Perceptions and Intention to get vaccinated against Mpox among the LGTBIQ+ Community during the 2022 outbreak: A Cross-Sectional Study in Peru

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Araoz-Salinas, Brando Ortiz-Saavedra, Linda Ponce-Rosas, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2795799/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Vaccination against mpox can control the outbreak by targeting high-risk groups, such as the LGTBIQ + community. The aim of the study was to evaluate the perception and intention to get vaccinated against mpox among the LGTBIQ + community in Peru. Methods We conducted a cross-sectional study from November 1, 2022, to January 17, 2023, in Peru. We included individuals over 18 years old, belonging to the LGBTIQ + community, and residing in the departments of Lima and Callao. To evaluate the factors associated with the intention to be vaccinated, we used Poisson regression with robust variance to create a multivariate model. Results The study comprised 373 individuals who self-identified as members of the LGBTIQ + community. The participants had a mean age of 31 years (SD ± 9), with 85.0% of males, and 75.3% reporting to be homosexual men. The majority (88.5%) expressed their intention to receive the vaccine against mpox. Believing that the vaccine is safe was associated with a higher intention to be vaccinated (aPR: 1.24; 95% CI: 1.02 to 1.50; p = 0.028). Conclusions Our study population showed a high level of mpox vaccination intent. Educational campaigns reinforcing the concept of vaccine safety should be conducted to increase the intention and possibly the vaccination rate in the LGTBIQ + community. Monkeypox Vaccination Public health Perception Intention Bisexuality Homosexuality Peru Figures Figure 1 Figure 2 Figure 3 Figure 4 1. Introduction Mpox, previously called Monkeypox, is a reemerging zoonotic disease [ 1 ], that was first reported in humans in the 1970s and then spread throughout the African continent. The first reported cases outside Africa occurred in 2003 in the United States [ 2 ]. As of 2018, cases were described in Israel, the United Kingdom, Singapore, and the United States [ 3 ]. In May 2022, there was a precipitous increase in the number of mpox cases reported in Europe and the Americas [ 3 ], for which, it was declared as a global health emergency by the World Health Organization (WHO) on July 23, 2022 [ 4 ]. In the current outbreak, according to Centers for Disease Control and Prevention (CDC) data through March 29, 2023, 86746 cases and 112 deaths from mpox have been reported in 110 countries [ 5 ]. Vaccination against human smallpox has been considered as a control measure against mpox because both viruses have antigenic similarity and cross-immunization can be generated [ 6 ]. Currently, the WHO proposes the use of 3 different vaccines against Mpox (MVA-BN, ACAM2000, and LC16) [ 7 ]; however, MVA-BN is the only vaccine approved by the Food and Drug Administration (FDA) for the prevention of Mpox in adults older than 18 years at high risk of mpox infection [ 8 ]. In the current outbreak, the most affected group has been men who have sex with men (MSM), a population also at high risk of other sexually transmitted infections such as HIV [ 9 ]. Among them, the risk of HIV infection is 26 times when compared with the general population [ 10 ]. Previous studies reported that individuals with uncontrolled HIV had worse outcomes in the course of mpox [ 11 – 13 ]; in this regard, the case series by Mitjà et al. [ 13 ] showed that severe complications in mpox were more frequent in HIV patients with a CD4 cell count < 100/mm3 and all deaths occurred in HIV patients with a CD4 cell count < 200/mm3. Although the CDC suggests the use of tecovirimat for the treatment of mpox under the Expanded Access to Investigational New Drugs (EA-IND) protocol [ 14 ], there is currently no quality evidence on the efficacy and safety of the various drug treatments against mpox [ 15 , 16 ]. It has even been hypothesized that resistance to tecovirimat could develop in patients at risk of receiving a prolonged regimen, such as patients co-infected with HIV and mpox. [ 17 ]. Therefore, the development and implementation of prevention strategies against mpox in the MSM population are of high importance to avoid significant sequelae and fatal outcomes. Furthermore, the vaccination against mpox in the principal risk group such as gay, bisexual, and MSM has been one of the most important strategies to control the current mpox outbreak [ 18 ]. From July 31 to October 1, 2022, among vaccine-eligible men aged 18–49 years in 43 U.S. jurisdictions, mpox incidence among unvaccinated individuals was estimated to be 10 times higher than that reported for fully vaccinated people and 7 times higher than the incidence described for those who received only the first vaccine dose [ 19 ]. Few studies have investigated the perception and acceptance of the vaccination against mpox in this high-risk group around the world. There is one study in the Netherlands in 2022 that reveals that 81.5% of gays, bisexuals, and MSM agreed with receiving the mpox vaccine [ 20 ] while another study made in China in the MSM population reports that 90,2% also agreed [ 21 ]. However, there are no studies in Latin America focusing on the acceptance of mpox vaccination in the MSM population, despite the high incidence reported in the Americas, making 87.8% of the cases worldwide by February 2023. Globally, among the top 10 countries with most cases of mpox infection, Peru (n = 3752) was