Men who have sex with men under mpox threat- changes in sexual behaviors and mpox-vaccines uptake

INTRODUCTION: Since May 2022, 261 cases of mpox were reported in Israel. Of those 259 (99.2%) were men who had sex with men (MSM). The outbreak was contained following the use of MVA-BN vaccines, which became available in August 2022. This longitudinal study aims to assess MSM’ change in sexual behaviors (CSB) due to mpox and appraise the adherence for vaccination. METHODS: The anonymous questionnaires were published in a popular geospatial application frequented by MSM (Grindr) between September and October 2022. Participants were asked to report their demographic characteristics, use of pre-exposure prophylaxis (PrEP), CSB and MVA-BN vaccines uptake. RESULTS: In total, 665 MSM included in the study with an average age of 35.5 years, 425 (63.6%) lived in Tel Aviv area, and 169 (25.4%) were in steady relationships. Mpox diagnosis and HIV infection were reported by 19 (2.9%) and 21 (3.2%), respectively. The 317 (47.7%) who CSB due to mpox concern were more likely to live in Tel Aviv, more commonly in open relationships, performed sex in gay-related venues, involved in unprotected anal sex, were concerned about mpox and more commonly vaccinated against mpox compared with participants who did not CSB. In multivariate analysis, living in Tel Aviv, open relationships, unprotected anal sex, being concerned with mpox and vaccination predicted CSB. The 221 (33.3%) who were vaccinated were more commonly older, more likely to live in Tel Aviv, in steady relationships, performed sex in gay-related venues, were infected with HIV, used PrEP and CSB compared with non-vaccinated participants. In multivariate analysis, living in Tel Aviv, being in steady relationships, HIV infection, PrEP use and CSB predicted vaccination. CONCLUSIONS: Nearly half of the participants CSB and one-third were vaccinated- both outcomes were more common among MSM who were at high risk for mpox infection. MSM are responsive to potential sexual risks and adopt their sexual behaviors according to the threat. KEY MESSAGES: • Nearly half of the MSM who participants in the study changed their sexual behavior and 1/3 were vaccinated against mpox. • MSM are responsive to potential sexual risks and adopt their sexual behaviors according to the threat, whether it is HIV, STD or mpox.