. This study examined correlates of mpox vaccination. Between July 28 and September 22, 2022, adult cisgender SMM (n = 2,620) not previously diagnosed with mpox responded to recruitment advertisements on social networking applications and completed an online survey. Of these, 730 (27.9%) received at least one vaccine dose. Logistic regression indicated sex with a casual partner was positively associated with vaccination. Stimulant drug use was negatively associated with vaccination; meanwhile, the use of ecstasy, ketamine, gamma-hydroxybutyrate (GHB) or psychedelics was positively associated with vaccination. Among partnered SMM, non-monogamous sexual agreements, relationship length of ≥2 years, and relationship functioning were positively associated with vaccination. Even at low levels of relationship functioning, SMM in non-monogamous relationships of ≥2 years were more likely to be vaccinated than single SMM. At very high levels of relationship functioning, partnered SMM were more likely to be vaccinated than single SMM regardless of sexual agreement or relationship length. Findings are discussed in relation to prior research on HIV, other STI prevention, and theories of dyadic functioning and health in this population.
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Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of CUNY, New York, NY, USA
| | - David Scales
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
- Critica, The Bronx, NY, USA
| | - Juan Castiblanco
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | | | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
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13
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Zheng M, Chen W, Qian X, Tao R, Ma L, Zhou F, Zhu Z, Yao Y, Yang G. Awareness of mpox-related knowledge among men who have sex with men in China. BMC Public Health 2023; 23:600. [PMID: 36997990 PMCID: PMC10061892 DOI: 10.1186/s12889-023-15503-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/22/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND With the rapid spread of the mpox epidemic, cases have emerged in multiple countries, mainly among men who have sex with men. Because of the connectedness of today's world, countries have to be prepared to face risks in advance. Therefore, this study aimed to investigate awareness of mpox-related knowledge among men who have sex with men in China. METHODS With the assistance of the social organizations of men who have sex with men, a cross-sectional survey of men who have sex with men in China was conducted through an online questionnaire between July 1 and July 18, 2022. A nationwide sample of Chinese men who have sex with men (N = 3,257) was recruited. RESULTS Only 36.9% of participants had mpox-related knowledge. Awareness of mpox-related knowledge among respondents was positively associated with those in older age groups (33 to 42 years and 51 years or older) (adjusted odds ratio [AOR] = 1.31; 95% confidence interval [CI]: 1.03-1.67, AOR = 1.61; 95% CI: 1.16-2.24; respectively), married (AOR = 1.55; 95% CI: 1.09-2.19), and those with a graduate degree or above (AOR = 2.14; 95% CI: 1.11-4.13), while negatively associated with those living in the western parts of China (AOR = 0.74; 95% CI: 0.60-0.92), and those who were unsure of their history of Human Immunodeficiency Virus (HIV) status (AOR = 0.44; 95% CI: 0.30-0.63). CONCLUSION Mpox-related knowledge is fairly low among men who have sex with men in China. China needs to spread knowledge to the public through multiple channels, especially in key populations (men who have sex with men, HIV-infected, etc.), and take preventive measures to effectively avoid outbreaks of mpox.
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Affiliation(s)
- Min Zheng
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China
| | - Wenyan Chen
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, Guizhou, China
| | - Xiaohan Qian
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China
| | - Rui Tao
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China
| | - Lin Ma
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China
| | - Feng Zhou
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, Guizhou, China
| | - Zhilin Zhu
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, Guizhou, China
| | - Yongming Yao
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China.
| | - Guanghong Yang
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, 550004, Guizhou, China.
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, Guizhou, China.