in seventh position, after Brazil, Colombia, and Mexico [ 22 ]. In Peru, the first case of mpox was described on June 26, 2022 [ 23 ]. Nationwide, 3785 confirmed cases and 20 deaths have been reported as of March 19, 2023 [ 24 ]. The vaccination process against this disease started in November 2022 in Peru, prioritizing people living with HIV in the first phase [ 25 ]. In the second phase, citizens at high risk of contracting sexually transmitted infections, such as MSM, transgender women, and sex workers were included; in this phase, healthcare workers were also eligible for vaccination [ 25 ]. According to WHO, the 3´C model (confidence, complacency, and convenience) represents several factors that work together to influence vaccination decisions [ 26 ]. To determine which factors are important to improve, it is necessary to conduct studies on mpox vaccine uptake and whether these might have led to a change in vaccination intention in the population at high risk for mpox. Therefore, it is crucial to focus on evaluating the perceptions and mpox vaccination acceptance in the group at the highest risk such as the LGTBIQ + community (L: Lesbian, G: Gay, T: Trans, B: Bisexual, I: Intersexual, Q: Queer, +: others) with the purpose of designing public health strategies to resolve doubts and fears about the vaccine. In this cross-sectional study, we evaluated the perception and intention to be vaccinated against mpox among the LGTBIQ + community during the 2022 outbreak in Peru. We also determined the factors that are independently associated to the vaccination intent. 2. Materials And Methods 2.1. Study design, setting, and participants We conducted a cross-sectional study from November 1, 2022, to January 17, 2023, in Peru. We adhered to the STROBE checklist for cross-sectional studies (Supplementary material 1). At the start of data collection, there were 1898 reported cases of mpox in the country, which increased to 3728 by the end of the study period [ 24 ]. In response to the outbreak, the Peruvian Ministry of Health initiated free mpox vaccination on November 7, 2022 [ 25 ]. Eligible participants for our study included individuals over 18 years old, self-identified as members of the LGBTIQ + community, residing in the departments of Lima or Callao, not previously vaccinated against mpox, and not enrolled in a mpox clinical trial. 2.2. Sample and diffusion Due to the exploratory nature of the study, we determined the sample size based on a 50% intention to be vaccinated against mpox, a 95% confidence level, and a 5% margin of error. Using these parameters, the targeted sample size was 385 individuals. In addition, we considered 5% of possible surveys that did not meet the inclusion criteria or were incorrectly completed, so the minimum target number of completed surveys was 404. We used non-probabilistic snowball sampling. We distributed the survey through various social media platforms, including Facebook, Twitter, Instagram, and WhatsApp. In order to recruit more participants, we used Grinder, which is a social networking and online dating application targeted towards members of the gay, bisexual, transgender, and queer community. In addition, we administered the survey in-person to individuals who attended the clinics of three Community Based Organizations: “Voluntades Lima Norte'', “Diversex Lima Este'', and “Plan Camino Lima Centro'' located in the department of Lima. These organizations focus on preventing sexually transmitted infections in the LGBTIQ + community. 2.3. Questionnaire The study utilized both online and printed surveys to gather data from participants (Supplementary material 2). The online survey was created using Google Forms. Meanwhile, participants surveyed in person received a printed survey. The survey sections were as follows: 1) Informed consent, 2) Inclusion criteria, 3) Sociodemographic data, 4) Perceptions about the risk of mpox infection, and 5) Perceptions about the mpox vaccine. To measure perceptions, we employed similar surveys utilized in other countries to assess the intention of the LGBTIQ + population to get vaccinated against mpox [ 27 , 28 ]. Additionally, we adapted the questions to the Peruvian reality and incorporated specific concepts of the current outbreak in the country. This survey was validated by experts in the field of infectious diseases from Peru and the United States of America. 2.4. Independent variables We considered the following independent variables: age, area of residence, healthcare worker status, education level, gender, sexual orientation, number of sexual partners in the last 3 months, HIV infection, sexually transmitted infection (other than HIV) in the last 3 months, knowledge of the current outbreak, history of mpox, perceptions towards the risk of infection with mpox, and perceptions regarding the mpox vaccine. 2.5. Dependent variable To define the variable "intention to be vaccinated against mpox", we used the following question: "Do you plan to get vaccinated against mpox when the vaccine becomes available?" This question had five response options: 1. "I will get vaccinated," 2. "It is likely that I will get vaccinated," 3. "It is very unlikely that I will get vaccinated," 4. "It is likely that I will not get vaccinated," and 5. "I will not get vaccinated." If the respondent answered option 1 or 2, they were considered to have the intention to get vaccinated. If they answered options 3, 4, or 5, they were considered to have no intention to get vaccinated. 