The prevalence of mpox and its association with sexual behavior among Chinese men who have sex with men in early August 2023

Abstract

Study investigating mpox infection and its association with sexual behavior among men who have sex with men (MSM) in China was lacking. This observational survey aimed to provide evidence on detail characteristics of mpox cases and sexual behavior, then analyze their relationship among MSM in China to help formulate prevention and control policies. An anonymous cross‐sectional study was conducted in 27 MSM social organizations across 21 provinces, municipalities, and autonomous regions from July 31 to August 4, 2023. A safe sexual behavior index was constructed based on three risky sexual behaviors in the last month, including condomless anal intercourse, commercial sex and group sex. High safe sexual behavior indicated that the participant engaged in none of the three, and low safe sexual behavior indicated that they engaged in all three behaviors; otherwise, moderate safe sexual behavior was indicated. Among 7538 MSM, the prevalence of mpox was 0.73% (55/7538). The proportion of high safe sexual behavior was 79.64% (6003/7538). The crude prevalence of mpox was lower in the high safe sexual behavior group (0.35%, 21/6003), compared with the low (12.12%, 8/66) and moderate safe (1.78%, 26/1469) sexual behavior group. In the multivariable‐adjusted analysis, after adjusting for all covariates, compared with low safe sexual behavior group, moderate safe sexual behavior group (aOR = 0.21; 95% CI = 0.08, 0.54) and high safe sexual behavior group (aOR = 0.04; 95% CI = 0.02, 0.12) both had lower risk of mpox. Of three sexual behaviors, MSM who reported no commercial sex had the lowest risk of mpox (aOR = 0.23; 95% CI = 0.13, 0.41), compared with those who reported commercial sex in the last month. The other two safe sexual behaviors both were associated with lower risk of mpox (no group sex vs. group sex: aOR = 0.15; 95% CI = 0.08, 0.28; no condomless anal intercourse vs. condomless anal intercourse: aOR = 0.23; 95% CI = 0.13, 0.41). The prevalence of mpox virus infection was nearly 1% among MSM in China. Strengthening mpox surveillance, emphasizing safe sexual behavior in health education are essential for the control of mpox among MSM in China.

Prevention of sexual transmission of mpox: a systematic review and qualitative evidence synthesis of approaches

“…We identified three studies meeting the inclusion criteria for question 1 (see Table 1 ). One retrospective observational study conducted in the US [ 16 ] examined contact tracing, while the other two cross-sectional studies [ 17 , 18 ] investigated specific sexual behaviours. All three studies included exclusively male participants, predominantly MSM, who self-reported their sexual behaviour.…”

“…Du et al. [ 18 ] investigated the association between sexual behaviour and mpox prevalence amongst men. They developed an index of safe sex behaviour based on three behaviours: condomless anal sex, commercial sex, and group sex.…”

“…Were co-Interventions similar between groups? Cope et al., 2023 [ 16 ] Definitely no Probably yes Definitely yes Definitely no Definitely no Probably no Probably yes Definitely no Du et al., [ 18 ] Definitely no Probably yes Probably yes Mostly yes Probably yes Probably yes Probably yes Definitely no Ghosn et al., 2023 [ 17 ] Definitely no Definitely yes Probably yes Mostly no Probably no Definitely yes Probably yes Definitely no Note: Response options: definitely yes (low risk of bias); probably yes; probably no; definitely no (high risk of bias). …”

Intentions of healthcare seeking and self-isolation for MPOX among men who have sex with men in China: a national cross-sectional study

“…Our study reveals a concerning trend as individuals engaging in risky sexual behaviour, including activities such as having multiple partners and engaging in group sex in the past 3 months, demonstrate hesitancy in seeking medical attention or practicing self-isolate even when there is clear evidence of an increased risk of MPOX infection [ 12 , 13 , 21 ]. This highlights a gap in MPOX prevention efforts and underscores the necessity for targeted interventions to promote safer sexual practices.…”