A recent study has examined the vaccination correlates among sexual minority men (SMM) during the 2022 outbreak of the orthopox virus known as mpox (previously “monkeypox”) in the US. The epidemic has disproportionately affected Black SMM in the Southern US, with men accounting for 97% of identified cases, and over 75% of those men infected disclosing a history of sexual contact with other men. The findings were published in the Journal of Sex Research.
The study, conducted between July 28 and September 22, 2022, surveyed 2,620 adult cisgender SMM who had not previously been diagnosed with mpox. Of the respondents, 730 (27.9%) received at least one vaccine dose. Logistic regression indicated that sex with a casual partner was positively associated with vaccination, while stimulant drug use was negatively associated with vaccination. However, the use of ecstasy, ketamine, gamma-hydroxybutyrate (GHB), or psychedelics was positively associated with vaccination.
Among partnered SMM, non-monogamous sexual agreements, relationship length of at least two years, and relationship functioning were positively associated with vaccination. Even at low levels of relationship functioning, SMM in non-monogamous relationships of at least two years were more likely to be vaccinated than single SMM. At very high levels of relationship functioning, partnered SMM were more likely to be vaccinated than single SMM regardless of sexual agreement or relationship length.
Mpox is most commonly spread through close physical contact with an infected individual, involving exposure to respiratory droplets or direct contact with mucocutaneous lesions. As a result, sexual contact has substantial transmission potential due to proximity and skin contact.
Two vaccines for smallpox, one of which is also FDA-approved for mpox, are currently available. Preliminary estimates for vaccine effectiveness are 37% for one dose and 69% for two doses of the JYNNEOS vaccine. Vaccination efforts have been focused on SMM due to the potential for sexual transmission and the concentration of mpox infections among this group.
The study provides valuable information about the correlates of mpox vaccination among SMM during a critical period in the US response to the outbreak. It highlights the vulnerability of SMM who use stimulant drugs and those who identify in ways other than gay. The findings also suggest that health-related benefits of being partnered emerge as a function of sexual agreement, relationship length, and relationship functioning in ways that align with interdependence theory.