2.6. Statistical analysis The statistical analysis was conducted using RStudio version 4. We described participant characteristics using frequencies for categorical variables and mean with standard deviation for numeric variables. In the bivariate analysis, we compared characteristics between the participants who had intention to be vaccinated and those who did not. We used the Wilcoxon rank sum test, Fisher's exact test, and chi-square test of independence depending on the nature of the variable. Finally, we used Poisson regression with robust variance to create a multivariate model that included all variables with a p-value < 0.20 in the bivariate analysis. Variables with a p-value < 0.05 were considered statistically significant associated factors. 2.7. Ethical Aspects The present study was approved by the institutional ethics committee of the Universidad Peruana Unión (Approval 2022-CE-FCS-UPeU-157) and was registered in the Proyectos de Investigación en Salud (PRISA, by its Spanish acronym) database of the Peruvian National Institute of Health. At the beginning of the survey, informed consent was requested from each participant, the survey was anonymous, and the data obtained were confidential. 3. Results A survey was conducted among 450 participants (272 virtual surveys and 178 in person surveys), of whom, 49 individuals were excluded due to not meeting the inclusion criteria, and 28 participants had incomplete or conflicting survey data. Finally, our analysis was carried out with data collected from 373 (237 virtual surveys and 134 in person surveys) participants who identified themselves as members of the LGBTIQ + community (Fig. 1 ). The study sample comprised participants with an average age of 31 (SD: 9) years, most of them resided in central Lima (29.2%) and held university or higher education degrees (61.1%). In terms of gender, the majority self-identified as male (85.0%), while smaller proportions self-identified as female (6.2%), queer (3.2%), transgender (1.3%), transgender female (3.8%), and transgender male (0.5%). Regarding sexual orientation, the majority self-identified as homosexual man (75.3%), while smaller proportions self-identified as bisexual (14.7%), lesbian (3.2%), heterosexual (1.9%), pansexual (3.8%), and other (1.1%). In addition, 35.1% reported being infected with HIV and 24.9% had a sexually transmitted infection other than HIV within the past 3 months (Table 1 ). Table 1 Comparison of characteristics between respondents with intention to be vaccinated and those who did not intend to be vaccinated (n = 373). Characteristics N = 373 No intention to be vaccinated Intention to be vaccinated p-value* N = 43 N = 330 Age, mean (SD) 31 (9) 29 (8) 31 (9) 0.111 Zone of residence 0.029 Callao 28 (7.5%) 5 (17.9%) 23 (82.1%) Central Lima 109 (29.2%) 9 (8.3%) 100 (91.7%) East Lima 89 (23.9%) 10 (11.2%) 79 (88.8%) North Lima 101 (27.1%) 18 (17.8%) 83 (82.2%) South Lima 46 (12.3%) 1 (2.2%) 45 (97.8%) Healthcare worker 0.838 No 326 (87.4%) 38 (11.7%) 288 (88.3%) Yes 47 (12.6%) 5 (10.6%) 42 (89.4%) Education level 0.022 High school 78 (20.9%) 13 (16.7%) 65 (83.3%) Technical 56 (15.0%) 9 (16.1%) 47 (83.9%) College / University 228 (61.1%) 18 (7.9%) 210 (92.1%) None of the above 11 (2.9%) 3 (27.3%) 8 (72.7%) Gender 0.053 Male 317 (85.0%) 32 (10.1%) 285 (89.9%) Female 23 (6.2%) 4 (17.4%) 19 (82.6%) Queer 12 (3.2%) 1 (8.3%) 11 (91.7%) Other 21 (5.6%) 6 (28.6%) 15 (71.4%) Sexual Orientation 0.340 Homosexual man 281 (75.3%) 30 (10.7%) 251 (89.3%) Bisexual 55 (14.7%) 6 (10.9%) 49 (89.1%) Other 37 (9.9%) 7 (18.9%) 30 (81.1%) Sexual partners in the last 3 months, mean (SD) 6 (10) 7 (8) 6 (10) 0.156 HIV infection 0.475 No 242 (64.9%) 30 (12.4%) 212 (87.6%) Yes 131 (35.1%) 13 (9.9%) 118 (90.1%) Sexually transmitted infection in the last 3 months (other than HIV) 0.048 No 280 (75.1%) 27 (9.6%) 253 (90.4%) Yes 93 (24.9%) 16 (17.2%) 77 (82.8%) Knowledge about the current mpox outbreak 0.999 No 30 (8.0%) 3 (10.0%) 27 (90.0%) Yes 343 (92.0%) 40 (11.7%) 303 (88.3%) History of mpox disease 0.141 No 329 (88.2%) 35 (10.6%) 294 (89.4%) Yes 44 (11.8%) 8 (18.2%) 36 (81.8%) Perceptions about mpox Do you think mpox is a very contagious disease? < 0.001 No 49 (13.1%) 15 (30.6%) 34 (69.4%) Yes 324 (86.9%) 28 (8.6%) 296 (91.4%) Mpox is transmitted by direct contact with the skin lesions of a sick person. 0.103 Agree 335 (89.8%) 35 (10.4%) 300 (89.6%) Neither agree nor disagree 30 (8.0%) 7 (23.3%) 23 (76.7%) Disagree 8 (2.1%) 1 (12.5%) 7 (87.5%) Monkeypox can be transmitted by talking with a sick person. 0.875 Agree 123 (33.0%) 13 (10.6%) 110 (89.4%) Neither agree nor disagree 69 (18.5%) 9 (13.0%) 60 (87.0%) Disagree 181 (48.5%) 21 (11.6%) 160 (88.4%) Mpox is transmitted by semen. 0.734 Agree 194 (52.0%) 20 (10.3%) 174 (89.7%) Neither agree nor disagree 114 (30.6%) 15 (13.2%) 99 (86.8%) Disagree 65 (17.4%) 8 (12.3%) 57 (87.7%) Mpox is transmitted by saliva. 0.141 Agree 199 (53.4%) 17 (8.5%) 182 (91.5%) Neither agree nor disagree 101 (27.1%) 16 (15.8%) 85 (84.2%) Disagree 73 (19.6%) 10 (13.7%) 63 (86.3%) Monkeypox is a disease that mainly affects gay or bisexual men. 0.293 Agree 138 (37.0%) 19 (13.8%) 119 (86.2%) Neither agree nor disagree 81 (21.7%) 11 (13.6%) 70 (86.4%) Disagree 154 (41.3%) 13 (8.4%) 141 (91.6%) Fear of contracting mpox disease. 