Outreach mpox vaccination at sex-on-premises venues in Sydney: An audit of a collaborative intervention by public health nurses and LGBTQI+ peer workers

Outreach mpox vaccination at sex-on-premises venues in Sydney: An audit of a collaborative intervention by public health nurses and LGBTQI+ peer workers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Outreach mpox vaccination at sex-on-premises venues in Sydney: An audit of a collaborative intervention by public health nurses and LGBTQI+ peer workers Vendula Belackova, Anna Doab, Joubert van der Merwe, Nicole Christie¹, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7596483/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 18 Feb, 2026 Read the published version in BMC Public Health → Version 1 posted 10 You are reading this latest preprint version Abstract Background/Purpose: In 2024, in response to a re-surge in mpox transmission in New South Wales, Australia, Kirketon Road Centre (KRC) partnered with an HIV and LGBTQI+ community organisation, ACON, to conduct outreach vaccination in two sex-on-premises venues (SOPVs), also known as “saunas”. SOPV attendees were approached by an ACON peer worker who offered health education and on-site mpox vaccination (Jynneos ® ) by a registered nurse. Data on the number of engagements, vaccination acceptance, and self-reported vaccination history were collected. With client consent, vaccinations were also recorded on the Australian Immunisation Register (AIR). Methods: In addition to a descriptive analysis of service records, we matched individual-level records with AIR and ran (comparative) descriptive and multivariate analyses, comparing individuals who received their mpox vaccine at KRC’s fixed-site vs. at an SOPV. Findings: During the outreach period, KRC administered 639 mpox vaccines at its fixed-site and conducted 22 outreach sessions at SOPVs in collaboration with ACON. These sessions resulted in 840 engagements; 522 individuals were eligible for mpox vaccination and 407 (78%) accepted. Among individuals who were matched with AIR, 77% at KRC’s fixed-site and 66% at SOPV received two doses of mpox vaccine. Overall, people vaccinated at SOPVs were older (mean 46 vs. 39 years) and less likely to reside locally (34% vs 51%). They were also less likely to have Medicare (57% vs. 74%), and/or to have an AIR record (60% vs. 67%). In a multivariate model, vaccine completion was not associated with receiving SOPV vs. KRC’s fixed-site. Conclusions: Mpox outreach vaccination done in collaboration between nurses and LGBTQI+ peer-workers at SOPVs proved feasible, acceptable, and beneficial in terms of reaching people who may be out of area and not be routinely engaged with sexual health services. This model should be considered in future models of care involving MSM. mpox vaccination outreach public health services men who have sex with men Figures Figure 1 Figure 2 Background Mpox is caused by the monkeypox virus with its two distinct virus clades ( 1 ). Mpox is mainly transmitted through sustained close physical contact, including sexual contact, with someone who has mpox, for example, in households and venues that offer sex-on-premises, and as well as through contact with shared surfaces, furniture, or linen ( 2 , 3 ); more research is needed regarding respiratory ( 4 ) or maternal-foetal routes of transmission ( 5 ). In 2022–2023, a global outbreak of mpox clade IIb resulted in more than 100,000 cases in 127 countries; most cases have been in males, primarily gay, bisexual and other men who have sex with men ( 6 ). Health authorities first detected mpox in Australia in May 2022, which led to 144 cases being reported during the 2022 outbreak ( 7 ). During this initial wave of vaccination, due to shortages in supply, many people received just one dose of the mpox vaccine intradermally ( 8 ). In 2024, local mpox transmission increased in New South Wales (NSW), exceeding two hundred notifications by August 2024 ( 9 ). This was an unexpected resurgence of the virus, following successful efforts to curb the spread in 2022–2023 via a prompt public health campaign ( 7 ) . Among the various strategies proposed to mitigate mpox outbreaks, administering mpox vaccine at “saunas’ or other sex-on-premise venues (SOPVs) has been identified as a potentially effective approach ( 10 ). As well as providing communal bathing facilities, the saunas provide a location for patrons to engage in consensual sexual activities, typically on an informal and non-commercial basis. Such settings provide anonymity and are often attended by men who have sex with men (MSM) but may not self-identify as gay ( 11 ). As such, SOPVs have been identified as important potential locations for HIV and other STI acquisition for over a decade ( 11 ), and therefore, sexual health services and community organisations have conducted outreach into SOPVs to offer access to STI testing ( 12 , 13 ). Despite existing outreach services, vaccination programs at SOPVs remain limited ( 14 ). Established in 1987, The Kirketon Road Centre (KRC) is a publicly funded community health service designed to deliver free low-threshold, harm-reduction-focused care. KRC is part of the Sexual Health and Blood-Borne Virus team (SHBBV) which encompasses a network of clinics across the South Eastern Sydney Local Health District (SESLHD). KRC primarily targets populations at risk, including people who inject drugs, sex workers, people experiencing homelessness, and young people under 25 who are at risk or affected by these factors. It also prioritises individuals requiring testing or treatment for sexually transmissible infections (STIs), HIV, hepatitis B and C; pre- and post-exposure prophylaxis (PrEP and PEP) for HIV; and engages in targeted outreach and health promotion, such as vaccination, to increase access among high-risk groups. Mpox vaccination became a core part of KRC and SHBBV’s services since 2022. The 2024 mpox resurgence in NSW triggered a public health and service response to deliver mpox vaccination to at-risk MSM. As part of a response by the local sexual health sector to maximise mpox vaccination uptake, KRC partnered with ACON (a community HIV and LGBTQ + health organisation, formerly known as the AIDS Council of NSW), to conduct outreach vaccination in “saunas” within the geographic remit of the Local Health District under which KRC operates (the South Eastern Sydney Local Health District (SESLHD)). Two SOPVs accepted the offer for vaccine outreach sessions (aliased as Sauna I and Sauna II) and these were conducted between September and December 2024. On a typical week, an outreach shift was conducted into each of those venues on two consecutive days. SOPV attendees were approached by an ACON peer worker first; the peer worker offered health education and those who were interested in mpox vaccine (Jynneos ® ) were referred to the accredited registered nurse immuniser for the vaccination. All participants were monitored for 15 minutes post-vaccination. This paper aimed to describe the scope, the acceptability, and the outcomes of mpox vaccination outreach at SOPVs in Sydney. It also aimed to compare characteristics of people who received mpox vaccination at SOPVs to those who were vaccinated for mpox at a KRC’s fixed-site vaccination clinic during the same period. Material and methods Data collection - service-level and client-level data During each outreach session at an SOPV, ACON peer workers collected service-level data on the number of engagements, vaccination acceptance, and self-reported vaccination history (no identifiers were retrieved by peer-workers). Clinical, individual-level data were also collected. Prior to administering mpox vaccination, registered nurses from KRC and from other SHBBV services at SESLHD provided Jynneos® consent forms that eligible participants self-administered. The registered nurse checked the consent for medical eligibility and participants were given the opportunity to ask questions as needed. For KRC’s fixed-site vaccination clinics, mpox vaccination records were administered as usual and recorded in its internal medication management system. With additional consent, mpox vaccinations at SOPVs and at KRC’s fixed-site were also recorded on the Australian Immunisation Register (AIR). This step was not made mandatory by the authorities because mpox vaccination targeted specific at-risk MSM populations who may wish not to be identified as such by other health providers. Individual-level data and the process of matching Data from Jynneos® consent forms were transcribed for this study, to form a set of participants who were vaccinated against mpox at SOPV outreach. For participants who received an mpox vaccine at KRC’s fixed-site, we extracted their details from KRC’s medication management system. Both the SOPV and the KRC’s fixed-site dataset were matched against mpox vaccination records in AIR using client’s name, date of birth, and Medicare number when available (neither SOPV nor KRC fixed-site participants were required to provide this number nor have their vaccination recorded on AIR). This allowed us to retrieve information on any additional mpox vaccinations administered by other providers. AIR records were also used to complement missing postcode data. In the process of matching, a report including all participants with any vaccination history was requested from the AIR. A unique identifier was created in both the AIR report and the SOPV and KRC fixed-site client lists from the first two letters of the last name, first name, and date of birth, and data were consolidated to one record per client with the number of doses received. These processed results were then matched back to the original client list using the unique identifier. The AIR report and the SOPV and KRC fixed-site client list were compared using VLOOKUP in Microsoft Excel to identify and correct variations in names and Medicare numbers. Data cleaning and processing were conducted in RStudio (R version 4.4.1). An anonymised dataset comprising of individual-level data, date of 1 st and 2 nd mpox vaccination (when applicable), residential postcode availability, whether the available postcode was in SESLHD, whether the person had Medicare (when available), and whether they were on AIR was used for the analysis. The process of retrieving, analysing, and publicising the data was reviewed by SESLHD’s Low Negligible Risk Committee on 25 February 2025 and deemed as not raising any ethical concerns. Analysis A descriptive analysis of service data collected by ACON’s peer workers was used to report on the number of engagements at SOPVs, vaccination eligibility, self-reported vaccination