Mpox Vaccination and Diagnosis Among Sexual and Gender Diverse Populations in Brazil: Results From a Large Nationwide Online Survey

IF 5.2 1区医学 Q2 IMMUNOLOGY

Journal of the International AIDS Society Pub Date : 2026-07-24 DOI:10.1002/jia2.70143

Mayara Secco Torres Silva, Paula Mendes Luz, Carolina Coutinho, Brenda Hoagland, Emilia Moreira Jalil, Cristina Pimenta, Marcos Benedetti, Sandra Wagner Cardoso, Valdilea Gonçalves Veloso, Beatriz Grinsztejn, Thiago Silva Torres

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引用次数: 0

Abstract

Introduction

Since the onset of the 2022 multinational mpox outbreak, Brazil has reported one of the highest case burdens globally, disproportionately affecting sexual and gender diverse populations. Mpox vaccination efforts in Brazil have been limited by delayed procurement, restricted eligibility criteria and structural access barriers. Understanding vaccination use, correlates of uptake and characteristics of individuals previously diagnosed with mpox is essential to guide equitable prevention strategies.

Methods

We conducted an online cross-sectional survey between August and December 2024 among individuals recruited through social media and dating apps. Eligible participants were aged ≥18 years, identified as a sexual and gender diverse person, and residing in Brazil. Primary outcomes were previous mpox vaccination and mpox diagnosis. Sociodemographic, behavioural, internalized LGBTQIAPN+phobia and HIV/sexually transmitted infections (STIs) variables were collected. Adjusted logistic regression models identified independent factors associated with both outcomes.

Results

Of 9546 respondents, most were cisgender men (91.8%), aged >30 years (81.5%) and residing in capital cities (77.2%). Overall, mpox vaccination coverage was 4.9%; nearly half received only one dose, and one quarter were vaccinated outside Brazil. Previous mpox diagnosis was reported by 2.1% of respondents, with 76.5% seeking healthcare and 7.0% requiring hospitalization. Factors associated with previous mpox vaccination were self-identification as White (aOR = 1.36; 95% CI: 1.10−1.69), more than five sex partners (aOR = 1.29; 95% CI: 1.03–1.62), living with HIV (aOR = 3.40; 95% CI: 2.59–4.47), current/prior HIV pre-exposure prophylaxis (PrEP) use (aOR = 1.88; 95% CI: 1.41–2.53) and internalized LGBTQIAPN+phobia score (aOR = 0.80; 95% CI: 0.71−0.90). Factors associated with previous mpox diagnosis were living in capital cities (aOR = 1.88; 95% CI: 1.17–3.20), more than five sex partners (aOR = 1.93; 95% CI: 1.35−2.79), stimulant drug use (aOR = 1.61; 95% CI: 1.14–2.25), any STI diagnosis (aOR = 2.41; 95% CI: 1.74–3.33), living with HIV (aOR = 3.73; 95% CI: 2.31–6.25) and current/prior PrEP use (aOR = 2.35; 95% CI: 1.43−4.01).

Conclusions

Mpox vaccination among sexual and gender diverse populations in Brazil remains critically low. Findings highlight structural barriers, including vaccine scarcity, delayed rollout and stigma, that hinder equitable vaccine access. Integrating mpox vaccination into combined HIV/STI prevention services, adopting differentiated care delivery models and partnering with community-led organizations are essential to expanding reach, improving dose completion and reducing health inequities during ongoing and future outbreaks.

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巴西性别和性别多样化人群中的m痘疫苗接种和诊断：来自一项大型全国性在线调查的结果。

自2022年跨国mpox暴发以来，巴西报告的病例负担是全球最高的之一，对性和性别多样化人群的影响不成比例。巴西的麻疹疫苗接种工作受到采购延迟、资格标准受限和结构性准入障碍的限制。了解疫苗接种的使用、接种的相关因素以及以前被诊断患有m痘的个体的特征，对于指导公平的预防战略至关重要。方法：我们在2024年8月至12月期间对通过社交媒体和约会应用程序招募的个人进行了在线横断面调查。符合条件的参与者年龄≥18岁，确定为性别和性别多样化的人，居住在巴西。主要结局是既往m痘疫苗接种和m痘诊断。收集社会人口学、行为学、内化LGBTQIAPN+恐惧症和HIV/性传播感染（STIs）变量。调整后的逻辑回归模型确定了与两种结果相关的独立因素。结果：9546名被调查者中，绝大多数为顺性别男性（91.8%），年龄在30岁以下（81.5%），居住在首都城市（77.2%）。总体而言，麻疹疫苗接种率为4.9%；近一半的人只接种了一剂疫苗，四分之一的人在巴西以外接种了疫苗。2.1%的应答者报告曾有过m痘诊断，其中76.5%寻求医疗保健，7.0%需要住院治疗。与既往m痘疫苗接种相关的因素有：自我认同为白人（aOR = 1.36; 95% CI: 1.10-1.69）、超过5个性伴侣（aOR = 1.29; 95% CI: 1.03-1.62）、携带HIV （aOR = 3.40; 95% CI: 2.59-4.47）、当前/既往使用HIV暴露前预防（PrEP）（aOR = 1.88; 95% CI: 1.41-2.53）和内化LGBTQIAPN+恐惧症评分（aOR = 0.80; 95% CI: 0.71-0.90）。与既往m痘诊断相关的因素包括居住在首都（aOR = 1.88; 95% CI: 1.17-3.20）、超过5名性伴侣（aOR = 1.93; 95% CI: 1.35-2.79）、使用兴奋剂（aOR = 1.61; 95% CI: 1.14-2.25）、任何性传播感染诊断（aOR = 2.41; 95% CI: 1.74-3.33）、感染艾滋病毒（aOR = 3.73; 95% CI: 2.31-6.25）和当前/既往使用PrEP （aOR = 2.35; 95% CI: 1.43-4.01）。结论：巴西不同性别人群的麻疹疫苗接种率仍然极低。调查结果强调了结构性障碍，包括疫苗短缺、延迟推广和污名化，阻碍了公平获得疫苗。将痘疫苗接种纳入艾滋病毒/性传播感染综合预防服务，采用差异化的护理提供模式，并与社区主导的组织合作，对于扩大覆盖面、改善剂量完成情况和减少正在发生和未来疫情期间的卫生不公平现象至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.