0.002 No 107 (28.7%) 21 (19.6%) 86 (80.4%) Yes 266 (71.3%) 22 (8.3%) 244 (91.7%) Do you think you are at risk of contracting mpox? 0.011 Agree 211 (56.6%) 18 (8.5%) 193 (91.5%) Neither agree nor disagree 99 (26.5%) 11 (11.1%) 88 (88.9%) Disagree 63 (16.9%) 14 (22.2%) 49 (77.8%) Do you believe mpox is a serious or dangerous disease? < 0.001 No 125 (33.5%) 24 (19.2%) 101 (80.8%) Yes 248 (66.5%) 19 (7.7%) 229 (92.3%) Condoms prevent the spread of mpox. 0.164 Agree 116 (31.1%) 17 (14.7%) 99 (85.3%) Neither agree nor disagree 94 (25.2%) 13 (13.8%) 81 (86.2%) Disagree 163 (43.7%) 13 (8.0%) 150 (92.0%) Having many sexual partners increases the risk of contracting mpox. 0.014 Agree 304 (81.5%) 28 (9.2%) 276 (90.8%) Neither agree nor disagree 42 (11.3%) 9 (21.4%) 33 (78.6%) Disagree 27 (7.2%) 6 (22.2%) 21 (77.8%) The Ministry of Health of Peru is adequately informing the population about mpox. 0.975 Agree 115 (30.8%) 13 (11.3%) 102 (88.7%) Neither agree nor disagree 99 (26.5%) 11 (11.1%) 88 (88.9%) Disagree 159 (42.6%) 19 (11.9%) 140 (88.1%) Perceptions about the mpox vaccine Is there a vaccine to prevent mpox? 0.115 No 20 (5.4%) 4 (20.0%) 16 (80.0%) I don't know 108 (29.0%) 16 (14.8%) 92 (85.2%) Yes 245 (65.7%) 23 (9.4%) 222 (90.6%) Do you think that the vaccine against mpox would protect your health? < 0.001 No 51 (13.7%) 18 (35.3%) 33 (64.7%) Yes 322 (86.3%) 25 (7.8%) 297 (92.2%) How safe do you think the mpox vaccine would be? < 0.001 Not safe 55 (14.7%) 19 (34.5%) 36 (65.5%) Safe 318 (85.3%) 24 (7.5%) 294 (92.5%) SD: standard deviation *Statistically significant p-values are in bold. The majority (92.0%) were aware of the mpox outbreak, with 11.8% reporting having experienced the disease. In terms of sources of information about mpox, the most common sources were television or radio (65.9%), social networks (64.7%), websites from official health institutions (MINSA, CDC, WHO, etc.) (46.9%), and conversations with friends (28.0%) (Fig. 2 ). In terms of intention to be vaccinated against mpox, we found that 56.0% reported that they would get vaccinated, while an additional 32.4% reported that they would likely get vaccinated. A minority of participants reported that they would likely not get vaccinated or would not receive the vaccine (Fig. 3 ). Furthermore, 54.4% of the participants reported that they would get vaccinated immediately. On the other hand, 32.4% indicated that they would wait to determine if the vaccine is safe before being vaccinated. A smaller proportion (7.2%) expressed they would only consider being vaccinated if it were mandatory, while 0.8% reported that they would never get vaccinated. Additionally, 5.1% of the respondents reported that they have not yet decided on vaccination. The intention to be vaccinated was significantly higher among participants who lived in South Lima (p = 0.029), had a university degree or higher education level (p = 0.022), did not report a history of sexually transmitted infection in the last 3 months (p = 0.048), believed that mpox was a highly contagious disease (p < 0.001), who were afraid of contracting mpox (p = 0.002), believed they were at risk of contracting mpox (p = 0.011), considered mpox as a severe or dangerous disease (p < 0.001), thought that having many sexual partners increased the risk of acquiring mpox (p = 0.014), believed the vaccine would protect their health (p < 0.001), and believed the vaccine would be safe (p < 0.001) (Table 1 ). In the multivariable model, we observed a positive association between the belief that the vaccine was safe and the intention to get vaccinated against mpox, which was statistically significant (aPR: 1.24; 95% CI: 1.02 to 1.50; p = 0.028) (Fig. 4 ). 4. Discussion This is the first study in Latin America that targeted the LGBTIQ + community to determine perceptions about mpox and vaccination intent. The overall intention to get vaccinated against mpox in the LGBTIQ + community in our study was 88.4%, which is one of the highest reported in the literature. One of the first studies on the LGBTIQ + community was conducted by Wang et al. in the Netherlands, who reported a high intention to get vaccinated (70%). This study was conducted before the start of targeted mpox vaccination in the Netherlands and included 394 MSM [ 29 ]. These findings were in line with another Dutch study conducted around the early roll-out of pre-exposure mpox vaccination, which showed an 81.5% vaccination acceptance [ 20 ]. A large-scale European survey observed 85–90% (northern countries) and 83–88% (western countries) intention to get vaccinated. This high vaccination acceptance was related to the perception of increased severity and transmission risk for mpox during this outbreak [ 30 ]. In addition, studies with a similar design were conducted in the United Kingdom [ 31 ] and China [ 21 ], which also reported a high rate of vaccination acceptance with 86% and 90.2% respectively. According to these studies, the LGBTIQ + community has a high intention to get vaccinated against mpox, which was also observed in our study. Regarding the factors independently associated to the intention to be vaccinated against mpox in the LGBTIQ + community, we found that 85.3% (n = 318) of the respondents considered the mpox vaccine to be safe. Furthermore, in adjusted multivariate analysis, believing that the vaccine was safe increased the intention of being vaccinated in 24%. There are few studies evaluating the association between the perception of safety and vaccination intent. In a study conducted in the Netherlands, it was reported that 45.1% of people eligible for pre-exposure vaccination (PPV) and 45% of people for non-pre-exposure vaccination (non-PPV) believed that the vaccine has no unpleasant adverse effects, and this factor increased the willingness to be vaccinated against mpox [ 20 ]. In a study conducted in Ghana on the general population, one of the main determinants