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Receptiveness to monkeypox vaccines and public health communication strategies among gay, bisexual and other men who have sex with men in Singapore: cross-sectional quantitative and qualitative insights
  1. Zach Yung Shen Chan1,
  2. Shao Yuan Chong2,
  3. Steph Niaupari3,
  4. Jack Harrison-Quintana3,
  5. Jue Tao Lim4,
  6. Borame Dickens2,
  7. Yudara Kularathne5,
  8. Chen Seong Wong1,6,
  9. Rayner Kay Jin Tan2
  1. 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  2. 2Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
  3. 3Grindr LLC, Los Angeles, California, USA
  4. 4Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  5. 5HeHealth.ai, Singapore
  6. 6Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
  1. Correspondence to Dr Rayner Kay Jin Tan, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549, Singapore; rayner.tan{at}nus.edu.sg

Abstract

Objectives Monkeypox (mpox) was declared as a global health emergency by the WHO, with most reported cases disproportionately involving gay, bisexual and other men who have sex with men (GBMSM). This study explored the willingness of Singaporean GBMSM to receive mpox vaccines and engage in changes to sexual behaviour, and analysed the factors influencing both decisions.

Methods An online cross-sectional study was disseminated through community groups and Grindr from September to October 2022 among GBMSM in Singapore, where we surveyed respondents’ demographics, stigma associated with mpox, perceived risks of sexually transmitted infections (STIs) and changes to sexual behaviours in response to mpox. Descriptive statistics and multivariable linear and logistics regression analyses, as well as thematic analysis of data, were also conducted.

Results 237 GBMSM community members responded to the survey, with the majority being receptive to vaccine and 67.5% indicating changes to sexual behaviour in view of rising mpox infections. Predictors of vaccine receptivity among GBMSM included self-perceived mpox risk (adjusted OR (aOR)=0.44, 95% CI 0.07, 0.82) and self-perceived STI risk (aOR=0.39, 95% CI 0.03, 0.76). Predictors for changes to sexual behaviour included self-perceived mpox stigma (aOR=1.17, 95% CI 1.08, 1.27), self-perceived mpox risk (aOR=1.22, 95% CI 1.03,1.44), age (aOR=0.96, 95% CI 0.93, 1.00) and race (aOR=0.31, 95% CI 0.10, 0.93). In the thematic analysis, respondents raised concerns about vaccine effectiveness, side effects, cost and privacy.

Conclusions Our findings suggest that the rise in mpox infections have prompted changes to GBMSM’s sexual practices. In general, GBMSM are willing to receive the mpox vaccine but are concerned about the physical and social consequences of uptake. These concerns should be addressed when vaccines are released.

  • Vaccines
  • Behavioral Sciences
  • Communicable Diseases
  • HEALTH PROMOTION

Data availability statement

Data are available upon reasonable request. Data are available from the corresponding author (RKJT) upon reasonable request.

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Data availability statement

Data are available upon reasonable request. Data are available from the corresponding author (RKJT) upon reasonable request.

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Footnotes

  • ZYSC and SYC are joint first authors.

  • Handling editor Anna Maria Geretti

  • X @raynerkjtan

  • Contributors ZYSC and RKJT conducted this analysis and developed the first manuscript draft with SYC. SN and JH-Q assisted with the distribution of the survey. SN, JH-Q, JTL, BD, YK, CSW and RKJT designed the survey. RKJT provided supervision on the project. All authors reviewed the manuscript and gave final approval prior to submission. RKJT is responsible for the overall content as guarantor for this study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.