history, and willingness to receive an mpox vaccine onsite at the SOPV. Next, a descriptive analysis of clinical data was ran to examine the characteristics of people who were vaccinated at SOPVs and at KRC’s fixed-site. The descriptive analysis used individual-level data that was available from Jynneos® consent forms (date of birth, previous vaccination) and from AIR (for matched participants) to assess mpox vaccine course completion and postcode of residence. Chi 2 and t-tests were used to compare these two groups. An additional analysis included restricting the comparative descriptive analysis above to people who could be matched with AIR records (67% of participants who received mpox vaccine onsite at KRC and 60% of those at SOPV). This was relevant because unmatched participants had inherent data gaps in key variables obtained through AIR, including postcode, Medicare number availability, and in their records of additional mpox doses administered by other providers. Finally, a multivariate analysis examined factors associated with receiving an mpox vaccine at an SOPV versus at KRC’s fixedsite. Participant age, postcode availability, residence within SESLHD, Medicare number availability, and mpox vaccine completion (two doses) were used as covariates. We also controlled for a variable we created – “having at least one of their mpox doses NOT recorded on AIR”, i.e. they were provided an mpox vaccine at SOVP or KRC’s fixed-site yet this dose either could not be found on AIR or the participant didn’t have any AIR records at all; we chose this indicator as a proxy for participants potentially not wanting to identify as MSM, although the reasons may vary. Results Descriptive analysis of service data Between September and December 2024, KRC and ACON conducted twenty-two outreach clinics across two SOPVs. The mean number of mpox vaccines administered per outreach session was n=16 (median was n=13); with a range of 3 to 41 doses per clinic ( see Figure 1 ). Figure 1 about here There were n=840 recorded engagements at SOPVs. In n=300 engagements (36%), the person stated they had already been fully vaccinated against mpox, n=18 (2%) were unable to consent; deeming n=522 (62%) engagements with participants who were eligible for mpox vaccination at an SOPV. From eligible engagements, on n=118 (22%) occasions, participants declined mpox vaccination onsite at an SOPV. A total of 407 mpox vaccinations were recorded onsite at SOPVs, representing 78% of eligible engagements(or 49% of all engagements). The number of unique participants vaccinated at SOPVs could not be determined from this data source, but we analyse this in the following section. Figure 2 about here Descriptive analysis of clinical data From the Jynneos® consent forms, we identified n=331 unique participants who received an mpox vaccination during SOPV outreach over the study period. Some participants received more than one dose, resulting in a total of n = 359 mpox vaccine doses administered during outreach. Several incomplete consent forms were excluded during transcription due to illegible handwriting (n = 32) or missing information (n = 15), accounting for the discrepancy from the n = 407 vaccinations reported in the previous section. During the same period, n=502 participants were vaccinated for mpox onsite at KRC; accounting for a total of n=639 mpox vaccine doses. There was a small overlap between participants who received mpox vaccines at SOPV and KRC’s fixed-site: seven people received their first mpox vaccine at an SOPV and their second at KRC’s fixed-site, while one person received their first dose at KRC and their second at an SOPV. For the purposes of this analysis, all eight participants were classified as SOPV participants. People vaccinated in SOPVs were, on average, older than those vaccinated at KRC’s fixed-site, with a mean age of 46 years compared to 39 years (t = -7.01, p < 0.001). SOPV participants were less likely to have an AIR record (60% vs. 67%, χ² = 4.46, p = 0.035) and less likely to have Medicare (57% vs. 74%, χ² = 26.54, p < 0.001), see Table 1 and Table 2 for details. Postcode information was available for fewer SOPV participants than those vaccinated at KRC’s fixed-site (51% vs. 79%, χ² = 66.79, p < 0.001). Among those with postcode data, only 34% of people vaccinated at SOPV resided in SESLHD compared to 56% of those who were vaccinated at KRC’s fixed-site (χ² = 61.82, p < 0.001). SOPV participants were less likely to be fully vaccinated (44% vs. 58%, χ² = 14.75, p < 0.001) and were more likely to have at least one mpox vaccine dose unrecorded in AIR (8% vs. 3%, χ² = 8.57, p = 0.003). People vaccinated at KRC’s fixed-site clinic were more likely to receive both mpox vaccine doses there, compared to just 9% of SOPV participants who received both doses at SOPV (χ² = 43.74, p < 0.001). Conversely, people vaccinated at SOPV were more likely to only receive their first dose there (11% vs. 7%, χ² = 5.54, p = 0.019). Among those fully vaccinated, the average number of days between doses was significantly higher in the SOPV group (200 days vs. 134 days, t = -2.62, p = 0.009; the number of days was lower for participants who received both doses at the same site, being 42 days at KRC’s fixed-site and 37 days at SOPV), 28 days being the minimum and recommended time between doses. Comparative descriptive analysis of people who were matched on AIR From participants who could be matched with a profile on AIR, n=327 participants received an mpox vaccine at KRC’s fixed-site and n=197 participants received a vaccine at SOPV. In the AIR-matched sub-sample, people vaccinated at SOPV remained significantly older than those vaccinated at KRC’s fixed-site (47 vs. 39 years, t = -6.39, p < 0.001). However, a similar proportion of AIR-matched SOPV participants and AIR-matched participants at KRC’s fixed-site had Medicare (86% and 83%, respectively), see Table 1 and Table 2 for details. More postcode data was available for AIR-matched than for non-matched participants, reflecting the fact that was where postcode information was largely retrieved from; however, the difference between the groups remained significant (97% of participants from KRC’s fixed-site and 86% participants from SOPV had a postcode available, χ² = 19.55, p < 0.001). Importantly, when looking only at people who were matched on AIR, a significantly higher proportion of participants compared to the non-matched ones received two doses of the mpox vaccine (77% of participants at KRC’s fixed-site received two doses vs. 58% of SOPV participants, χ² = 13.18, p < 0.001 ). Table 1 about here Table 2 about here Odds of receiving mpox vaccination at SOPV vs. at KRC’s fixed-site The multivariate logistic regression was used to explore the odds of receiving mpox vaccination at an SOPV vs. at KRC’s fixed-site, adjusting for all covariates. The findings corroborated those of the comparative descriptive analysis (see Table 3). In the model, each additional year of age increased the likelihood of receiving mpox vaccination at an SOPV rather than at KRC’s fixed-site by 5% (p < 0.001). Participants residing in SESLHD were 61% less likely to receive an mpox vaccine at SOPVs (p < 0.001) and not having Medicare was associated with a 48% increase in the odds of receiving an mpox vaccine at an SOPV (p = 0.001). Having at least one mpox dose unrecorded on AIR increased the odds of receiving the mpox vaccine at an SOPV by 382% (p < 0.001). In the multivariate model, receiving two doses of the mpox vaccine (“fully vaccinated”) wasn’t significantly associated with the vaccination site, suggesting that vaccine completion was more influenced by participant characteristics and data completeness than by the vaccination site alone. Table 3 about here Discussion Mpox outreach vaccination administered at SOPVs proved both beneficial and acceptable, with 78% of eligible participants agreeing to receive an mpox vaccination there. Given the success of the mpox vaccination outreach at SOPVs in engaging priority populations, SOPV-based vaccination models should be included in future public health responses targeting MSM. Compared to participants vaccinated at the KRC’s fixed-site, those vaccinated at SOPVs were older and less likely to reside in SESLHD. Indeed, our research showed that participants vaccinated at SOPV were more likely to have an incomplete vaccination record on AIR (i.e. receive mpox doses from KRC that were not recorded on AIR), which may indicate higher concern about confidentiality. These findings align with a previous study which found that men attending SOPVs were older than those coming to a fixed sexual health clinic, were more commonly married or widowed to a woman, were at higher risk of sexually transmissible infections, and attended for less STI and HIV testing compared to participants from a fixed-site clinic ( 15 ). The difference in postcode suggests that men who were vaccinated at SOPVs may have travelled from other health districts to access these venues while maintaining confidentiality. As such, the mpox vaccination outreach into SOPVs reached outside of the borders of SESLHD and, with that, may have enabled a better control of the mpox epidemic in NSW. People vaccinated at SOPVs and at KRC’s fixed-site had high rates of vaccine completion – for those were matched with a record on AIR, this was 66% and 77%, respectively. The fixed-site vaccine completion rate is consistent with other studies of mpox vaccine completion. A recent study reporting on mpox vaccination rates from a survey among MSM found that among n = 4,252 participants in Australia, 41.5% had received both doses of the vaccine, 12.3% had received one dose, and 46.2% were unvaccinated. Overall, 77% of people receiving any vaccine had received two doses of mpox; this respective proportion was 79% among n = 1214 men in Sydney ( 16 ). An audit of mpox vaccine records in NSW indeed found that approximately 75–76% of people who received at least one dose of mpox vaccine also received their second ( 8 ). The lower rate of achieving full vaccination among SOPV participants could be explained by the characteristics of the participants, indicating that people not typically reached by conventional sexual health services in SESLHD were engaged at SOPVs. SOPV participants compared to KRC’s fixed-site were less likely to have Medicare, postcode information, or a matching profile on AIR. This indicates that the SOPV outreach may have engaged participants who were more likely to be non-residents of Australia or who were not well-integrated into the formal healthcare system. These men may have been missed by public health campaigns that target more