of vaccine acceptance was confidence in the vaccine, which increased the odds of mpox vaccine acceptance (aOR: 2.45, 95% CI, 1.93–3.15, p < 0.001) [ 32 ]. Furthermore, in a study from China, one of the predictors of willingness to get the mpox vaccine among MSM living with HIV was to believe that mpox vaccine was safe (aOR: 6.6, CI 95%: 2.7–16.4)[ 33 ]. It is worth mentioning that the mpox vaccine safety has been demonstrated in pre-licensure studies, such as the phase 3 study conducted in 2019 on the modified vaccinia Ankara vaccine [ 34 ]. Also, the CDC considers MVA-BN a safe vaccine, as it only generates mild adverse effects such as pain, redness, and itching in the inoculation site. Severe allergic reactions are extremely rare [ 35 ]. Several authors have theorized that the high acceptance of mpox vaccine may be due to the fact the population witnessed a worldwide decline in mortality during the COVID-19 pandemic following the implementation of COVID-19 vaccines [ 36 , 37 ]. We postulate that the good safety profile of COVID vaccines observed in many countries including Peru could have contributed to the perception of safety for the mpox vaccine in our study. Regarding the place of residence, our study showed that the area with the highest intention of vaccination was South Lima. The reason behind that may have been that the vaccination campaign was initiated in East and South Lima, so people in those areas were probably better informed about the safety profile and efficacy of the vaccine [ 25 , 38 ]. Other studies have also reported differences in vaccination intent depending on the place of residence. Ahmed et al. [ 39 ] revealed that there were significant differences in knowledge and acceptance in the Kurdistan region of Iraq. Kurdistan is divided into four regions: Sulaymaniyah, Erbil, Duhok, and Halabja, where Sulaymaniyah demonstrated the highest level of knowledge, positive attitude, and concern towards mpox. In the bivariate analysis of our study, we observed that mpox vaccination intent was significantly higher among participants who believed that mpox was a highly contagious disease (p < 0.001). This important finding has not been reported in the current literature and should be considered in future studies on mpox vaccine acceptance. Mpox is a contagious disease that is transmitted primarily through sexual contact [ 40 ]; however, transmission can also occur through other exposures, including non-sexual contact with active skin lesions and less commonly via direct contact (face to face) with saliva or upper respiratory secretions [ 41 , 42 ]. Of note, mpox is less contagious than smallpox and usually causes a less severe illness [ 43 ]. We also found a higher vaccination intent in participants that believed they were at higher risk of contracting mpox. A recent study performed in France showed that among MSM on pre-exposure prophylaxis (PrEP) or living with HIV, 54% of participants felt at risk of being infected with mpox. The authors also found that feeling at risk was an independent determinant of vaccine acceptance [ 44 ]. It is important to know that the current data have demonstrated that gay, bisexual, and other men who have sex with men (MSM) made up the majority of cases in the current mpox outbreak [ 18 ]. A case series across 16 countries identified several distinct features of the early 2022 mpox outbreak, in which 95% of the transmission was sexual contact and mostly in gay or bisexual men [ 45 ]. In Peru, 71.5% of monkeypox cases were mainly MSM and 55% living with HIV [ 24 ]. Also, of all the patients hospitalized with mpox, 94% were MSM [ 46 ]. The present study also revealed that the intention to be vaccinated against mpox was higher in people who believed that the vaccine would protect their health (p < 0.001). These findings are similar to those reported by Ghazy et al. [ 32 ] who found that confidence was significantly associated with mpox vaccine acceptance in the Ghanaian population. In their study, they defined confidence as "trust in the vaccine’s dependability and effectiveness, in the health system, and the healthcare personnel'' [ 32 ]. The vaccines proposed by WHO for mpox were initially designed for the prevention of smallpox [ 7 ], so evidence of their efficacy and effectiveness against mpox at the beginning of the current outbreak was sparse. However, observational studies on the effectiveness of the MVA-BN vaccine have been recently published. Payne et al. [ 47 ] analyzed weekly reports from 43 U.S. jurisdictions and found that the incidence of mpox in unvaccinated adult men was 7,4-fold higher compared with adult men who received only 1 dose of MVA-BN vaccine and 9,6-fold higher compared with men who received 2 doses. Similarly, Wolff Sagy et al. [ 48 ] conducted a retrospective analysis in 2054 Israeli adults with risk factors for mpox infection, where they found that vaccination with one dose of MVA-BN was associated with an 86% reduction in the risk of mpox. These real-world data demonstrated that the MVA-BN vaccine effectively protects against mpox infection. Another important finding of our study was that mpox vaccination intent was higher among respondents who considered mpox to be a severe or dangerous disease (p < 0.001). Before the current mpox outbreak, WHO reported mpox mortality rates of up to 11% [ 49 ]. In addition, at the beginning of the current outbreak, different studies reported that the main affected group was MSM [ 50 ], who have a higher HIV prevalence compared to the general population [ 10 ] and were the predominant group