Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Location
2.3. Population, Sample, and Inclusion Criteria
2.4. Data Collection Procedures
2.5. Collection Instrument
2.6. Variables
- (1)
- Dependent variable: Dichotomous outcome (yes or no) for the intention to get vaccinated against Mpox, if a vaccine were available.
- (2)
- Independent variables:
- (a)
- Sociodemographic data: Variables analyzed included age, gender identity, sexual orientation, marital status, race/skin color, education level, formal income, and COVID-19 vaccination status.
- (b)
- Sexual behaviors and practices: Variables included sexual partnerships (fixed and casual); having unprotected sex (bareback); participation in chemsex, cruising, and orgies; and the frequency of using saunas and apps to find sexual partners.
- (c)
- Beliefs and information about Mpox: Beliefs about Mpox impact, previous diagnosis, intimate contact with diagnosed individuals, and fear of discrimination by healthcare services, friends, or family were included.
- (a)
- Double penetration (DP): simultaneous sexual penetration by two or more penises.
- (b)
- Challenging sexual practice: consistent engagement in two or three of these practices, defined by the circumstances in which they occur.
- (c)
- Fisting or footing: anal penetration using the fist or foot.
- (d)
- Cruising: free, consensual, and anonymous sex practiced between men in public spaces such as parks, forests, beaches, or parking lots.
- (e)
- Glory hole: a round opening in a wall that allows the insertion of the penis, so someone on the other side can engage with it sexually in various ways.
- (f)
- Bugchasing: when an HIV-negative man deliberately seeks out an HIV-positive man to become infected [34].
2.7. Data Analysis
2.8. Ethical Considerations
3. Results
4. Discussion
5. Contributions to Public Health
6. Limitations
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Vaccine Hesitancy for Mpox | p-Value | ||||
---|---|---|---|---|---|---|
Yes | No | |||||
(n = 102) | (n = 1347) | |||||
n | % | n | % | |||
Sociodemographic data | ||||||
Young adult (<30 years) | Yes | 41 | 6.3 | 613 | 93.7 | 0.305 |
No | 61 | 7.7 | 734 | 92.3 | ||
Gender identity | Trans | 2 | 4.1 | 47 | 95.9 | 0.575 |
Cis | 100 | 7.1 | 1300 | 92.9 | ||
Homosexual orientation | Yes | 87 | 7.1 | 1135 | 92.9 | 0.888 |
No | 15 | 6.6 | 212 | 93.4 | ||
Marital status | Single | 75 | 6.9 | 1019 | 93.1 | 0.633 |
With a partner | 27 | 7.6 | 326 | 92.4 | ||
Race or skin color | Non-white | 62 | 7.2 | 805 | 92.8 | 0.917 |
White | 40 | 6.9 | 542 | 93.1 | ||
Religion | Yes | 57 | 7.9 | 660 | 92.1 | 0.215 |
No | 44 | 6.1 | 672 | 93.9 | ||
Higher education | Yes | 86 | 6.7 | 1190 | 93.3 | 0.265 |
No | 16 | 9.2 | 157 | 90.8 | ||
Formal income | Yes | 71 | 6.7 | 990 | 93.3 | 0.417 |
No | 31 | 8.0 | 357 | 92.0 | ||
Was immunized against COVID-19 | Yes | 102 | 7.0 | 1345 | 93.0 | 1.000 |
No | 0 | 0 | 2 | 100.0 | ||
Sexual behaviors and practices | ||||||
Type of sexual partnership (last 6 months) | No partners | 7 | 7.9 | 82 | 92.1 | 0.813 |
Fixed | 29 | 7.7 | 348 | 92.3 | ||
Fixed + casual | 66 | 6.8 | 905 | 93.2 | ||
Stopped casual sex after the Mpox outbreak | Yes | 55 | 6.9 | 744 | 93.1 | 0.837 |
No | 47 | 7.2 | 603 | 92.8 | ||
Bareback practice | Yes | 43 | 5.3 | 765 | 94.7 | 0.005 |
No | 59 | 9.2 | 582 | 90.8 | ||
Chemsex practice | Yes | 27 | 9.6 | 255 | 90.4 | 0.070 |
No | 75 | 6.4 | 1092 | 93.6 | ||
Cruising practice | Yes | 13 | 6.9 | 176 | 93.1 | 1.000 |
No | 89 | 7.1 | 1171 | 92.9 | ||
Challenging sexual practices | Yes | 20 | 8.9 | 204 | 91.1 | 0.255 |
No | 82 | 6.7 | 1143 | 93.3 | ||
Bugchasing practice | Yes | 20 | 15.9 | 106 | 84.1 | <0.001 |
No | 82 | 6.2 | 1241 | 93.8 | ||
Participates in orgies | Yes | 10 | 6.2 | 151 | 93.8 | 0.746 |
No | 92 | 7.1 | 1196 | 92.9 | ||
Use of glory hole | Yes | 2 | 2.1 | 93 | 97.9 | 0.059 |
No | 100 | 7.4 | 1254 | 92.6 | ||
Use of apps to seek sex | Yes | 54 | 6.6 | 767 | 93.4 | 0.469 |
No | 48 | 7.6 | 580 | 92.4 | ||
Use of saunas to seek sex | Yes | 7 | 3.2 | 210 | 96.8 | 0.020 |
No | 95 | 7.7 | 1137 | 92.3 | ||