mainstream MSM and, as such, have less access to information about mpox. Indeed, SOPV participants experienced longer delays between their two mpox doses, suggesting they may have been experiencing additional barriers to accessing mpox vaccines. As such, the SOPV outreach may have filled in a gap by accessing an otherwise under-serviced population of MSM at risk. Limitations Mpox vaccination has had an exemption from AIR data entry (mpox vaccination has an exemption from AIR data entry whereby it is not mandatory to record as it may identify someone as MSM or at risk on their health record). A key limitation of this study was the uncertainty surrounding people who were unmatched on AIR. Whilst we assume this reflects their lack of integration into the healthcare system, this could, in some cases, be a result of incomplete or incorrect information recorded on the Jynneos consent forms. In particular, participants with long names or inaccurately transcribed Medicare numbers were more likely to remain unmatched, potentially leading to underestimation of vaccine uptake and other data points that we retrieved from AIR. Moreover, 22% of participants who were eligible to receive an mpox vaccination at SOPVs declined this offer; we couldn’t access characteristics of these participants specifically. Other factors that could have biased the findings about SOPV participants (besides the lower vaccination completion, less Medicare information, postcode availability, or less likely having a profile on AIR) are issues in accessing the internet or AIR whilst on outreach. Conclusions Our study suggests that an SOPV-based models of care, particularly when done in collaboration between sexual health clinicians and LGBTQI + organisations is feasible, acceptable, and effective in reaching populations at risk who may not engage with conventional sexual health services and campaigns. Further models of care may be explored in these settings beyond vaccination, such as testing for sexually transmissible infections or nurse-led pre-exposure prophylaxis to HIV (PrEP). Abbreviations AIR – Australian Immunisation Register ACON – AIDS Council of New South Wales (now a community HIV and LGBTQ+ health organisation) AOR – Adjusted Odds Ratio CI – Confidence Interval KRC – Kirketon Road Centre LHD – Local Health District MSM – Men who have sex with men NSW – New South Wales OR – Odds Ratio PEP – Post-Exposure Prophylaxis PrEP – Pre-Exposure Prophylaxis SD – Standard Deviation SESLHD – South Eastern Sydney Local Health District SHBBV – Sexual Health and Blood-Borne Virus SOPV – Sex-on-Premises Venue STI – Sexually Transmissible Infection UNSW – University of New South Wales Declarations Ethics approval and consent to participate: The process of retrieving, analysing, and publicising the data was reviewed by SESLHD’s Low Negligible Risk Committee on 25 February 2025 and deemed as not raising any ethical concerns according to the NHMRC National Statement (updated 2023) —Section 5.1.22, the NHMRC Ethical Considerations in Quality Assurance and Evaluation Activities (2014) guidance and NSW Health Guideline GL2007_020 Human Research Ethics Committees - Quality Improvement and Ethics Review: A Practice Guide for NSW . The study was conducted in accordance with the principles of the Declaration of Helsinki (2013), which underpins the ethical standards referenced above and guides the responsible conduct of research involving human participants and data. Consent for publication: The project utilised routinely collected clinical and administrative data, which were de-identified prior to analysis. As the study was conducted for quality assurance purposes and did not involve identifiable individual data, the requirement for informed consent to participate was waived in accordance with national guidelines and the determination made by the institutional ethics committee. Availability of data and materials: The datasets generated and/or analysed during the current study are not publicly available due to NSW Health policies regarding transfer of individual-level client data. No questionnaire was used in this study; the project used de-identified, routinely collected clinical and administrative data. Competing interests: The authors declare that they have not received any financial support, sponsorship, or other assistance from the company that manufactures the medication mentioned in this abstract. Phillip Read has received research funding from Gilead Sciences, as well as institutional and individual honoraria from Gilead Sciences, Abbvie and MSD. No pharmaceutical grants were received in the development of this study. Funding: This work was supported from KRC’s and ACON’s internal resources. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Authors’ contributions: AD, NC, MV, JvM, BP, WM, and PR designed the program reported in this study. AD, JvM, and NC contributed to data collection. PR, JK, AD, NCH and VB designed the data audit. VB, JvM, and SC conducted data analysis. VB drafted the manuscript and all co-authors (AD, NC, MV, JvM, BP, WM, BP, SCH, IA, BT, JK) made substantial contributions to it and reviewed the final version. Acknowledgements: We would like to thank all participants who received their mpox vaccine dose at SOPV or at KRC’s fixed-site. KRC and SHBBV staff who undertook the SOPV vaccination program, in particular Jo Mawson, Kelly O'Reilly, Rob Cherry, Toan Do, Alice Eggerton-Smith, Sue Laird-Portch, Anton Wyson, Dave Sanders, Imogen Geste, Chelsea Dalton, Eddie Gorman, Lotty Smith, Lucy Fromel, Alex Ray, Matilda Eyre, Guianna Noble, Julia Stafford, Eliza Van der Veer, Alex Murphy, and Timmy Lockwoo, and the staff that assisted in data processing, namely Imraan Daniels, Robyn van Der Sanden, and Amelia Garpendal. We would like to thank Bernie Fang who provided feedback on the manuscript. References Americo JL, Earl PL, Moss B. Virulence differences of mpox (monkeypox) virus clades I, IIa, and IIb. 1 in a small animal model. 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All participants vaccinated for mpox by KRC’s fixed site or at SOPV Participants vaccinated for mpox by KRC’s fixed site or at SOPV who were matched on AIR † KRC’s fixed site N=490, Mean (SD) SOPV N=331 Mean (SD) Test Statistic (p-value), other tests KRC’s fixed site N=327 Mean (SD) SOPV N=197 Mean (SD) Test Statistic (p-value) Age (years) 38.6 (± 12.6) 45.5 (± 15.7) t = -7.01 ( p < 0.001 ) 39.0 (± 13.2) 46.9 (± 14.5) t = -6.39, ( p < 0.001 ) Number of days between vaccine doses (for those fully vaccinated) 133.6 (232.0) 200.0 (278.5) t = -2.62 ( p = 0.009 ) 145.5 (243.8) 200.5 (284.8) t = -1.93 ( p = 0.054 ) No of days when both doses received at the same site 37.4 (13.2) 42.6 (14.5) t = -1.85 (p = 0.066) 36.3 (12.8) 39.0 (8.1) t = -0.97 ( p = 0.334) NOTE: There was no statistically significant difference between all vaccinated participants vs. those matched on AIR record within each group (KRC’s fixed site and SOPV), when assessed upon the presence of overlap between their 95% confidence intervals (no overlap meaning significant difference). † Participants who were vaccinated and had an AIR record are a subset of all participants reported in previous columns. Table 2. Comparative descriptive characteristics – sex on premises venues (SOPVs) vs. KRC onsite, categorical variables (YES / NO). All participants vaccinated for mpox by KRC onsite or at SOPV Participants vaccinated for mpox by KRC’s fixed site or at SOPV who were matched on AIR † KRC’s Fixed Site Onsite (N=490), n (%) SOPV (N=331), n (%) Chi2 Test, (p-value) KRC’s Fixed Site(N=327) n (%) SOPV (N=197) n (%) Chi2 Test (p-value) Has an AIR record 327 (66.7%) 197 (59.5%) χ² = 4.46 ( p = 0.035 ) 327 (100%) 197 (100%) n.a. Has Medicare 364 (74.3%) 189 (57.1%)* χ² = 26.54 ( p < 0.001 ) 272 (83.2%) 169 (85.8%)* χ² = 0.63 (p = 0.429) Postcode information available 385 (78.6%) 170 (51.4%)* χ² = 66.79 ( p<0.001 ) 316 (96.6%) 170 (86.3%)* χ² = 19.55 ( p < 0.001 ) From those with postcode info, resides in SESLHD 215 (55.8%) 58 (34.1%) χ²=61.82 ( p <0.001 ) 177 (55.8%) 58 (34.1%) χ² = 22.27 ( p < 0.001 ) Fully vaccinated (i.e. two mpox vaccines) 283 (57.8%) 146 (44.1%)* χ² = 14.75 ( p < 0.001 ) 251 (76.8%) 122 (62.0%)* χ² = 13.18 (p < 0.001 ) Only 1 st dose received at the site 32 (6.5%) 37 (11.2%) χ² = 5.54 ( p = 0.019 ) 32 (9.8%) 37 (18.8%) χ² = 8.70 ( p = 0.003 ) Only 2 nd dose received at the site 118 (24.1%) 80 (24.2%)* χ² = 0.00 (p = 0.977) 118 (36.1%) 61 (31.0%) χ² = 1.43 (p = 0.231) Both doses received at the same site 133 (27.1%) 28 (8.5%) χ² = 43.74 ( p < 0.001 ) 101 (30.9%) 23 (11.7%) χ² = 25.12 ( p < 0.001 ) Has had at least one of their mpox doses unrecorded on AIR 1 16 (3.3%) 26 (7.9%) χ² = 8.57 ( p = 0.003 ) 16 (4.9%) 26 (13.2%) χ² = 11.50 ( p = 0.001 ) In bold italics is statistically significant difference between participants at SOPV and at KRC’s fixed site. *Statistically significant difference between all vaccinated participants vs. those who were matched on AIR record within each group (KRC’s fixed site and SOPV), assessed upon the presence of overlap between their 95% confidence intervals (no overlap meaning significant difference). † Participants who were vaccinated and had an AIR record are a subset of all participants reported in previous columns. Table 3: Odds Ratios and p-values from Bivariate and Multivariate Logistic Regression Models predicting SOPV Recruitment Variable Bivariate OR (95% CI) p-value Model 1 AOR (95% CI) p-value Age (years) 1.036 (1.025 – 1.047) <0.001 1.047 (1.035 – 1.060) <0.001 Postcode data available (Yes) — — 0.565 (0.368 – 0.869) 0.009 SESLHD postcode (Yes) † 0.272 (0.194 – 0.380) <0.001 0.376 (0.253 – 0.560) <0.001 Has Medicare (Yes) 0.464 (0.345 – 0.625) <0.001 0.536 (0.368 – 0.782) 0.001 Has had at least one of their mpox doses unrecorded on AIR (Yes) †† 2.531 (1.336 – 4.795) 0.004 4.023 (1.962 – 8.248) <0.001 Fully vaccinated (i.e. two mpox vaccines, Yes) 0.577 (0.436 – 0.765) <0.001 0.785 (0.545 – 1.131) 0.193 † Participants with no postcode info were coded as “not SESLHD postcode” in the multivariate model. ††This includes participants who received an mpox vaccine dose at SOPV or at KRC’s fixed site, but either could not be matched with a profile on AIR or did have an AIR profile but their mpox vaccine dose wasn’t’ recorded there. