Mpox (monkeypox) knowledge, concern, willingness to change behaviour, and seek vaccination: results of a national cross-sectional survey
James MacGibbon
A * , Vincent J. Cornelisse B C , Anthony K. J. Smith A , Timothy R. Broady A , Mohamed A. Hammoud B , Benjamin R. Bavinton B , Dash Heath-Paynter D , Matthew Vaughan E , Edwina J. Wright F G H and Martin Holt A
A Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia.
B Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
C NSW Health, Sydney, NSW, Australia.
D Health Equity Matters, Sydney, NSW, Australia.
E ACON, Sydney, NSW, Australia.
F Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia.
G Burnet Institute, Melbourne, Vic., Australia.
H The Peter Doherty Institute of Infection and Immunity, Melbourne, Vic., Australia.
Abstract
In mid-2022, a global mpox (formerly ‘monkeypox’) outbreak affecting predominantly gay and bisexual men emerged in non-endemic countries. Australia had never previously recorded mpox cases and there was no prior research on knowledge or attitudes to mpox among gay and bisexual men across Australia.
We conducted a national, online cross-sectional survey between August 2022 and September 2022. Participants were recruited through community organisation promotions, online advertising, and direct email invitations. Eligible participants were gay, bisexual or queer; identified as male (cisgender or transgender) or non-binary; aged 16 years or older; and lived in Australia. The main outcome measures were: knowledge and concern about mpox; recognition of mpox symptoms and transmission routes; vaccination history; acceptability of behavioural changes to reduce mpox risk, and willingness to be vaccinated.
Of 2287 participants, most participants were male (2189/2287; 95.7%) and gay (1894/2287; 82.8%). Nearly all had heard about mpox (2255/2287; 98.6%), and the majority were concerned about acquiring it (1461/2287; 64.4%). Most of the 2268 participants not previously diagnosed with mpox correctly identified skin lesions (2087; 92%), rash (1977; 87.2%), and fever (1647; 72.6%) as potential symptoms, and prolonged and brief skin-to-skin contact as potential ways to acquire mpox (2124, 93.7%; and 1860, 82%, respectively). The most acceptable behavioural changes were reducing or avoiding attendance at sex parties (1494; 65.9%) and sex-on-premises venues (1503; 66.4%), and having fewer sexual partners (1466; 64.6%). Most unvaccinated and undiagnosed participants were willing to be vaccinated (1457/1733; 84.1%).
People at risk of mpox should be supported to adopt acceptable risk reduction strategies during outbreaks and to seek vaccination.
Keywords: attitudes, Australia, gay and bisexual men, men who have sex with men, monkeypox, mpox, sexual behaviour, sexual practice, sexually transmissible infection, vaccination, vaccine.
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