Wang Haoyi, d'Abreu de Paulo Kennedy J I, Gültzow Thomas, Zimmermann Hanne M L, Jonas Kai J
Department of Work and Social Psychology, Maastricht University, 6200 ER Maastricht, The Netherlands.
Trop Med Infect Dis. 2022 Oct 10;7(10):293. doi: 10.3390/tropicalmed7100293.
The current monkeypox epidemic is most prevalent among men who have sex with men (MSM). PrEP users and MSM with HIV (MSMHIV) are considered at highest risk of monkeypox infection in The Netherlands, and are being targeted for monkeypox vaccination. Together with the epidemiological evidence, perceived concern and risk are also relevant for decision making about health behaviour, e.g., vaccination uptake. It is thus timely to examine which subpopulations among MSM consider themselves to be most at risk and are most concerned about monkeypox. This study aimed to help determine if the current measures to curb the epidemic are successfully targeted or not in The Netherlands. We conducted an online survey among 394 MSM living in The Netherlands. We first calculated the prevalence and standardised prevalence ratio (SPR) of high perceived monkeypox concern/risk by PrEP-use and HIV status. We then conducted two multivariable logistic regression analyses to investigate perceived monkeypox concern/risk and their potential socio-demographic/behavioural/health/psycho-social determinants. Among the included MSM, 52% showed high perceived concern about and 30% showed high perceived risk of monkeypox infection. PrEP users (SPR = 0.83) showed a significantly lower chance of perceived concern; in addition, MSMHIV (SPR = 2.09) were found to have a significantly higher chance of perceiving high risk of monkeypox infection. In the multivariable logistic analyses, non-PrEP users (aOR = 2.55) were more likely to perceive higher concern, while MSM who were retired (aOR = 0.23) and who had had chemsex recently (aOR = 0.63) were less likely to perceive higher concern. MSMHIV (aOR = 4.29) and MSM who had an unknown/undisclosed HIV status (aOR = 6.07), who had attended private sex parties (aOR = 2.10), and who knew people who have/had monkeypox (aOR = 2.10) were more likely to perceive a higher risk for monkeypox infection. We found that high perceived risk (aOR = 2.97) and high perceived concern (aOR = 3.13) were correlated with each other. In sum, only one-third of MSM living in The Netherlands considered themselves at high risk of monkeypox infection, and only half of them reported high concern. We identified a potential discrepancy between "actual risk" and perceived risk of and concern about monkeypox among MSM in this early stage of the monkeypox epidemic in The Netherlands, especially among PrEP users and MSMHIV. More refined public health communication strategies may be needed to improve the understanding and knowledge of the "actual risk" of monkeypox infections among MSM sub-populations, to facilitate health behaviour uptake.
当前的猴痘疫情在男男性行为者（MSM）中最为普遍。在荷兰，暴露前预防（PrEP）使用者和感染艾滋病毒的男男性行为者（MSM-HIV）被认为感染猴痘的风险最高，他们也是猴痘疫苗接种的目标人群。连同流行病学证据，感知到的担忧和风险对于健康行为（如疫苗接种率）的决策也很重要。因此，及时研究男男性行为者中的哪些亚群体认为自己风险最高且最担心猴痘是很有必要的。本研究旨在帮助确定荷兰目前遏制疫情的措施是否成功靶向了目标人群。我们对居住在荷兰的394名男男性行为者进行了一项在线调查。我们首先按PrEP使用情况和艾滋病毒感染状况计算了对猴痘高度担忧/高风险感知的患病率和标准化患病率比（SPR）。然后我们进行了两项多变量逻辑回归分析，以调查对猴痘的担忧/风险感知及其潜在的社会人口学/行为/健康/心理社会决定因素。在纳入的男男性行为者中，52%表现出对猴痘感染的高度担忧，30%表现出对猴痘感染的高风险感知。PrEP使用者（SPR = 0.83）表现出担忧感知的可能性显著更低；此外，发现MSM-HIV（SPR = 2.09）有更高的可能性感知到猴痘感染的高风险。在多变量逻辑分析中，非PrEP使用者（调整后的比值比[aOR] = 2.55）更有可能感知到更高的担忧，而退休的男男性行为者（aOR = 0.23）和最近有过群交性行为的男男性行为者（aOR = 0.63）感知到更高担忧的可能性较小。MSM-HIV（aOR = 4.29）以及艾滋病毒感染状况未知/未公开的男男性行为者（aOR = 6.07）、参加过私人派对的男男性行为者（aOR = 2.10）以及认识患有/曾患猴痘的人的男男性行为者（aOR = 2.10）更有可能感知到猴痘感染的更高风险。我们发现高风险感知（aOR = 2.97）和高担忧感知（aOR = 3.13）相互关联。总之，居住在荷兰的男男性行为者中只有三分之一认为自己有感染猴痘的高风险，其中只有一半表示高度担忧。在荷兰猴痘疫情的这个早期阶段，我们发现男男性行为者中猴痘的“实际风险”与风险感知及担忧之间存在潜在差异，特别是在PrEP使用者和MSM-HIV中。可能需要更精细的公共卫生传播策略来提高男男性行为者亚群体对猴痘感染“实际风险”的理解和认识，以促进健康行为的采取。
