Knowledge of Human Mpox (Monkeypox) and Attitude towards Mpox Vaccination among Male Sex Workers in China: A Cross-Sectional Study

Abstract

Background: Re-emerging human mpox (previously known as monkeypox) is spreading around the world. According to existing studies, the current mpox pandemic mainly affects men who have sex with men (MSM), including male sex workers (MSW). Our study aimed to assess mpox knowledge and attitude towards mpox vaccination among MSW in China. Methods: A web-based, cross-sectional survey was conducted in August 2022. We collected participants’ socio-demographic characteristics and knowledge with 15 knowledge items related to mpox. Modified Bloom’s cut-off points of 80% (total score > 12) was used to indicate good knowledge. Multivariable regression analysis was used to assess factors of mpox knowledge and attitude towards mpox vaccination. Results: A total of 154 MSW were recruited (age: median = 22, interquartile range, IQR = 12). Of the 154 MSW, 49.4% had good knowledge of mpox, and 63.0% were willing to be vaccinated against mpox. We found that good knowledge was associated with being single [adjusted odds ratio (AOR) = 2.46, 95% confident interval (CI) (1.22–4.87)], being unemployed [5.01, 1.21–20.70] and willingness to be vaccinated [2.51, 1.14–5.54]. Willingness to get vaccinated was related to age [1.06, 1.00–1.12], chronic diseases history [8.53, 1.01–71.68], and agreement with “priority for high-risk groups if mpox vaccine is in short supply” [2.57, 1.01–6.54]. Conclusions: We found that MSW had suboptimal mpox knowledge and a high willingness to be vaccinated against mpox. MSW who are single and willing to be vaccinated may have good knowledge of mpox. These findings underscore the necessity of providing health education on mpox among MSW. When the mpox vaccine is in short supply, priority should be given to high-risk groups, such as MSW.

Mpox patients' experience from infection to treatment and implications for prevention and control: A multicenter qualitative study in China

“…Compared with previous research, 36,37 patients in our interviews had poorer knowledge of mpox, limited to the name of the disease and the basic symptom of rash. Common initial symptoms included mild rashes and fever, aligning with previous findings.…”

“…This suggests that mpox may be spreading beyond high‐risk groups to the general population, highlighting the need to update guidelines for screening and epidemiological investigations. Compared with previous research, 36,37 patients in our interviews had poorer knowledge of mpox, limited to the name of the disease and the basic symptom of rash. Common initial symptoms included mild rashes and fever, aligning with previous findings 38 .…”

Knowledge, concerns, and vaccine acceptance related to Mpox (Monkeypox) among university students in North and Northeast China: An online cross-sectional study

“… 23 Several other studies in China focused on healthcare workers, 24 , 25 the general public, 26–28 or MSM. 29–33 These findings indicated that the general population 26 , 27 and MSM population 29–32 in China had limited knowledge level of Mpox, while the knowledge level of Mpox was high in healthcare workers. 24 Moreover, Chinese individuals had a relatively strong willingness to vaccinate against Mpox.…”

“… 24 Moreover, Chinese individuals had a relatively strong willingness to vaccinate against Mpox. 24–26 , 28 , 29 Only one study reported a high knowledge level of Mpox among the Chinese population, which might be due to large selection bias resulting from a small sample size ( N = 521). 28 At present, there were few studies on the level of concern about Mpox in the Chinese population, the rates of which varied from 37.1% to 62.7%.…”

Prevalence of intentions to receive monkeypox vaccine. A systematic review and meta- analysis

“…Analyzing the data by continent, the following vaccination intention prevalences were found: In Asian countries, it was 64% (95% CI: 53-74%; 13883 participants; 17 studies; I 2 = 99%) (17, 18, 20, 22, 24-27, 29, 34, 35, 37, 39-42, 44); in African countries, it was 43% (95% CI: 39-47%; 1538 participants; 3 studies; I 2 = 53%) (19,23,28); in European countries, it was 62% (95% CI: 45-78%; 35811 participants; 6 studies; I 2 = 99%) (21, 30-32, 36, 38); and in American countries, it was 63% (95% CI: 32-89%; 1426 participants; 3 studies; I 2 = 99%) (16, 33, 43) (Figure S2). Furthermore, when focusing on the target population of the studies, the following vaccination intention prevalences against Mpox were observed: among the general population, it was 54% (95% CI: 45-62%; 10296 participants; 11 studies; I 2 = 99%) (18, 19,22,23,25,26,29,[39][40][41]43); among healthcare workers, it was 57% (95% CI: 33-79%; 3333 participants; 10 studies; I 2 = 99%) (17,24,28,30,33,35,37,38,42,44); and among the LGBTI community, it was 76% (95% CI: 70-82%;39029 participants; 8 studies; I 2 = 98%) (16, 20,21,27,31,32,34,36) (Figure S4).…”