COVID-19 infection and vaccination uptake in men and gender-diverse people who have sex with men in the UK: analyses of a large, online community cross-sectional survey (RiiSH-COVID) undertaken November–December 2021

Abstract

Background Men and gender-diverse people who have sex with men are disproportionately affected by health conditions associated with increased risk of severe illness due to COVID-19 infection. Methods An online cross-sectional survey of men and gender-diverse people who have sex with men in the UK recruited via social networking and dating applications from 22 November-12 December 2021. Eligible participants included self-identifying men, transgender women, or gender-diverse individuals assigned male at birth (AMAB), aged ≥ 16, who were UK residents, and self-reported having had sex with an individual AMAB in the last year. We calculated self-reported COVID-19 test-positivity, proportion reporting long COVID, and COVID-19 vaccination uptake anytime from pandemic start to survey completion (November/December 2021). Logistic regression was used to assess sociodemographic, clinical, and behavioural characteristics associated with SARS-CoV-2 (COVID-19) test positivity and complete vaccination (≥ 2 vaccine doses). Results Among 1,039 participants (88.1% white, median age 41 years [interquartile range: 31-51]), 18.6% (95% CI: 16.3%-21.1%) reported COVID-19 test positivity, 8.3% (95% CI: 6.7%-10.1%) long COVID, and 94.5% (95% CI: 93.3%-96.1%) complete COVID-19 vaccination through late 2021. In multivariable models, COVID-19 test positivity was associated with UK country of residence (aOR: 2.22 [95% CI: 1.26-3.92], England vs outside England) and employment (aOR: 1.55 [95% CI: 1.01-2.38], current employment vs not employed). Complete COVID-19 vaccination was associated with age (aOR: 1.04 [95% CI: 1.01-1.06], per increasing year), gender (aOR: 0.26 [95% CI: 0.09-0.72], gender minority vs cisgender), education (aOR: 2.11 [95% CI: 1.12-3.98], degree-level or higher vs below degree-level), employment (aOR: 2.07 [95% CI: 1.08-3.94], current employment vs not employed), relationship status (aOR: 0.50 [95% CI: 0.25-1.00], single vs in a relationship), COVID-19 infection history (aOR: 0.47 [95% CI: 0.25-0.88], test positivity or self-perceived infection vs no history), known HPV vaccination (aOR: 3.32 [95% CI: 1.43-7.75]), and low self-worth (aOR: 0.29 [95% CI: 0.15-0.54]). Conclusions In this community sample, COVID-19 vaccine uptake was high overall, though lower among younger age-groups, gender minorities, and those with poorer well-being. Efforts are needed to limit COVID-19 related exacerbation of health inequalities in groups who already experience a greater burden of poor health relative to other men who have sex with men.

Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022

“…In our study, participants with lower educational qualifications and those without employment reported lower vaccine uptake, differences that we also found in sensitivity analyses restricted to vaccine-eligible participants. Those findings mirrored COVID-19 vaccine uptake inequalities identified in the previous RiiSH survey; during that survey period (December 2021), COVID-19 vaccination was widely accessible in the United Kingdom ( 27 ). We found bisexual and straight-identifying participants also were less likely to report mpox vaccination, consistent with findings in a smaller cross-sectional study exploring mpox vaccination uptake ( 24 ).…”

“…Fourth, given higher educational attainment and employment, RiiSH-Mpox participants might represent a more health-literate sample relative to national probability survey estimates in GBMSM ( 41 ). Prior RiiSH cross-sectional samples reported near universal uptake of complete COVID-19 vaccination ( 27 ). Thus, although RiiSH-Mpox participants might not be representative of all GBMSM in the United Kingdom, our study sample likely represents key groups targeted for mpox vaccination and vaccination for other sexually transmissible pathogens, such as hepatitis A.…”

Factors associated with human papillomavirus, hepatitis A, hepatitis B and mpox vaccination uptake among gay, bisexual and other men who have sex with men in the UK – findings from the large community-based RiiSH-Mpox survey

“…This study used data collected by the 2022 round of the ‘Reducing inequalities in Sexual Health during the mpox outbreak’ (RiiSH-mpox) survey, part of a series of cross-sectional community-based surveys first run in 2017 13 . The RiiSH surveys focus on health and wellbeing, sexual risk behaviours, and use of SHS amongst GBMSM, and have been used to improve understanding of the factors underlying STI trends among GBMSM in the UK 14,15 . RiiSH-Mpox included questions on these core topics as well as mpox vaccine uptake during the 2022 mpox outbreak.…”

Predicting the Influences of Depression and Sexual Stigma on Motivation to Get Vaccinated against COVID-19 in Lesbian, Gay, and Bisexual Young Adults: A 4-Year Follow-Up Study

“…Multiple studies have identified several common factors associated with MoVAC-19 in both LGB individuals and the general population. These factors include male sex, older age, educational attainment beyond an undergraduate degree, being in a relationship, being employed, holding positive attitudes toward the safety of COVID-19 vaccines, a positive HIV status, a negative COVID-19 infection history, and having chronic physical illnesses [ 5 , 14 , 17 , 18 , 19 ]. The WHO also recommended the individuals with significant comorbidities (e.g., diabetes, heart disease, serious immunocompromising conditions, severe obesity, and pregnancy) as the high priority group for vaccination [ 20 ].…”