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 18 Feb, 2026 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 17 Nov, 2025 Reviews received at journal 13 Nov, 2025 Reviewers agreed at journal 03 Nov, 2025 Reviews received at journal 28 Oct, 2025 Reviewers agreed at journal 16 Oct, 2025 Reviewers invited by journal 16 Oct, 2025 Editor assigned by journal 01 Oct, 2025 Editor invited by journal 23 Sep, 2025 Submission checks completed at journal 23 Sep, 2025 First submitted to journal 22 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7596483","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":536438433,"identity":"9c3491e4-5d1f-470a-b34c-80935aa1e9e0","order_by":0,"name":"Vendula Belackova","email":"data:image/png;base64,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","orcid":"","institution":"South Eastern Sydney Local Health District","correspondingAuthor":true,"prefix":"","firstName":"Vendula","middleName":"","lastName":"Belackova","suffix":""},{"id":536438434,"identity":"ca3c00ae-7cf6-45a1-9663-b3430e26b2cf","order_by":1,"name":"Anna Doab","email":"","orcid":"","institution":"South Eastern Sydney Local Health 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12:31:56","extension":"html","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":98975,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7596483/v1/2373d3a6ab11bae2fb5eaf8f.html"},{"id":94764634,"identity":"a1b13199-3921-4ee6-9699-542fc87ca9ab","added_by":"auto","created_at":"2025-10-30 12:31:56","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":56527,"visible":true,"origin":"","legend":"\u003cp\u003eMpox vaccines administered by outreach setting (Sauna I and Sauna II).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7596483/v1/a62855ec7cc5c91eae853f30.png"},{"id":94764636,"identity":"41f682a1-bb76-4071-94e6-f37a88b6ae02","added_by":"auto","created_at":"2025-10-30 12:31:56","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":123934,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eFlow-chart of occasions of service and mpox vaccinations at SOPV.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7596483/v1/50ad4da744a96fac2d63d362.png"},{"id":103251269,"identity":"d5045991-aef3-46d4-86be-73e1e56bf793","added_by":"auto","created_at":"2026-02-23 16:07:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":998023,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7596483/v1/ecb21609-b547-4ca5-9dd7-66fd94bf71a4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Outreach mpox vaccination at sex-on-premises venues in Sydney: An audit of a collaborative intervention by public health nurses and LGBTQI+ peer workers","fulltext":[{"header":"Background","content":"\u003cp\u003eMpox is caused by the monkeypox virus with its two distinct virus clades (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Mpox is mainly transmitted through sustained close physical contact, including sexual contact, with someone who has mpox, for example, in households and venues that offer sex-on-premises, and as well as through contact with shared surfaces, furniture, or linen (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e); more research is needed regarding respiratory (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) or maternal-foetal routes of transmission (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In 2022\u0026ndash;2023, a global outbreak of mpox clade IIb resulted in more than 100,000 cases in 127 countries; most cases have been in males, primarily gay, bisexual and other men who have sex with men (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Health authorities first detected mpox in Australia in May 2022, which led to 144 cases being reported during the 2022 outbreak (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). During this initial wave of vaccination, due to shortages in supply, many people received just one dose of the mpox vaccine intradermally (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). In 2024, local mpox transmission increased in New South Wales (NSW), exceeding two hundred notifications by August 2024 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This was an unexpected resurgence of the virus, following successful efforts to curb the spread in 2022\u0026ndash;2023 via a prompt public health campaign (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) .\u003c/p\u003e\u003cp\u003eAmong the various strategies proposed to mitigate mpox outbreaks, administering mpox vaccine at \u0026ldquo;saunas\u0026rsquo; or other sex-on-premise venues (SOPVs) has been identified as a potentially effective approach (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). As well as providing communal bathing facilities, the saunas provide a location for patrons to engage in consensual sexual activities, typically on an informal and non-commercial basis. Such settings provide anonymity and are often attended by men who have sex with men (MSM) but may not self-identify as gay (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). As such, SOPVs have been identified as important potential locations for HIV and other STI acquisition for over a decade (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e), and therefore, sexual health services and community organisations have conducted outreach into SOPVs to offer access to STI testing (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Despite existing outreach services, vaccination programs at SOPVs remain limited (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEstablished in 1987, The Kirketon Road Centre (KRC) is a publicly funded community health service designed to deliver free low-threshold, harm-reduction-focused care. KRC is part of the Sexual Health and Blood-Borne Virus team (SHBBV) which encompasses a network of clinics across the South Eastern Sydney Local Health District (SESLHD). KRC primarily targets populations at risk, including people who inject drugs, sex workers, people experiencing homelessness, and young people under 25 who are at risk or affected by these factors. It also prioritises individuals requiring testing or treatment for sexually transmissible infections (STIs), HIV, hepatitis B and C; pre- and post-exposure prophylaxis (PrEP and PEP) for HIV; and engages in targeted outreach and health promotion, such as vaccination, to increase access among high-risk groups. Mpox vaccination became a core part of KRC and SHBBV\u0026rsquo;s services since 2022.\u003c/p\u003e\u003cp\u003eThe 2024 mpox resurgence in NSW triggered a public health and service response to deliver mpox vaccination to at-risk MSM. As part of a response by the local sexual health sector to maximise mpox vaccination uptake, KRC partnered with ACON (a community HIV and LGBTQ\u0026thinsp;+\u0026thinsp;health organisation, formerly known as the AIDS Council of NSW), to conduct outreach vaccination in \u0026ldquo;saunas\u0026rdquo; within the geographic remit of the Local Health District under which KRC operates (the South Eastern Sydney Local Health District (SESLHD)). Two SOPVs accepted the offer for vaccine outreach sessions (aliased as Sauna I and Sauna II) and these were conducted between September and December 2024. On a typical week, an outreach shift was conducted into each of those venues on two consecutive days. SOPV attendees were approached by an ACON peer worker first; the peer worker offered health education and those who were interested in mpox vaccine (Jynneos\u003csup\u003e\u0026reg;\u003c/sup\u003e) were referred to the accredited registered nurse immuniser for the vaccination. All participants were monitored for 15 minutes post-vaccination.\u003c/p\u003e\u003cp\u003eThis paper aimed to describe the scope, the acceptability, and the outcomes of mpox vaccination outreach at SOPVs in Sydney. It also aimed to compare characteristics of people who received mpox vaccination at SOPVs to those who were vaccinated for mpox at a KRC\u0026rsquo;s fixed-site vaccination clinic during the same period.\u003c/p\u003e"},{"header":"Material and methods","content":"\u003cp\u003e\u003cem\u003eData collection - service-level and client-level data\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eDuring each outreach session at an SOPV, ACON peer workers collected service-level data on the number of engagements, vaccination acceptance, and self-reported vaccination history (no identifiers were retrieved by peer-workers).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eClinical, individual-level data were also collected. Prior to administering mpox vaccination, registered nurses from KRC and from other SHBBV services at SESLHD provided Jynneos\u0026reg; consent forms that eligible participants self-administered. The registered nurse checked the consent for medical eligibility and participants were given the opportunity to ask questions as needed. For KRC\u0026rsquo;s fixed-site vaccination clinics, mpox vaccination records were administered as usual and recorded in its internal medication management system.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWith additional consent, mpox vaccinations at SOPVs and at KRC\u0026rsquo;s fixed-site were also recorded on the Australian Immunisation Register (AIR). This step was not made mandatory by the authorities because mpox vaccination targeted specific at-risk MSM populations \u0026nbsp;who may wish not to be identified as such by other health providers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIndividual-level data and the process of matching\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData from Jynneos\u0026reg; consent forms were transcribed for this study, to form a set of participants who were vaccinated against mpox at SOPV outreach. For participants who received an mpox vaccine at KRC\u0026rsquo;s fixed-site, we extracted their details from KRC\u0026rsquo;s medication management system.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBoth the SOPV and the KRC\u0026rsquo;s fixed-site dataset were matched against mpox vaccination records in AIR using client\u0026rsquo;s name, date of birth, and Medicare number when available (neither SOPV nor KRC fixed-site participants were required to provide this number nor have their vaccination recorded on AIR). This allowed us to retrieve information on any additional mpox vaccinations administered by other providers. AIR records were also used to complement missing postcode data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the process of matching, a report including all participants with any vaccination history was requested from the AIR. A unique identifier was created in both the AIR report and the SOPV and KRC fixed-site client lists from the first two letters of the last name, first name, and date of birth, and data were consolidated to one record per client with the number of doses received. These processed results were then matched back to the original client list using the unique identifier. The AIR report and the SOPV and KRC fixed-site client list were compared using VLOOKUP in Microsoft Excel to identify and correct variations in names and Medicare numbers. Data cleaning and processing were conducted in RStudio (R version 4.4.1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAn anonymised dataset comprising of individual-level data, date of 1\u003csup\u003est\u003c/sup\u003e and 2\u003csup\u003end\u003c/sup\u003e mpox vaccination (when applicable), residential postcode availability, whether the available postcode was in SESLHD, whether the person had Medicare (when available), and whether they were on AIR was used for the analysis. The process of retrieving, analysing, and publicising the data was reviewed by SESLHD\u0026rsquo;s Low Negligible Risk Committee on 25 February 2025 and deemed as not raising any ethical concerns.