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14
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Miraglia Del Giudice G, Della Polla G, Folcarelli L, Napoli A, Angelillo IF. Knowledge and attitudes of health care workers about monkeypox virus infection in Southern Italy. Front Public Health 2023; 11:1091267. [PMID: 36923038 PMCID: PMC10009274 DOI: 10.3389/fpubh.2023.1091267] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Background This present survey sought to investigate the level of knowledge and the attitudes pertaining the monkeypox (mpox) virus infection among a sample of health care workers (HCWs) in Italy, as well as the possible role of different factors on these outcomes. Methods The cross-sectional survey was performed from July through October, 2022 at four randomly selected hospitals located in Southern Italy. Results The questionnaire was completed by 421 HCWs, for an overall 59% response rate. Less than two-thirds were able to define the disease and the correct answer of the transmission mechanisms ranged from 22.8% for contact with contaminated objects to 75.8% through close contact with body fluids. Only 4% and 12.8% indicated HCWs and elderly/frail/people with underlying immune deficiencies as risk groups. The mean overall score of the knowledge assessment on mpox was 3.4 (0-9). The multivariate logistic regression analysis showed that HCWs with a lower number of years of working experience and those who had acquired information about mpox from scientific journals were more likely to have a higher level of knowledge. The average score of the perception of the severity of the disease was 6.3. A similar score with a value of 6.1 has been observed for the statement that mpox is a serious problem for the population. Regarding the level of concern about contracting mpox, the mean score was 5.1. Only 10.5% reported that they feel that this disease can be prevented, with an overall mean score of 6.5. Almost all HCWs reported that they are still living as usual, with no modification of their behavior for fear of contracting the mpox. The results of the multivariate logistic regression model showed that women, HCWs with a higher level of knowledge about mpox, and those who needed additional information about mpox were more likely to have a higher level of perception of the severity of the disease. Conclusion This survey has demonstrated that HCWs had an unsatisfactory level of knowledge toward mpox and only nearly half showed positive attitudes. Strategic health training programs should be made so that knowledge can be acquired.
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Affiliation(s)
| | - Giorgia Della Polla
- Department of Public Health and Laboratory Services, Teaching Hospital of the University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lucio Folcarelli
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Annalisa Napoli
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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15
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Vallée A. Sexual behaviors, cannabis, alcohol and monkeypox infection. Front Public Health 2022; 10:1054488. [PMID: 36733281 PMCID: PMC9887129 DOI: 10.3389/fpubh.2022.1054488] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
The emergence of the monkeypox virus (MPXV) outbreak in 2022 is a worldwide health issue. The rapid increase of monkeypox cases caused the WHO to designate the escalating global monkeypox outbreak a Public Health Emergency of International Concern on July 23, 2022. The WHO has called on the group currently most affected by the virus, men who have sex with men (MSM), to limit their sexual partners. The diminution in number of sexual partners not only decreases the proportion of infected MSM but could also increases the number of days needed to reach a given infection level among the general population. Several behavioral factors could be associated with high levels of different sexual partners, such as cannabis use and alcohol consumption. Firstly, this review focuses on the association between cannabis and alcohol consumption and the number of sexual partners, and their possible impact on the current MPXV outbreak by impairing the immune responses. Secondly, this review investigated in the UK Biobank cohort the relationship between alcohol and cannabis use and the number of sexual partners. Among the 115,604 participants, 1.8% declared to be MSM, 1.9% to be WSW (women having sex with women), 43.3% men heterosexuals and 53.0% women heterosexuals. MSM and WSW showed higher lifetime sexual partners (N = 17.4 (SD:17.52) and N = 13.65 (SD: 13.21), respectively) compared to heterosexual men (N = 6.89 (SD: 9.47) and women (N = 5.19 (SD:6.56), p < 0.001. After adjustment for age, body mass index, lifetime sexual activity, educational and income levels, tobacco and cardiovascular diseases, cannabis use and alcohol consumption remained significantly associated with increase in the number of different sexual partners in all four subgroups. Thus, cannabis use and alcohol consumption may have two detrimental effects on the MPXV outbreak: by participating in the increase of the number of sexual partners which are mainly responsible for the augmentation of the number of new MPXV infected cases and by impairing the immune response to a viral infection. Health and safety policies should address the factors and practices, including chemsex, leading to an increase in risk of sexual behaviors responsible for MPXV dissemination in the worldwide population.
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