Mpox vaccination coverage among Australian gay and bisexual men and non-binary people: Results of behavioural surveillance in early 2024.

We examined characteristics associated with mpox vaccine uptake among gay, bisexual, queer and other men who have sex with men and non-binary people (GBQ+ people), the primary target group for Australian vaccination programs following the mid-2022 outbreak. Vaccine uptake was assessed using cross-sectional surveys of GBQ+ people from three Australian jurisdictions in 2024: Australian Capital Territory, New South Wales, and Victoria. Sexually active, mpox-undiagnosed participants were included. Multivariable logistic regression examined: (1) no vaccination vs. partial/full vaccination, and (2) partial vs. full vaccination. Among 4252 participants, 46.2 % were unvaccinated, 12.3 % had received one vaccine dose, and 41.5 % had received two doses. Any vaccination was associated with: being >30 years old, being university-educated, being in a relationship, greater GBQ+ social engagement, being a PrEP user or person living with HIV vs. an HIV-negative non-PrEP-user, testing for HIV in the last year vs. >12 months ago, being diagnosed with chlamydia ≤12 months ago, having 2-10 recent sexual partners or > 10 partners vs. one recent partner, and meeting sex partners at sex venues and overseas. No vaccination was associated with: being bisexual vs. gay, being born in Asia or Latin America vs. Australia, and living in outer metropolitan or regional/remote areas vs. inner metropolitan areas. Compared to partial vaccination, full vaccination was associated with: being >30 years old, being a transgender vs. cisgender man, being university educated, and having >10 recent sexual partners vs. one. Socially and clinically engaged gay men were more likely to be vaccinated against mpox. Younger participants, bisexual participants, those born in Asia and Latin America, and those living outside inner metropolitan areas were less likely to be vaccinated. We recommend targeted messaging and outreach to increase vaccination among people who attend sexual health services less frequently and those less socially engaged with QBQ+ people.

MacGibbon J ，Storer D ，Bavinton BR ，Cornelisse VJ ，Broady TR ，Chan C ，Smith AKJ ，Rule J ，Mao L ，Holt M ... -  《-》

Suspected Mpox Symptoms and Testing in Men Who Have Sex With Men in the United States: Cross-Sectional Study.

The 2022 mpox outbreak in the United States disproportionately affected gay, bisexual, and other men who have sex with men (GBMSM). Uptake of mpox testing may be related to symptomology, sociodemographic characteristics, and behavioral characteristics. This study aimed to describe suspected mpox symptoms and testing uptake among a sample of GBMSM recruited via the internet in the United States in August 2022. We conducted a rapid internet-based mpox survey from August 5 to 15, 2022, among cisgender men 15 years and older who had previously participated in the 2021 American Men's Internet Survey. We estimated the prevalence of suspected mpox symptoms (fever or rash or sores with unknown cause in the last 3 mo) and uptake of mpox testing. We calculated adjusted prevalence ratios (aPRs) and 95% CIs for associations between participant characteristics and suspected mpox symptoms and summarized characteristics of GBMSM reporting mpox testing. Among symptomatic GBMSM who did not receive mpox testing, we described testing self-efficacy, barriers, and facilitators. Of 824 GBMSM, 126 (15.3%) reported at least 1 mpox symptom in the last 3 months; 58/126 (46%) with rash or sores, 57 (45.2%) with fever, and 11 (8.7%) with both. Increased prevalence of suspected mpox symptoms was associated with condomless anal sex (CAS; aPR 1.53, 95% CI 1.06-2.20). Mpox testing was reported by 9/824 GBMSM (1%), including 5 with symptoms. Most GBMSM reporting mpox testing were non-Hispanic White men (7/9 vs 1 Black and 1 Hispanic or Latino man), and all 9 lived in urban areas. Most reported having an sexually transmitted infections test (8/9), 2 or more partners (8/9), CAS (7/9), and group sex (6/9) in the last 3 months. Of those tested, 3 reported living with HIV and all were on treatment, whereas the remaining 6 men without HIV reported current pre-exposure prophylaxis (PrEP) use. Of symptomatic GBMSM who did not report mpox testing, 47/105 (44.8%) had low mpox testing self-efficacy. Among those with low self-efficacy, the most common barriers to testing were not knowing where to get tested (40/47, 85.1%) and difficulty getting appointments (23/47, 48.9%). Among those with high testing self-efficacy (58/105, 55.2%), the most common facilitators to testing were knowing where to test (52/58, 89.7%), convenient site hours (40/58, 69%), and low-cost testing (38/58, 65.5%). While all GBMSM who reported testing for mpox were linked to HIV treatment or PrEP, those with symptoms but no mpox testing reported fewer such links. This suggests targeted outreach is needed to reduce structural barriers to mpox services among GBMSM in rural areas, Black and Hispanic or Latino GBMSM, and GBMSM living with HIV. Sustaining and scaling community-tailored messaging to promote testing and vaccination represent critical interventions for mpox control among GBMSM in the United States.