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAnalysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive analysis of service data collected by ACON\u0026rsquo;s peer workers was used to report on the number of engagements at SOPVs, vaccination eligibility, self-reported vaccination history, and willingness to receive an mpox vaccine onsite at the SOPV.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNext, a descriptive analysis of clinical data was ran to examine the characteristics of people who were vaccinated at SOPVs and at KRC\u0026rsquo;s fixed-site. The descriptive analysis used individual-level data that was available from Jynneos\u0026reg; consent forms (date of birth, previous vaccination) and from AIR (for matched participants) to assess mpox vaccine course completion and postcode of residence. Chi\u003csup\u003e2\u003c/sup\u003e and t-tests were used to compare these two groups.\u003c/p\u003e\n\u003cp\u003eAn additional analysis included restricting the comparative descriptive analysis above to people who could be matched with AIR records (67% of participants who received mpox vaccine onsite at KRC and 60% of those at SOPV). This was relevant because unmatched participants had inherent data gaps in key variables obtained through AIR, including postcode, Medicare number availability, and in their records of additional mpox doses administered by other providers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFinally, a multivariate analysis examined factors associated with receiving an mpox vaccine at an SOPV versus at KRC\u0026rsquo;s fixedsite. Participant age, postcode availability, residence within SESLHD, Medicare number availability, and mpox vaccine completion (two doses) were used as covariates. \u0026nbsp;We also controlled for a variable we created \u0026ndash; \u0026ldquo;having at least one of their mpox doses \u003cem\u003eNOT\u003c/em\u003e recorded on AIR\u0026rdquo;, i.e. they were provided an mpox vaccine at SOVP or KRC\u0026rsquo;s fixed-site yet this dose either could not be found on AIR or the participant didn\u0026rsquo;t have any AIR records at all; we chose this indicator as a proxy for participants potentially not wanting to identify as MSM, although the reasons may vary.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eDescriptive analysis of service data\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBetween September and December 2024, KRC and ACON conducted twenty-two outreach clinics across two SOPVs. The mean number of mpox vaccines administered per outreach session was n=16 (median was n=13); with a range of 3 to 41 doses per clinic (\u003cem\u003esee Figure 1\u003c/em\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFigure 1 about here\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThere were n=840 recorded engagements at SOPVs. In n=300 engagements (36%), the person stated they had already been fully vaccinated against mpox, n=18 (2%) were unable to consent; deeming n=522 (62%) engagements with participants who were eligible for mpox vaccination at an SOPV. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFrom eligible engagements, on n=118 (22%) occasions, participants declined mpox vaccination onsite at an SOPV. A total of 407 mpox vaccinations were recorded onsite at SOPVs, representing 78% of eligible engagements(or 49% of all engagements). The number of unique participants vaccinated at SOPVs could not be determined from this data source, but we analyse this in the following section.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFigure 2 about here\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDescriptive analysis of clinical data\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFrom the Jynneos\u0026reg; consent forms, we identified n=331 unique participants who received an mpox vaccination during SOPV outreach over the study period. Some participants received more than one dose, resulting in a total of \u003cem\u003en\u003c/em\u003e = 359 mpox vaccine doses administered during outreach. Several incomplete consent forms were excluded during transcription due to illegible handwriting (n = 32) or missing information (n = 15), accounting for the discrepancy from the n = 407 vaccinations reported in the previous section.\u003c/p\u003e\n\u003cp\u003eDuring the same period, n=502 participants were vaccinated for mpox onsite at KRC; accounting for a total of n=639 mpox vaccine doses. There was a small overlap between participants who received mpox vaccines at SOPV and KRC\u0026rsquo;s fixed-site: seven people received their first mpox vaccine at an SOPV and their second at KRC\u0026rsquo;s fixed-site, while one person received their first dose at KRC and their second at an SOPV. For the purposes of this analysis, all eight participants were classified as SOPV participants.\u003c/p\u003e\n\u003cp\u003ePeople vaccinated in SOPVs were, on average, older than those vaccinated at KRC\u0026rsquo;s fixed-site, with a mean age of 46 years compared to 39 years (t = -7.01, p \u0026lt; 0.001). SOPV participants were less likely to have an AIR record (60% vs. 67%, \u0026chi;\u0026sup2; = 4.46, p = 0.035) and less likely to have Medicare (57% vs. 74%, \u0026chi;\u0026sup2; = 26.54, p \u0026lt; 0.001), see Table 1 and Table 2 for details.\u003c/p\u003e\n\u003cp\u003ePostcode information was available for fewer SOPV participants than those vaccinated at KRC\u0026rsquo;s fixed-site (51% vs. 79%, \u0026chi;\u0026sup2; = 66.79, p \u0026lt; 0.001). Among those with postcode data, only 34% of people vaccinated at SOPV resided in SESLHD compared to 56% of those who were vaccinated at KRC\u0026rsquo;s fixed-site (\u0026chi;\u0026sup2; = 61.82, p \u0026lt; 0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSOPV participants were less likely to be fully vaccinated (44% vs. 58%, \u0026chi;\u0026sup2; = 14.75, p \u0026lt; 0.001) and were more likely to have at least one mpox vaccine dose unrecorded in AIR (8% vs. 3%, \u0026chi;\u0026sup2; = 8.57, p = 0.003).\u003c/p\u003e\n\u003cp\u003ePeople vaccinated at KRC\u0026rsquo;s fixed-site clinic were more likely to receive both mpox vaccine doses there, compared to just 9% of SOPV participants who received both doses at SOPV (\u0026chi;\u0026sup2; = 43.74, p \u0026lt; 0.001). Conversely, people vaccinated at SOPV were more likely to only receive their first dose there (11% vs. 7%, \u0026chi;\u0026sup2; = 5.54, p = 0.019). Among those fully vaccinated, the average number of days between doses was significantly higher in the SOPV group (200 days vs. 134 days, t = -2.62, p = 0.009; the number of days was lower for participants who received both doses at the same site, being 42 days at KRC\u0026rsquo;s fixed-site and 37 days at SOPV), 28 days being the minimum and recommended time between doses.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eComparative descriptive analysis of people who were matched on AIR\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFrom participants who could be matched with a profile on AIR, n=327 participants received an mpox vaccine at KRC\u0026rsquo;s fixed-site and n=197 participants received a vaccine at SOPV.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the AIR-matched sub-sample, people vaccinated at SOPV remained significantly older than those vaccinated at KRC\u0026rsquo;s fixed-site (47 vs. 39 years, t = -6.39, p \u0026lt; 0.001). However, a similar proportion of AIR-matched SOPV participants and AIR-matched participants at KRC\u0026rsquo;s fixed-site had Medicare (86% and 83%, respectively), see Table 1 and Table 2 for details.\u003c/p\u003e\n\u003cp\u003eMore postcode data was available for AIR-matched than for non-matched participants, reflecting the fact that was where postcode information was largely retrieved from; however, the difference between the groups remained significant (97% of participants from KRC\u0026rsquo;s fixed-site and 86% participants from SOPV had a postcode available, \u0026chi;\u0026sup2; = 19.55, p \u0026lt; 0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eImportantly, when looking only at people who were matched on AIR, a significantly higher proportion of participants compared to the non-matched ones received two doses of the mpox vaccine (77% of participants at KRC\u0026rsquo;s fixed-site received two doses vs. 58% of SOPV participants,\u0026nbsp;\u0026chi;\u0026sup2; = 13.18, \u003cstrong\u003e\u003cem\u003ep \u0026lt; 0.001\u003c/em\u003e\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 1 about here\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 2 about here\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOdds of receiving mpox vaccination at SOPV vs. at KRC\u0026rsquo;s fixed-site\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe multivariate logistic regression was used to explore the odds of receiving mpox vaccination at an SOPV vs. at KRC\u0026rsquo;s fixed-site, adjusting for all covariates. The findings corroborated those of the comparative descriptive analysis (see Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the model, each additional year of age increased the likelihood of receiving mpox vaccination at an SOPV rather than at KRC\u0026rsquo;s fixed-site by 5% (p \u0026lt; 0.001). Participants residing in SESLHD were 61% less likely to receive an mpox vaccine at SOPVs (p \u0026lt; 0.001) and not having Medicare was associated with a 48% increase in the odds of receiving an mpox vaccine at an SOPV (p = 0.001). Having at least one mpox dose unrecorded on AIR increased the odds of receiving the mpox vaccine at an SOPV by 382% (p \u0026lt; 0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the multivariate model, receiving two doses of the mpox vaccine (\u0026ldquo;fully vaccinated\u0026rdquo;) wasn\u0026rsquo;t significantly associated with the vaccination site, suggesting that vaccine completion was more influenced by participant characteristics and data completeness than by the vaccination site alone.