JMIR Publications

ABSTRACT

Background:

The multi-country human mpox (monkeypox) outbreak has constituted a Public Health Emergency of International Concern since 2022. In China, young men who have sex with men (YMSM) may become the population with a high risk of mpox infection due to their social activeness and eased restrictions on COVID-19.

Objective:

This study aimed to investigate the behavioral intentions of receiving mpox vaccination and testing under different scenarios and to explore their associations with background and behavioral theory-related factors among YMSM aged 18-29 years in China.

Methods:

The online cross-sectional survey was conducted among 2,493 YMSM aged 18-29 years in September 2022 in six provincial regions in China. The participants were recruited via the facility-based sampling method with the assistance of the local MSM-oriented community-based organizations, and were asked to self-administer the online anonymous questionnaire. The questionnaire was designed based on prior knowledge about mpox and classic health behavior theories. Background information, mpox knowledge and cognitions, cognitions of mpox vaccination and testing, and behavior intentions of receiving mpox vaccination and testing were collected. Descriptive analysis, univariate and multivariable linear regression were performed.

Results:

A total of 2,493 YMSM with the mean age of 24.6 (SD=2.9) years were included in this study. The recruitment rate was 67.2%. The prevalence of having an intention of mpox vaccination ranged 66.2-88.4% by scenarios varying in epidemic status and cost. The prevalence of having a testing intention were above 90% under all scenarios concerning presence of symptoms and cost. The positive factors of the vaccination intention included mpox knowledge (ba=0.060, 95%CI=0.016, 0.103), perceived susceptibility of mpox (ba=0.091, 95%CI=0.035, 0.146), perceived severity of mpox (ba=0.230, 95%CI=0.164, 0.296), emotional distress caused by mpox (ba=0.270, 95%CI=0.160, 0.380), perceived benefits of mpox vaccination (ba=0.455, 95%CI=0.411, 0.498), self-efficacy of mpox vaccination (ba=0.586, 95%CI=0.504, 0.668), and having one male sex partner (ba=0.452, 95%CI=0.098, 0.806); the negative factor of the vaccination intention was perceived barriers to vaccination (ba=-0.056, 95%CI=-0.090, -0.022). The positive factors of the testing intention included perceived severity of mpox (ba=0.283, 95%CI=0.241, 0.325), perceived benefits of mpox testing (ba=0.679, 95%CI=0.636, 0.721), self-efficacy of mpox testing (ba=0.195, 95%CI=0.146, 0.245), having one male sex partner (ba=0.290, 95%CI=0.070, 0.510), and having in-person gatherings with MSM (ba=0.219, 95%CI=0.072, 0.366); the negative factor was emotional distress caused by mpox (ba=-0.069, 95%CI=-0.137, -0.001).

Conclusions:

Future national response to mpox in China should raise YMSM’s mpox knowledge, disseminate updated information about the disease and preventive measures, improve accessibility and privacy of preventive services, and provide advice on coping with the associated emotional distress positively.