of reported cases with mpox and HIV coinfection [ 45 , 51 , 52 ]. In response, in July 2022, the Peruvian government issued a guideline for the prevention and management of patients with mpox, which considered HIV + and immunosuppressed patients to be at risk of developing more severe disease and mpox complications [ 53 ]. Likewise, the Ministry of Health of Peru organized multiple information campaigns on the prevention of mpox infection, mainly among vulnerable populations such as people with HIV and MSM [ 54 ]. This data provided by the Ministry of Health during the current outbreak alerted the LGBTQ + community and may explain our results. It is important to note that most participants in our study (92.0%) were aware of the mpox outbreak. The main source of information was television or radio (65.9%), followed by social networks (64.7%), and web pages of official health institutions (MINSA, CDC, WHO, etc.) (46.9%). The dissemination of truthful information with simple and easy-to-understand language by the competent entities is key, as this factor probably contributed to a high acceptance of the mpox vaccine. However, when asked about the information provided by the Peruvian Ministry of Health, only 30.8% of participants claimed that this institution was adequately informing about mpox, which is concerning because it may lead to the development of conspiracy theories about the vaccine in the community [ 55 ]. This is clearly an aspect that the central government should improve, providing transparency and effective factual correction on the fake news spread through different media. 4.1. Limitations and Strengths Our study has some limitations. Despite having a good sample size, it is not representative of the LGBTQ + population from Peru because we used non-probability snowball sampling. Also, it is possible that there was a response bias, as respondents probably wanted to give a socially accepted answer [ 56 ] in the context of the disinformation campaigns carried out in Peru [ 57 ]. Finally, most of the surveys were online, in which there was no face-to-face control of the completion, so different factors could have affected the veracity of the answers given, such as the search for information and the completion of the same survey by two or more people. Regarding strengths, to our knowledge, this study is the first one in Latin America to assess mpox vaccination intent among the LGBTIQ + community during the 2022 mpox outbreak. In addition, the survey (beginning: November 1st) was conducted at the beginning of the vaccination campaign in Peru on November 7th, 2022 [ 25 ], which would probably reflect more accurately a defined opinion of the participants regarding their willingness to receive the mpox vaccine [ 58 ]. 5. Conclusions Our study showed a high intention to be vaccinated against mpox among the LGBTIQ + community in the departments of Lima and Callao in Peru, a finding that is related to the perception for this population to be at higher risk of contracting mpox, which is believed to be severe and very contagious disease according to the study participants. We found that the perception of safety for the mpox vaccine was the only factor independently associated to the intention to be vaccinated; thus, this factor should be considered and reinforced in educational campaigns, which could potentially lead to an increase in the rate of vaccination. Despite the high percentage of mpox vaccine awareness found in our study, there are still concerns about the information adequacy provided by the central government, which is a problem that should be addressed to avoid the development of conspiracy theories and misconceptions about the vaccine, especially in areas where the acceptance has been lower, such as Callao and East Lima. Declarations Author Contributions: J.M.A.-S., B.O.-S., and J.A.G.-Z. participated in the conceptualization of the study. J.M.A.-S., B.O.-S., J.A., and J.A.G.-Z. designed the study. J.M.A.-S. and L.P.-R. participated in the recruitment of study participants and data collection. D.R.S.-M. and A.N.S. performed the data analyses. J.M.A.-S., B.O.-S., L.P.-R., D.R.S.-M., J.A., and J.A.G.-Z. wrote the manuscript. All authors have read and agreed to the published version of the manuscript. Funding: The study did not have any funding. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee of the Universidad Peruana Unión (Protocol code: 2022-CE-FCS-UPeU-157| Date: October 18th, 2022). Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Data Availability Statement: Research data is not available due to privacy. Acknowledgments: We are grateful to the following people for their support in the recruitment of study participants: Dr. Katty Chong-Chinchay, Luis O. Castro-Asencios, Alberto E. Sánchez-Delgado, Gabriel M. Castro Jiménez, Carlos Campos-Urteaga, and Cesar Grados- Casalino. Conflicts of Interest: The authors declare that they do not have any conflict of interest. References Lum, F.-M.; Torres-Ruesta, A.; Tay, M.Z.; Lin, R.T.P.; Lye, D.C.; Rénia, L.; Ng, L.F.P. Monkeypox: Disease Epidemiology, Host Immunity and Clinical Interventions. 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Gonzales-Zamora, J.A.; Soriano-Moreno, D.R.; Soriano, A.N.; Ponce-Rosas, L.; De-Los-Rios-Pinto, A.; Murrieta-Ruiz, V.; Morocho-Alburqueque, N.; Caira-Chuquineyra, B.; Alave, J. Percepciones e Intención de Los Padres de Vacunar a Sus Hijos Bajo 12 Años de Edad Contra La COVID-19: Estudio Transversal En Perú. Rev. chil. infectol. 