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 3 about here\u003c/em\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eMpox outreach vaccination administered at SOPVs proved both beneficial and acceptable, with 78% of eligible participants agreeing to receive an mpox vaccination there. Given the success of the mpox vaccination outreach at SOPVs in engaging priority populations, SOPV-based vaccination models should be included in future public health responses targeting MSM.\u003c/p\u003e\u003cp\u003eCompared to participants vaccinated at the KRC\u0026rsquo;s fixed-site, those vaccinated at SOPVs were older and less likely to reside in SESLHD. Indeed, our research showed that participants vaccinated at SOPV were more likely to have an incomplete vaccination record on AIR (i.e. receive mpox doses from KRC that were not recorded on AIR), which may indicate higher concern about confidentiality. These findings align with a previous study which found that men attending SOPVs were older than those coming to a fixed sexual health clinic, were more commonly married or widowed to a woman, were at higher risk of sexually transmissible infections, and attended for less STI and HIV testing compared to participants from a fixed-site clinic (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The difference in postcode suggests that men who were vaccinated at SOPVs may have travelled from other health districts to access these venues while maintaining confidentiality. As such, the mpox vaccination outreach into SOPVs reached outside of the borders of SESLHD and, with that, may have enabled a better control of the mpox epidemic in NSW.\u003c/p\u003e\u003cp\u003ePeople vaccinated at SOPVs and at KRC\u0026rsquo;s fixed-site had high rates of vaccine completion \u0026ndash; for those were matched with a record on AIR, this was 66% and 77%, respectively. The fixed-site vaccine completion rate is consistent with other studies of mpox vaccine completion. A recent study reporting on mpox vaccination rates from a survey among MSM found that among n\u0026thinsp;=\u0026thinsp;4,252 participants in Australia, 41.5% had received both doses of the vaccine, 12.3% had received one dose, and 46.2% were unvaccinated. Overall, 77% of people receiving any vaccine had received two doses of mpox; this respective proportion was 79% among n\u0026thinsp;=\u0026thinsp;1214 men in Sydney (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). An audit of mpox vaccine records in NSW indeed found that approximately 75\u0026ndash;76% of people who received at least one dose of mpox vaccine also received their second (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe lower rate of achieving full vaccination among SOPV participants could be explained by the characteristics of the participants, indicating that people not typically reached by conventional sexual health services in SESLHD were engaged at SOPVs. SOPV participants compared to KRC\u0026rsquo;s fixed-site were less likely to have Medicare, postcode information, or a matching profile on AIR. This indicates that the SOPV outreach may have engaged participants who were more likely to be non-residents of Australia or who were not well-integrated into the formal healthcare system. These men may have been missed by public health campaigns that target more mainstream MSM and, as such, have less access to information about mpox. Indeed, SOPV participants experienced longer delays between their two mpox doses, suggesting they may have been experiencing additional barriers to accessing mpox vaccines. As such, the SOPV outreach may have filled in a gap by accessing an otherwise under-serviced population of MSM at risk.\u003c/p\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eMpox vaccination has had an exemption from AIR data entry (mpox vaccination has an exemption from AIR data entry whereby it is not mandatory to record as it may identify someone as MSM or at risk on their health record). A key limitation of this study was the uncertainty surrounding people who were unmatched on AIR. Whilst we assume this reflects their lack of integration into the healthcare system, this could, in some cases, be a result of incomplete or incorrect information recorded on the Jynneos consent forms. In particular, participants with long names or inaccurately transcribed Medicare numbers were more likely to remain unmatched, potentially leading to underestimation of vaccine uptake and other data points that we retrieved from AIR. Moreover, 22% of participants who were eligible to receive an mpox vaccination at SOPVs declined this offer; we couldn\u0026rsquo;t access characteristics of these participants specifically. Other factors that could have biased the findings about SOPV participants (besides the lower vaccination completion, less Medicare information, postcode availability, or less likely having a profile on AIR) are issues in accessing the internet or AIR whilst on outreach.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOur study suggests that an SOPV-based models of care, particularly when done in collaboration between sexual health clinicians and LGBTQI\u0026thinsp;+\u0026thinsp;organisations is feasible, acceptable, and effective in reaching populations at risk who may not engage with conventional sexual health services and campaigns. Further models of care may be explored in these settings beyond vaccination, such as testing for sexually transmissible infections or nurse-led pre-exposure prophylaxis to HIV (PrEP).\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAIR\u0026nbsp;\u0026ndash; Australian Immunisation Register\u003c/p\u003e\n\u003cp\u003eACON\u0026nbsp;\u0026ndash; AIDS Council of New South Wales (now a community HIV and LGBTQ+ health organisation)\u003c/p\u003e\n\u003cp\u003eAOR\u0026nbsp;\u0026ndash; Adjusted Odds Ratio\u003c/p\u003e\n\u003cp\u003eCI\u0026nbsp;\u0026ndash; Confidence Interval\u003c/p\u003e\n\u003cp\u003eKRC\u0026nbsp;\u0026ndash; Kirketon Road Centre\u003c/p\u003e\n\u003cp\u003eLHD\u0026nbsp;\u0026ndash; Local Health District\u003c/p\u003e\n\u003cp\u003eMSM\u0026nbsp;\u0026ndash; Men who have sex with men\u003c/p\u003e\n\u003cp\u003eNSW\u0026nbsp;\u0026ndash; New South Wales\u003c/p\u003e\n\u003cp\u003eOR\u0026nbsp;\u0026ndash; Odds Ratio\u003c/p\u003e\n\u003cp\u003ePEP\u0026nbsp;\u0026ndash; Post-Exposure Prophylaxis\u003c/p\u003e\n\u003cp\u003ePrEP\u0026nbsp;\u0026ndash; Pre-Exposure Prophylaxis\u003c/p\u003e\n\u003cp\u003eSD\u0026nbsp;\u0026ndash; Standard Deviation\u003c/p\u003e\n\u003cp\u003eSESLHD\u0026nbsp;\u0026ndash; South Eastern Sydney Local Health District\u003c/p\u003e\n\u003cp\u003eSHBBV\u0026nbsp;\u0026ndash; Sexual Health and Blood-Borne Virus\u003c/p\u003e\n\u003cp\u003eSOPV\u0026nbsp;\u0026ndash; Sex-on-Premises Venue\u003c/p\u003e\n\u003cp\u003eSTI\u0026nbsp;\u0026ndash; Sexually Transmissible Infection\u003c/p\u003e\n\u003cp\u003eUNSW \u0026ndash; University of New South Wales\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e The process of retrieving, analysing, and publicising the data was reviewed by SESLHD\u0026rsquo;s Low Negligible Risk Committee on 25 February 2025 and deemed as not raising any ethical concerns according to the \u003cem\u003eNHMRC National Statement (updated 2023) \u0026mdash;Section 5.1.22,\u0026nbsp;\u003c/em\u003ethe \u003cem\u003eNHMRC Ethical Considerations in Quality Assurance and Evaluation Activities (2014)\u0026nbsp;\u003c/em\u003eguidance and \u003cem\u003eNSW Health Guideline GL2007_020 Human Research Ethics Committees - Quality Improvement and Ethics Review: A Practice Guide for NSW\u003c/em\u003e. The study was conducted in accordance with the principles of the Declaration of Helsinki (2013), which underpins the ethical standards referenced above and guides the responsible conduct of research involving human participants and data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e The project utilised routinely collected clinical and administrative data, which were de-identified prior to analysis. As the study was conducted for quality assurance purposes and did not involve identifiable individual data, the requirement for informed consent to participate was waived in accordance with national guidelines and the determination made by the institutional ethics committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e The datasets generated and/or analysed during the current study are not publicly available due to NSW Health policies regarding transfer of individual-level client data. No questionnaire was used in this study; the project used de-identified, routinely collected clinical and administrative data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors declare that they have not received any financial support, sponsorship, or other assistance from the company that manufactures the medication mentioned in this abstract. Phillip Read has received research funding from Gilead Sciences, as well as institutional and individual honoraria from Gilead Sciences, Abbvie and MSD. No pharmaceutical grants were received in the development of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This work was supported from KRC\u0026rsquo;s and ACON\u0026rsquo;s internal resources. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u003c/strong\u003e AD, NC, MV, JvM, BP, WM, and PR designed the program reported in this study. AD, JvM, and NC contributed to data collection. PR, JK, AD, NCH and VB designed the data audit. VB, JvM, and SC conducted data analysis. VB drafted the manuscript and all co-authors (AD, NC, MV, JvM, BP, WM, BP, SCH, IA, BT, JK) made substantial contributions to it and reviewed the final version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e We would like to thank all participants who received their mpox vaccine dose at SOPV or at KRC\u0026rsquo;s fixed-site. KRC and SHBBV staff who undertook the SOPV vaccination program, in particular Jo Mawson, Kelly O\u0026apos;Reilly, Rob Cherry, Toan Do, Alice Eggerton-Smith, Sue Laird-Portch, Anton Wyson, Dave Sanders, Imogen Geste, Chelsea Dalton, Eddie Gorman, Lotty Smith, Lucy Fromel, Alex Ray, Matilda Eyre, Guianna Noble, Julia Stafford, Eliza Van der Veer, Alex Murphy, and Timmy Lockwoo, and the staff that assisted in data processing, namely Imraan Daniels, Robyn van Der Sanden, and Amelia Garpendal. We would like to thank Bernie Fang who provided feedback on the manuscript.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmerico JL, Earl PL, Moss B. Virulence differences of mpox (monkeypox) virus clades I, IIa, and IIb. 1 in a small animal model. Proceedings of the National Academy of Sciences. 