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Background <p>Following the 2022 outbreak, vaccination against mpox became available in many European countries using a third-generation non-replicating smallpox vaccine (MVA-BN). It is primarily recommended for individuals at higher risk of exposure, including men who have sex with men (MSM), especially those reporting multiple partners, group sex, chemsex, or recent sexually transmitted infections (STIs).</p> Methods <p>A cross-sectional survey about mpox vaccination uptake was conducted between October 2023 and October 2025 among MSM attendees of an STI/HIV center (Rome, Italy). An anonymous questionnaire, self-administered online, investigated demographic data, sexual behaviors, STI history, and drug use for sex. Univariable and multivariable logistic regression models were used to identify factors associated with self-reported mpox vaccination.</p> Results <p>Of the 331 MSM who completed the questionnaire, 85 (25.7%) reported having received mpox vaccination, whereas 17 had already been vaccinated against smallpox (5.1%). Four participants reported having acquired mpox infection (1.2%). In univariable analyses, mpox vaccination was associated with history of STI, higher number of sexual partners, group sex, use of dating apps, HIV PrEP, use of erectile dysfunction agents (EDA), sexualised drug use (SDU), and chemsex. In multivariable analysis, uptake of mpox vaccination remained independently and positively associated with EDA (aOR: 1.88, 95% CI: 1.02-3.48, p=0.044), HIV PrEP (aOR: 3.32, 95% CI: 1.62-6.81, p&lt;0.001) and chemsex (aOR: 2.44, 95% CI: 1.22-4.90, p=0.012), whereas it showed an inverse association with reporting female partners in the previous year (aOR: 0.25, 95% CI: 0.07-0.89, p=0.033).</p> Conclusions <p>Among MSM participants in our survey, mpox vaccination uptake was reported by only about one quarter of the individuals. Uptake was independently and positively associated with both chemsex and HIV-PrEP use, with HIV-PrEP showing the strongest association. Overall uptake remains suboptimal, highlighting persistent gaps in mpox vaccination coverage among individuals at higher risk. This underscores the need to reinforce integrated combination-prevention pathways in HIV/STI services, also in the context of HIV PrEP continuum.</p>

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Who got vaccinated for mpox? A cross-sectional survey on behavioral correlates of vaccine uptake among men who have sex with men attending an STI/HIV reference center in Rome, Italy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Maria Gabriella Donà,
  • Mauro Zaccarelli,
  • Eugenia Giuliani,
  • Laura Gianserra,
  • Christof Stingone,
  • Francesca Di Tullio,
  • Massimo Giuliani,
  • Alessandra Latini

摘要

Background

Following the 2022 outbreak, vaccination against mpox became available in many European countries using a third-generation non-replicating smallpox vaccine (MVA-BN). It is primarily recommended for individuals at higher risk of exposure, including men who have sex with men (MSM), especially those reporting multiple partners, group sex, chemsex, or recent sexually transmitted infections (STIs).

Methods

A cross-sectional survey about mpox vaccination uptake was conducted between October 2023 and October 2025 among MSM attendees of an STI/HIV center (Rome, Italy). An anonymous questionnaire, self-administered online, investigated demographic data, sexual behaviors, STI history, and drug use for sex. Univariable and multivariable logistic regression models were used to identify factors associated with self-reported mpox vaccination.

Results

Of the 331 MSM who completed the questionnaire, 85 (25.7%) reported having received mpox vaccination, whereas 17 had already been vaccinated against smallpox (5.1%). Four participants reported having acquired mpox infection (1.2%). In univariable analyses, mpox vaccination was associated with history of STI, higher number of sexual partners, group sex, use of dating apps, HIV PrEP, use of erectile dysfunction agents (EDA), sexualised drug use (SDU), and chemsex. In multivariable analysis, uptake of mpox vaccination remained independently and positively associated with EDA (aOR: 1.88, 95% CI: 1.02-3.48, p=0.044), HIV PrEP (aOR: 3.32, 95% CI: 1.62-6.81, p<0.001) and chemsex (aOR: 2.44, 95% CI: 1.22-4.90, p=0.012), whereas it showed an inverse association with reporting female partners in the previous year (aOR: 0.25, 95% CI: 0.07-0.89, p=0.033).

Conclusions

Among MSM participants in our survey, mpox vaccination uptake was reported by only about one quarter of the individuals. Uptake was independently and positively associated with both chemsex and HIV-PrEP use, with HIV-PrEP showing the strongest association. Overall uptake remains suboptimal, highlighting persistent gaps in mpox vaccination coverage among individuals at higher risk. This underscores the need to reinforce integrated combination-prevention pathways in HIV/STI services, also in the context of HIV PrEP continuum.