COVID-19 Testing in a Weekly Cohort Study of Gay and Bisexual Men: The Impact of Health-Seeking Behaviors and Social Connection

Factors Associated with COVID-19 Testing, Vaccination, and Use of Digital Contact Tracing Apps among Black and Latinx MSM (BLMSM) in Los Angeles

This study examines the factors associated with COVID-19 testing, vaccination intent (both individually and jointly), and willingness to use contact tracing digital apps among a cohort of Black and Latinx men who have sex with men (BLMSM) living in Los Angeles during the initial peak (July 2020) of the COVID-19 pandemic. A questionnaire detailing participants COVID-19 experiences was sent to 300 primarily BLMSM after the first state-wide COVID-19 lockdown. Logistic regression models with random cluster effects were used for analyses. Forty-two percent (42%) tested for COVID-19, 27% were willing to get vaccinated, and about 45% reported willingness to use contact tracing digital apps. Controlling for intervention participation, age, education, marital status, employment, health, tobacco, binge drinking, and self-reported anxiety, those who were depressed had 33% (95% CI: 0.13 to 0.82) odds of using a prevention strategy (either test for COVID-19 or vaccination intent) as the group who were not depressed. Those who had high school diploma or less had 23% (95% CI: 0.11 to 0.48) odds to use digital contact tracing apps as the group with education level of at least Associate's or Bachelor's degree. Without considering the format of the test kits, vaccine side effects, and ease of use for digital contact tracing apps, participants appeared to still be hesitant in using COVID-19 prevention strategies at the initial height of the pandemic. Our findings suggest the need for further investigation into this hesitancy to better inform and prepare for future epidemics.

Mpox vaccination willingness, determinants, and communication needs in gay, bisexual, and other men who have sex with men, in the context of limited vaccine availability in the Netherlands (Dutch Mpox-survey)

Introduction

In the 2022 multicountry mpox (formerly named monkeypox) outbreak, several countries offered primary preventive vaccination (PPV) to people at higher risk for infection. We study vaccine acceptance and its determinants, to target and tailor public health (communication-) strategies in the context of limited vaccine supply in the Netherlands.

Methods

Online survey in a convenience sample of gay, bisexual and other men who have sex with men, including transgender persons (22/07-05/09/2022, the Netherlands). We assessed determinants for being (un)willing to accept vaccination. We used multivariable multinominal regression and logistic regression analyses, calculating adjusted odds ratios (aOR) and 95 percent confidence-intervals. An open question asked for campaigning and procedural recommendations.

Results

Of respondents, 81.5% (n = 1,512/1,856) were willing to accept vaccination; this was 85.2% (799/938) in vaccination-eligible people and 77.7% (713/918) in those non-eligible. Determinants for non-acceptance included: urbanization (rural: aOR:2.2;1.2-3.7; low-urban: aOR:2.4;1.4-3.9; vs. high-urban), not knowing mpox-vaccinated persons (aOR:2.4;1.6-3.4), and lack of connection to gay/queer-community (aOR:2.0;1.5-2.7). Beliefs associated with acceptance were: perception of higher risk/severity of mpox, higher protection motivation, positive outcome expectations post vaccination, and perceived positive social norms regarding vaccination. Respondents recommended better accessible communication, delivered regularly and stigma-free, with facts on mpox, vaccination and procedures, and other preventive options. Also, they recommended, "vaccine provision also at non-clinic settings, discrete/anonymous options, self-registration" to be vaccinated and other inclusive vaccine-offers (e.g., also accessible to people not in existing patient-registries).

Conclusion

In the public health response to the mpox outbreak, key is a broad and equitable access to information, and to low-threshold vaccination options for those at highest risk. Communication should be uniform and transparent and tailored to beliefs, and include other preventive options. Mpox vaccine willingness was high. Public health efforts may be strengthened in less urbanized areas and reach out to those who lack relevant (community) social network influences.