2023;120(8):e2220415120.\u003c/li\u003e\n\u003cli\u003ePinto P, Costa MA, Gon\u0026ccedil;alves MF, Rodrigues AG, Lisboa C. Mpox person-to-person transmission\u0026mdash;where have we got so far? A systematic review. Viruses. 2023;15(5):1074.\u003c/li\u003e\n\u003cli\u003eThornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox virus infection in humans across 16 countries\u0026mdash;April\u0026ndash;June 2022. New England Journal of Medicine. 2022;387(8):679-91.\u003c/li\u003e\n\u003cli\u003eBeeson A, Styczynski A, Hutson CL, Whitehill F, Angelo KM, Minhaj FS, et al. Mpox respiratory transmission: the state of the evidence. The Lancet Microbe. 2023;4(4):e277-e83.\u003c/li\u003e\n\u003cli\u003eClemente NS, Coles C, Paixao ES, Brickley EB, Whittaker E, Alfven T, et al. Paediatric, maternal, and congenital mpox: a systematic review and meta-analysis. The Lancet Global Health. 2024;12(4):e572-e88.\u003c/li\u003e\n\u003cli\u003eLaurenson-Schafer H, Sklenovsk\u0026aacute; N, Hoxha A, Kerr SM, Ndumbi P, Fitzner J, et al. Description of the first global outbreak of mpox: an analysis of global surveillance data. The Lancet Global Health. 2023;11(7):e1012-e23.\u003c/li\u003e\n\u003cli\u003eCornelisse VJ, Heath‐Paynter D, Delpech V, Read P, Apostolellis A, Medland NA, et al. How Australia and Aotearoa New Zealand avoided large‐scale mpox (formerly monkeypox) outbreaks in 2022\u0026ndash;2023. Internal Medicine Journal. 2023;53(10).\u003c/li\u003e\n\u003cli\u003eChaverot S, Katelaris LA, Read P, Sheppeard V. JYNNEOS series completion by route of dose 1, and an SMS reminder intervention, Sydney. Communicable Diseases and Immunisation Conference; Brisbane2024.\u003c/li\u003e\n\u003cli\u003eHealth N. NSW Mpox Surveillance Report. Epidemiological week 07. North Sydney2025.\u003c/li\u003e\n\u003cli\u003eHolloway IW. Lessons for Community-Based Scale-Up of Monkeypox Vaccination From Previous Disease Outbreaks Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States. American Journal of Public Health. 2022;112(11):1572-5.\u003c/li\u003e\n\u003cli\u003eOoi C, Kong FYS, Lewis DA, Hocking JS. Prevalence of sexually transmissible infections and HIV in men attending sex-on-premises venues in Australia: a systematic review and meta-analysis of observational studies. Sexual Health. 2020;17(2):135.\u003c/li\u003e\n\u003cli\u003eBennett C, Knight V, Knox D, Gray J, Hartmann G, McNulty A. An alternative model of sexually transmissible infection testing in men attending a sex-on-premises venue in Sydney: a cross-sectional descriptive study. Sexual Health. 2016;13(4):353.\u003c/li\u003e\n\u003cli\u003eLister N, Smith A, Tabrizi S, Hayes P, Medland N, Garland S, et al. Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men at male-only saunas. Sexually transmitted diseases. 2003;30(12):886-9.\u003c/li\u003e\n\u003cli\u003eRoy P, Heathcock ST, Bullock M, Nutland W, Mandal S, editors. P075 An outbreak of hepatitis A amongst gay and bisexual men linked to a sex-on-premises venue in London: the incident response2023: BMJ Publishing Group Ltd.\u003c/li\u003e\n\u003cli\u003eOoi C, Donovan B, Lewis DA. Cross-sectional study of sexual behaviour and health of gay and bisexual men in suburban Sydney, New South Wales, Australia: contrasts between sex venue and clinic attendees. Sexual Health. 2021;18(3):248-53.\u003c/li\u003e\n\u003cli\u003eMacgibbon J, Storer D, Bavinton BR, Cornelisse VJ, Broady TR, Chan C, et al. Mpox vaccination coverage among Australian gay and bisexual men and non-binary people: Results of behavioural surveillance in early 2024. Vaccine. 2025;55:127014.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cem\u003eTable 1. Comparative descriptive Characteristics \u0026ndash; sex on premises venues (SOPVs) vs. KRC\u0026rsquo;s fixed site, continuous variables.\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 302px;\"\u003e\n \u003cp\u003eAll participants vaccinated for mpox by KRC\u0026rsquo;s fixed site or at SOPV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003eParticipants vaccinated for mpox by KRC\u0026rsquo;s fixed site or at SOPV who were matched on AIR\u003csup\u003e\u0026nbsp; \u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKRC\u0026rsquo;s fixed site N=490,\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSOPV N=331 \u0026nbsp; \u0026nbsp; Mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTest Statistic (p-value), other tests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKRC\u0026rsquo;s fixed site N=327\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSOPV\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN=197 Mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTest Statistic (p-value)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e38.6 (\u0026plusmn; 12.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e45.5 (\u0026plusmn; 15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cem\u003et = -7.01\u0026nbsp;\u003c/em\u003e\u003cbr\u003e\u0026nbsp;\u003cem\u003e(\u003cstrong\u003ep \u0026lt; 0.001\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e39.0 (\u0026plusmn; 13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e46.9 (\u0026plusmn; 14.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003et = -6.39,\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep \u0026lt; 0.001\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eNumber of days between vaccine doses (for those fully vaccinated)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e133.6 (232.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e200.0 (278.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cem\u003et = -2.62\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep = 0.009\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e145.5 (243.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e200.5 (284.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003et = -1.93\u0026nbsp;\u003cbr\u003e\u0026nbsp;(\u003c/em\u003e\u003cem\u003ep = 0.054\u003c/em\u003e\u003cem\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eNo of days when both doses received at the same site\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e37.4 (13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e42.6 (14.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003et = -1.85\u0026nbsp;\u003cbr\u003e(p = 0.066)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e36.3 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e39.0 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003et = -0.97\u0026nbsp;\u003cbr\u003e\u0026nbsp;(\u003c/em\u003e\u003cem\u003ep = 0.334)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNOTE: There was no statistically significant difference between all vaccinated participants vs. those matched on AIR record within each group (KRC\u0026rsquo;s fixed site and SOPV), when assessed upon the presence of overlap between their 95% confidence intervals (no overlap meaning significant difference).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e\u0026dagger;\u003c/sup\u003eParticipants who were vaccinated and had an AIR record are a subset of all participants reported in previous columns.\u003cem\u003e\u003cbr\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 2. Comparative descriptive characteristics \u0026ndash; sex on premises venues (SOPVs) vs. KRC onsite, categorical variables (YES / NO).\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 264px;\"\u003e\n \u003cp\u003eAll participants vaccinated for mpox by KRC onsite or at SOPV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eParticipants vaccinated for mpox by KRC\u0026rsquo;s fixed site or at SOPV who were matched on AIR\u003cstrong\u003e\u003csup\u003e\u0026nbsp;\u0026dagger;\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKRC\u0026rsquo;s Fixed Site Onsite (N=490), n (%) \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSOPV (N=331),\u0026nbsp;\u003cbr\u003e\u0026nbsp;n (%)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eChi2 Test, (p-value)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKRC\u0026rsquo;s Fixed Site(N=327)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%) \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSOPV\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N=197)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eChi2 Test (p-value)\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eHas an AIR record\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e327 (66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e197 (59.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 4.46\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep = 0.035\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e327 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e197 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cem\u003en.a.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eHas Medicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e364 (74.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e189 (57.1%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 26.54\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep \u0026lt; 0.001\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e272 (83.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e169 (85.8%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 0.63\u0026nbsp;\u003cbr\u003e(p = 0.429)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003ePostcode information available\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e385 (78.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e170 (51.4%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 66.79 \u0026nbsp;(\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e316 (96.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e170 (86.3%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 19.55\u0026nbsp;\u003cbr\u003e(\u003cstrong\u003e\u003cem\u003ep \u0026lt; 0.001\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eFrom those with postcode info, resides in SESLHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e215 (55.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e58 (34.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2;=61.82\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026lt;0.001\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e177 (55.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e58 (34.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 22.27\u0026nbsp;\u003cbr\u003e(\u003cstrong\u003e\u003cem\u003ep \u0026lt; 0.001\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eFully vaccinated (i.e. two mpox vaccines)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e283 (57.