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RESEARCH ARTICLE (Open Access)

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

Eric P. F. Chow https://orcid.org/0000-0003-1766-0657 A B C * , Ranjit S. Samra A , Catriona S. Bradshaw https://orcid.org/0000-0002-6643-5678 A B C , Marcus Y. Chen https://orcid.org/0000-0002-8924-2043 A B , Deborah A. Williamson https://orcid.org/0000-0001-7363-6665 D E F , Janet M. Towns https://orcid.org/0000-0003-2714-4680 A B , Kate Maddaford https://orcid.org/0000-0001-5213-1289 A B , Finn Mercury A and Christopher K. Fairley https://orcid.org/0000-0001-9081-1664 A B
+ Author Affiliations
- Author Affiliations

A Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.

B Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.

C Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.

D Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia.

E Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia.

F Walter and Eliza Hall Institute, Melbourne, Vic., Australia.

* Correspondence to: eric.chow@monash.edu

Handling Editor: Jason Ong

Sexual Health 20(5) 390-402 https://doi.org/10.1071/SH23075
Submitted: 13 April 2023  Accepted: 8 June 2023  Published: 10 July 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

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.

Keywords: control, epidemiology, gay men, harm reduction, monkeypox, mpox, outbreak, prevention, sexual behaviour, sexual practice, sexually transmitted disease, sexually transmitted infection, STIs, vaccination, vaccine.

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