2022 , 39 , 273–286, doi:10.4067/s0716-10182022000200273. Supplementary Files Supplementarymaterial1.docx Supplementary Material 1 Supplementarymaterial2.docx Supplementary Material 2 Cite Share Download PDF Status: Posted Version 1 posted 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. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-2795799","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":190364002,"identity":"a3fea902-2ffc-467b-bce5-e2b3fc935360","order_by":0,"name":"Julieta M. Araoz-Salinas","email":"","orcid":"https://orcid.org/0000-0003-0267-8942","institution":"Peruvian American Medical Society. 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Soriano","email":"","orcid":"https://orcid.org/0000-0002-5535-811X","institution":"Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima 15464, Peru.","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Anderson","middleName":"N.","lastName":"Soriano","suffix":""},{"id":190364835,"identity":"5b895107-55b3-475b-b59e-408aaaadcdd5","order_by":5,"name":"Jorge Alave","email":"","orcid":"https://orcid.org/0000-0002-1178-2445","institution":"Departamento de Medicina, Facultad de Medicina, Universidad Peruana Unión. Lima 15464, Peru.","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jorge","middleName":"","lastName":"Alave","suffix":""},{"id":190364836,"identity":"68beff22-5efa-4dd4-9940-1eb68ace25e4","order_by":6,"name":"Jose A. 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17:31:59","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-2795799/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2795799/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":35605805,"identity":"9eb27fc0-3e23-4991-845f-b8188e2f3201","added_by":"auto","created_at":"2023-04-11 18:58:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":41654,"visible":true,"origin":"","legend":"\u003cp\u003eParticipant selection flowchart\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/321a16e18f8ac5079a7665d9.png"},{"id":35605802,"identity":"d5a086c8-91b2-4924-8f5d-261968818092","added_by":"auto","created_at":"2023-04-11 18:58:26","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":52772,"visible":true,"origin":"","legend":"\u003cp\u003eSources of information on mpox in the Peruvian LGBTIQ+ population (n=343).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/a98ea81a45783c7a30661e9c.png"},{"id":35606734,"identity":"3731a393-0eb3-4679-b773-ec9f8ffba397","added_by":"auto","created_at":"2023-04-11 19:06:26","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":41265,"visible":true,"origin":"","legend":"\u003cp\u003eIntention of the LGBTIQ+ population to be vaccinated against mpox.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/62126c43d2aba4dffddc74d0.png"},{"id":35605807,"identity":"3a030d5a-7691-4563-9c2b-9c51a0821ebe","added_by":"auto","created_at":"2023-04-11 18:58:26","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":416291,"visible":true,"origin":"","legend":"\u003cp\u003eMultivariable analysis of factors associated with intention to vaccinate (n=373). aPR= Adjusted Prevalence Ratio, CI = Confidence Interval, Ref.: Reference.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/b90c770d25697ecf8077401f.png"},{"id":35606739,"identity":"8a907dab-1401-4203-b1fa-adfeb6b32822","added_by":"auto","created_at":"2023-04-11 19:06:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1014044,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/62ed7026-0ece-45b6-a526-500bd06cabc1.pdf"},{"id":35605804,"identity":"38c525cd-1741-43b4-aa7a-5c94eb1bf3a1","added_by":"auto","created_at":"2023-04-11 18:58:26","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":32861,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Material 1\u003c/p\u003e","description":"","filename":"Supplementarymaterial1.docx","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/d5e3efa834a64c9eeccff7f0.docx"},{"id":35605806,"identity":"eb22a120-7283-45e9-a7b8-a21619970518","added_by":"auto","created_at":"2023-04-11 18:58:26","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":22365,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Material 2\u003c/p\u003e","description":"","filename":"Supplementarymaterial2.docx","url":"https://assets-eu.researchsquare.com/files/rs-2795799/v1/3408b809646684a57d066a48.docx"}],"financialInterests":"","formattedTitle":"\u003cp\u003ePerceptions and Intention to get vaccinated against Mpox among the LGTBIQ+ Community during the 2022 outbreak: A Cross-Sectional Study in Peru\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eMpox, previously called Monkeypox, is a reemerging zoonotic disease [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], that was first reported in humans in the 1970s and then spread throughout the African continent. The first reported cases outside Africa occurred in 2003 in the United States [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. As of 2018, cases were described in Israel, the United Kingdom, Singapore, and the United States [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In May 2022, there was a precipitous increase in the number of mpox cases reported in Europe and the Americas [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], for which, it was declared as a global health emergency by the World Health Organization (WHO) on July 23, 2022 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In the current outbreak, according to Centers for Disease Control and Prevention (CDC) data through March 29, 2023, 86746 cases and 112 deaths from mpox have been reported in 110 countries [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eVaccination