Seeking sex in public places (parties and clubs) | Yes | 23 | 5.1 | 430 | 94.9 | 0.059 |
No | 79 | 7.9 | 917 | 92.1 | ||
Beliefs and information about Mpox | ||||||
Previous Mpox diagnosis | Yes | 19 | 9.0 | 192 | 91.0 | 0.243 |
No | 83 | 6.7 | 1155 | 93.3 | ||
Knows close people who have been diagnosed with Mpox | Yes | 14 | 3.8 | 355 | 96.2 | 0.006 |
No | 88 | 8.1 | 992 | 91.9 | ||
Intimate contact with a person diagnosed with Mpox | Yes | 19 | 10.9 | 156 | 89.1 | 0.041 |
No | 83 | 6.5 | 1191 | 93.5 | ||
Would disclose Mpox serological status | Yes | 72 | 6.3 | 1067 | 93.7 | 0.044 |
No | 30 | 9.7 | 278 | 90.3 | ||
Fear of being discriminated against by healthcare services | Yes | 55 | 6.8 | 755 | 93.2 | 0.679 |
No | 47 | 7.4 | 586 | 92.6 | ||
Fear of being discriminated against by friends | Yes | 65 | 6.9 | 883 | 93.1 | 0.746 |
No | 37 | 7.4 | 464 | 92.6 | ||
Fear of being discriminated against by family | Yes | 54 | 7.3 | 689 | 92.7 | 0.759 |
No | 48 | 6.8 | 658 | 93.2 | ||
Belief that one might suffer homophobia because of Mpox | Yes | 68 | 5.6 | 1150 | 94.4 | <0.001 |
No | 34 | 14.8 | 195 | 85.2 | ||
Would undergo pre- and post-exposure testing for Mpox | Yes | 50 | 4.1 | 1166 | 95.9 | <0.001 |
No | 33 | 30.3 | 76 | 69.7 | ||
If there are specialized centers and/or testing services for Mpox, would you seek out one of these health services? | Yes | 86 | 6.2 | 1310 | 93.8 | <0.001 |
No | 16 | 30.2 | 37 | 69.8 | ||
If you are diagnosed with Mpox, would you take steps to take care of yourself and inform the people you have been in contact with? | Yes | 89 | 6.4 | 1298 | 93.6 | <0.001 |
No | 13 | 21.0 | 49 | 79.0 | ||
If you are diagnosed with Mpox, would you follow the treatment or recommendations of healthcare professionals? | Yes | 98 | 6.9 | 1331 | 93.1 | 0.047 |
No | 4 | 20.0 | 16 | 80.0 |
Variables | β | aOR | CI95% | p-Value | VIF | Tolerance | |
---|---|---|---|---|---|---|---|
Lower | Superior | ||||||
Not using a glory hole | 2.99 | 19.82 | 1.60 | 245.69 | 0.020 | 1.11 | 0.90 |
Would not undergo pre- and post-exposure testing for Mpox | 2.25 | 9.54 | 5.52 | 16.48 | <0.001 | 1.02 | 0.98 |
Would not seek out specialized centers and testing services for Mpox | 1.81 | 6.09 | 2.62 | 14.13 | <0.001 | 1.07 | 0.94 |
Not knowing close people who have been diagnosed with Mpox | 1.41 | 4.09 | 1.72 | 9.73 | <0.001 | 1.01 | 0.99 |
Would not take steps to take care of yourself and communicate with people you have been in contact with if diagnosed with Mpox | 1.10 | 3.00 | 1.27 | 7.07 | 0.012 | 1.08 | 0.93 |
Would not disclose Mpox serological status | 0.66 | 1.93 | 1.13 | 3.30 | 0.001 | 1.03 | 0.97 |
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Santos, G.R.d.S.; Ribeiro, C.J.N.; Santos Júnior, J.F.C.d.; Almeida, V.S.; Nascimento, R.d.C.D.; Barreto, N.M.P.V.; Sousa, A.R.d.; Bezerra-Santos, M.; Cepas, L.A.; Fernandes, A.P.M.; et al. Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study. Vaccines 2024, 12, 1229. https://doi.org/10.3390/vaccines12111229
Santos GRdS, Ribeiro CJN, Santos Júnior JFCd, Almeida VS, Nascimento RdCD, Barreto NMPV, Sousa ARd, Bezerra-Santos M, Cepas LA, Fernandes APM, et al. Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study. Vaccines. 2024; 12(11):1229. https://doi.org/10.3390/vaccines12111229
Chicago/Turabian StyleSantos, Guilherme Reis de Santana, Caíque Jordan Nunes Ribeiro, José Flávio Cerqueira dos Santos Júnior, Valdemar Silva Almeida, Rita de Cassia Dias Nascimento, Nilo Manoel Pereira Vieira Barreto, Anderson Reis de Sousa, Márcio Bezerra-Santos, Lariane Angel Cepas, Ana Paula Morais Fernandes, and et al. 2024. "Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study" Vaccines 12, no. 11: 1229. https://doi.org/10.3390/vaccines12111229
APA StyleSantos, G. R. d. S., Ribeiro, C. J. N., Santos Júnior, J. F. C. d., Almeida, V. S., Nascimento, R. d. C. D., Barreto, N. M. P. V., Sousa, A. R. d., Bezerra-Santos, M., Cepas, L. A., Fernandes, A. P. M., Mendes, I. A. C., Santos Júnior, A. G. d., Maronesi, M. L. P., & Sousa, Á. F. L. d. (2024). Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study. Vaccines, 12(11), 1229. https://doi.org/10.3390/vaccines12111229