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e146 (44.1%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 14.75\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep \u0026lt; 0.001\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e251 (76.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e122 (62.0%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 13.18\u0026nbsp;\u003cbr\u003e\u003cstrong\u003e\u003cem\u003e(p \u0026lt; 0.001\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eOnly 1\u003cstrong\u003e\u003csup\u003est\u003c/sup\u003e\u003c/strong\u003e dose received at the site\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e32\u0026nbsp;\u003cbr\u003e\u0026nbsp;(6.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e37 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 5.54\u0026nbsp;\u003cbr\u003e\u0026nbsp;(\u003c/em\u003e\u003cstrong\u003e\u003cem\u003ep = 0.019\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e32 (9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e37 (18.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 8.70\u0026nbsp;\u003cbr\u003e(\u003cstrong\u003e\u003cem\u003ep = 0.003\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eOnly 2\u003cstrong\u003e\u003csup\u003end\u003c/sup\u003e\u003c/strong\u003e dose received at the site\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e118 (24.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e80 (24.2%)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 0.00\u0026nbsp;\u003cbr\u003e\u0026nbsp;(p = 0.977)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e118 (36.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e61 (31.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 1.43\u0026nbsp;\u003cbr\u003e\u0026nbsp;(p = 0.231)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eBoth doses received at the same site\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e133 (27.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e28 (8.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 43.74\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e(\u003cstrong\u003ep \u0026lt; 0.001\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e101 (30.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e23 (11.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 25.12\u003cbr\u003e(\u003cstrong\u003e\u003cem\u003ep \u0026lt; 0.001\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eHas had at least one of their mpox doses unrecorded on AIR\u003ca href=\"#_ftn1\" name=\"_ftnref1\" title=\"\"\u003e\u003cstrong\u003e\u003c/strong\u003e\u003c/a\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e16 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e26 (7.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026chi;\u0026sup2; = 8.57\u0026nbsp;\u003cbr\u003e (\u003cstrong\u003ep = 0.003\u003c/strong\u003e)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e16 (4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 88px;\"\u003e\n \u003cp\u003e26 (13.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2; = 11.50\u0026nbsp;\u003cbr\u003e(\u003cstrong\u003e\u003cem\u003ep = 0.001\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIn bold italics\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eis statistically significant difference between participants at SOPV and at KRC\u0026rsquo;s fixed site.\u003c/p\u003e\n\u003cp\u003e*Statistically significant difference between all vaccinated participants vs. those who were matched on AIR record within each group (KRC\u0026rsquo;s fixed site and SOPV), assessed upon the presence of overlap between their 95% confidence intervals (no overlap meaning significant difference).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e\u0026dagger;\u003c/sup\u003eParticipants who were vaccinated and had an AIR record are a subset of all participants reported in previous columns.\u003cem\u003e\u003cbr\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 3: Odds Ratios and p-values from Bivariate and Multivariate Logistic Regression Models predicting SOPV Recruitment\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"627\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBivariate\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e1.036 (1.025 \u0026ndash; 1.047)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e1.047 (1.035 \u0026ndash; 1.060)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003ePostcode data available (Yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e0.565 (0.368 \u0026ndash; 0.869)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eSESLHD postcode (Yes)\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e0.272 (0.194 \u0026ndash; 0.380)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e0.376 (0.253 \u0026ndash; 0.560)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eHas Medicare (Yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e0.464 (0.345 \u0026ndash; 0.625)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e0.536 (0.368 \u0026ndash; 0.782)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eHas had at least one of their mpox doses unrecorded on AIR (Yes)\u003csup\u003e\u0026dagger;\u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e2.531 (1.336 \u0026ndash; 4.795)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e4.023 (1.962 \u0026ndash; 8.248)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 159px;\"\u003e\n \u003cp\u003eFully vaccinated (i.e. two mpox vaccines, Yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e0.577 (0.436 \u0026ndash; 0.765)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e0.785 (0.545 \u0026ndash; 1.131)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.193\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026dagger; Participants with no postcode info were coded as \u0026ldquo;not SESLHD postcode\u0026rdquo; in the multivariate model.\u003c/p\u003e\n\u003cp\u003e\u0026dagger;\u0026dagger;This includes participants who received an mpox vaccine dose at SOPV or at KRC\u0026rsquo;s fixed site, but either could not be matched with a profile on AIR or did have an AIR profile but their mpox vaccine dose wasn\u0026rsquo;t\u0026rsquo; recorded there.\u0026nbsp;\u003c/p\u003e\n\u003cdiv id=\"ftn1\"\u003e\n \u003cp\u003e\u003ca href=\"#_ftnref1\" name=\"_ftn1\" title=\"\"\u003e\u003c/a\u003e\u003c/p\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"mpox vaccination, outreach, public health services, men who have sex with men","lastPublishedDoi":"10.21203/rs.3.rs-7596483/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7596483/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground/Purpose: \u003c/strong\u003eIn 2024, in response to a re-surge in mpox transmission in New South Wales, Australia, Kirketon Road Centre (KRC) partnered with an HIV and LGBTQI+ community organisation, ACON, to conduct outreach vaccination in two sex-on-premises venues (SOPVs), also known as “saunas”. SOPV attendees were approached by an ACON peer worker who offered health education and on-site mpox vaccination (Jynneos\u003csup\u003e®\u003c/sup\u003e) by a registered nurse. Data on the number of engagements, vaccination acceptance, and self-reported vaccination history were collected. With client consent, vaccinations were also recorded on the Australian Immunisation Register (AIR).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eIn addition to a descriptive analysis of service records, we matched individual-level records with AIR and ran \u0026nbsp;(comparative) descriptive and \u0026nbsp;multivariate analyses, comparing individuals who received their mpox vaccine at KRC’s fixed-site vs. at an SOPV.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFindings: \u003c/strong\u003eDuring the outreach period, KRC administered 639 mpox vaccines at its fixed-site and conducted 22 outreach sessions at SOPVs in collaboration with ACON. These sessions resulted in 840 engagements; 522 individuals were eligible for mpox vaccination and 407 (78%) accepted. Among individuals who were matched with AIR, 77% at KRC’s fixed-site and 66% at SOPV received two doses of mpox vaccine. Overall, people vaccinated at SOPVs were older (mean 46 vs. 39 years) and less likely to reside locally (34% vs 51%). They were also less likely to have Medicare (57% vs. 74%), and/or to have an AIR record (60% vs. 67%). In a multivariate model, vaccine completion was not associated with receiving SOPV vs. KRC’s fixed-site.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eMpox outreach vaccination done in collaboration between nurses and LGBTQI+ peer-workers at SOPVs proved feasible, acceptable, and beneficial in terms of reaching people who may be out of area and not be routinely engaged with sexual health services. This model should be considered in future models of care involving MSM.\u003c/p\u003e","manuscriptTitle":"Outreach mpox vaccination at sex-on-premises venues in Sydney: An audit of a collaborative intervention by public health nurses and LGBTQI+ peer workers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-30 12:31:52","doi":"10.21203/rs.3.rs-7596483/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-17T08:10:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-14T03:00:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"96968043317324650454684992281461646022","date":"2025-11-03T21:57:10+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-28T17:16:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"84404900902506094754079631823036666753","date":"2025-10-16T16:14:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-16T07:40:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-02T01:22:42+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-23T13:03:53+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-23T06:04:42+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-09-23T00:37:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f9dc14b7-58b4-4bcc-be80-b98e43156101","owner":[],"postedDate":"October 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-23T16:04:41+00:00","versionOfRecord":{"articleIdentity":"rs-7596483","link":"https://doi.org/10.1186/s12889-026-26525-y","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2026-02-18 15:59:35","publishedOnDateReadable":"February 18th, 2026"},"versionCreatedAt":"2025-10-30 12:31:52","video":"","vorDoi":"10.1186/s12889-026-26525-y","vorDoiUrl":"https://doi.org/10.1186/s12889-026-26525-y","workflowStages":[]},"version":"v1","identity":"rs-7596483","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7596483","identity":"rs-7596483","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}