Atkins K ，Carpino T ，Rao A ，Sanchez T ，Edwards OW ，Hannah M ，Sullivan PS ，Ogale YP ，Abara WE ，Delaney KP ，Baral SD ... -  《JMIR Public Health and Surveillance》

Temporary adaptations to sexual behaviour during the mpox outbreak in 23 countries in Europe and the Americas: findings from a retrospective cross-sectional online survey.

Prochazka M ，Vinti P ，Hoxha A ，Seale A ，Mozalevskis A ，Lewis R ，Sagastume RM ，Scherzer M ，Dore L ，Doherty M ... -  《-》

Increasing event-driven HIV pre-exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019-2023.

HIV pre-exposure prophylaxis (PrEP) has been publicly available since 2018 in Australia as a daily regimen. In 2019, clinical guidelines were updated to support guidance on event-driven PrEP (ED-PrEP) use. We assessed trends in the PrEP dosing regimen by comparing daily PrEP use to ED-PrEP among cisgender gay, bisexual and other men who have sex with men (GBMSM). Data from repeated, cross-sectional, national behavioural surveillance surveys were analysed from 2019 to 2023 among participants not living with HIV. Logistic regression models were conducted to assess trends and compared ED-PrEP users to non-PrEP users and daily PrEP. Among 38,880 participants, overall PrEP use with any regimen increased from 27.6% in 2019 to 42.7% in 2023 (OR = 1.16, 95% CI = 1.15-1.18, p < 0.001). Among 12,922 participants who reported PrEP use in the last 6 months, the proportion reporting ED-PrEP use increased from 7.6% in 2019 to 27.8% in 2023 (OR = 1.41, 95% CI = 1.37-1.46, p < 0.001) with those who reported daily PrEP decreasing from 92.4% to 63.3% (OR = 0.64, 95% CI = 0.62-0.66, p < 0.001). In a cross-sectional sub-sample in 2022-2023 (n = 8840), compared to ED-PrEP users, non-PrEP users were less likely to have received three or more HIV tests in the last 12 months (aRRR = 0.26, 95% CI = 0.22-0.31, p < 0.001), have 2-10 male sexual partners in the last 6 months (aRRR = 0.24, 95% CI = 0.14-0.41, p < 0.001) or 11 or more (aRRR = 0.26, 95% CI = 0.15-0.45, p < 0.001) compared to none, or to report condomless anal intercourse with casual partners (aRRR = 0.38, 95% CI = 0.32-0.46, p < 0.001). Compared to ED-PrEP users, daily PrEP users were more likely to have received three of more HIV tests in the last year (aRRR = 3.73, 95% CI = 3.15-4.40, p < 0.001) and less likely to be born overseas and lived in Australia for less than 5 years compared to being born in Australia (aRRR = 0.64, 95% CI = 0.49-0.83, p = 0.001). While daily PrEP remains the most common PrEP dosing regimen among GBMSM in Australia, there has been a steep increase in the proportion of PrEP users who are taking ED-PrEP. Monitoring of PrEP use should continue to adapt to new dosing methods and future PrEP options. As ED-PrEP use increases, further work is needed to ensure those taking ED-PrEP are taking it effectively to prevent HIV.

Chan C ，Holt M ，Smith AKJ ，Broady TR ，MacGibbon J ，Mao L ，Wilcock B ，Rule J ，Bavinton BR ... -  《Journal of the International AIDS Society》

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.

Baldry G ，Phillips D ，Wilkie R ，Checchi M ，Folkard K ，Simmons R ，Saunders J ，Mandal S ，Mercer CH ，Mohammed H ，Ogaz D ... -  《-》