Mpox Awareness, Risk Reduction, and Vaccine Acceptance among Pwh in Washington, Dc

ABSTRACT

Background: PWH are disproportionally affected by mpox and at high risk for severe complications. The recent mpox outbreak response included increasing awareness, encouraging behavioral changes and pre- and post-exposure vaccination. We assessed knowledge and perceptions of mpox, adoption of preventive behaviors, and attitudes towards vaccination among PWH in Washington, DC. Method(s) Data from a cross-sectional mpox survey were collected between August and December 2022 from PWH enrolled in a longitudinal HIV cohort, the DC Cohort. We conducted uni- and bivariable analyses comparing participants by vaccination status (vaccinated, plan to vaccinate, no plan to vaccinate) and by HIV risk group (MSM vs. non-MSM). We conducted multinomial regression to identify factors associated with vaccine acceptance. Result(s) Among 178 PWH completing the survey (median age 55;71% male, 81% non-Hispanic Black, 37% MSM), 162 (91%) had heard of mpox. Among 159 PWH who had heard of mpox and answered vaccination questions, 21% (n=33) were vaccinated, 43% (n=69) planned to vaccinate and 36% (n=57) did not plan to vaccinate. Comparing the 3 groups, significant differences were observed by age, gender, education, income, HIV risk group, and level of worry about mpox (all p< 0.01). Viral suppression, prior COVID and influenza vaccination, access to STI services, and STI diagnoses in the last year were not associated with vaccine status. Behaviorally, a higher proportion of vaccinated participants reported limiting their number of sexual partners (p< 0.001) and using more preventive behaviors (e.g., limiting gatherings, increased condom use, avoiding skin-to-skin contact;p=0.034) in response to mpox. A higher proportion of MSM reported limiting their number of sexual partners compared to non-MSM (33% vs 7%, p< 0.0001) and were more likely to be vaccinated or plan to vaccinate vs non-MSM (p< 0.001). In adjusted multinomial regression models comparing vaccinated PWH and those planning to vaccinate to those not planning to vaccinate, age (p= 0.0231) and HIV risk factor/gender (p< 0.0001) were significantly associated with vaccination status with younger PWH and MSM more likely to vaccinate (Figure). Conclusion(s) High levels of mpox awareness were observed among this cohort of PWH in Washington, DC with more MSM employing risk reduction behaviors and vaccination as mpox prevention strategies. Ensuring that all PWH, regardless of gender, sexual orientation, or age, understand the risks of mpox may improve vaccination uptake.