against human smallpox has been considered as a control measure against mpox because both viruses have antigenic similarity and cross-immunization can be generated [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Currently, the WHO proposes the use of 3 different vaccines against Mpox (MVA-BN, ACAM2000, and LC16) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]; however, MVA-BN is the only vaccine approved by the Food and Drug Administration (FDA) for the prevention of Mpox in adults older than 18 years at high risk of mpox infection [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In the current outbreak, the most affected group has been men who have sex with men (MSM), a population also at high risk of other sexually transmitted infections such as HIV [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Among them, the risk of HIV infection is 26 times when compared with the general population [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Previous studies reported that individuals with uncontrolled HIV had worse outcomes in the course of mpox [\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]; in this regard, the case series by Mitj\u0026agrave; et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] showed that severe complications in mpox were more frequent in HIV patients with a CD4 cell count\u0026thinsp;\u0026lt;\u0026thinsp;100/mm3 and all deaths occurred in HIV patients with a CD4 cell count\u0026thinsp;\u0026lt;\u0026thinsp;200/mm3. Although the CDC suggests the use of tecovirimat for the treatment of mpox under the Expanded Access to Investigational New Drugs (EA-IND) protocol [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], there is currently no quality evidence on the efficacy and safety of the various drug treatments against mpox [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. It has even been hypothesized that resistance to tecovirimat could develop in patients at risk of receiving a prolonged regimen, such as patients co-infected with HIV and mpox. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Therefore, the development and implementation of prevention strategies against mpox in the MSM population are of high importance to avoid significant sequelae and fatal outcomes.\u003c/p\u003e \u003cp\u003eFurthermore, the vaccination against mpox in the principal risk group such as gay, bisexual, and MSM has been one of the most important strategies to control the current mpox outbreak [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. From July 31 to October 1, 2022, among vaccine-eligible men aged 18\u0026ndash;49 years in 43 U.S. jurisdictions, mpox incidence among unvaccinated individuals was estimated to be 10 times higher than that reported for fully vaccinated people and 7 times higher than the incidence described for those who received only the first vaccine dose [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Few studies have investigated the perception and acceptance of the vaccination against mpox in this high-risk group around the world. There is one study in the Netherlands in 2022 that reveals that 81.5% of gays, bisexuals, and MSM agreed with receiving the mpox vaccine [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] while another study made in China in the MSM population reports that 90,2% also agreed [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. However, there are no studies in Latin America focusing on the acceptance of mpox vaccination in the MSM population, despite the high incidence reported in the Americas, making 87.8% of the cases worldwide by February 2023. Globally, among the top 10 countries with most cases of mpox infection, Peru (n\u0026thinsp;=\u0026thinsp;3752) was in seventh position, after Brazil, Colombia, and Mexico [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn Peru, the first case of mpox was described on June 26, 2022 [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Nationwide, 3785 confirmed cases and 20 deaths have been reported as of March 19, 2023 [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The vaccination process against this disease started in November 2022 in Peru, prioritizing people living with HIV in the first phase [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In the second phase, citizens at high risk of contracting sexually transmitted infections, such as MSM, transgender women, and sex workers were included; in this phase, healthcare workers were also eligible for vaccination [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. According to WHO, the 3\u0026acute;C model (confidence, complacency, and convenience) represents several factors that work together to influence vaccination decisions [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. To determine which factors are important to improve, it is necessary to conduct studies on mpox vaccine uptake and whether these might have led to a change in vaccination intention in the population at high risk for mpox. Therefore, it is crucial to focus on evaluating the perceptions and mpox vaccination acceptance in the group at the highest risk such as the LGTBIQ\u0026thinsp;+\u0026thinsp;community (L: Lesbian, G: Gay, T: Trans, B: Bisexual, I: Intersexual, Q: Queer, +: others) with the purpose of designing public health strategies to resolve doubts and fears about the vaccine. In this cross-sectional study, we evaluated the perception and intention to be vaccinated against mpox among the LGTBIQ\u0026thinsp;+\u0026thinsp;community during the 2022 outbreak in Peru. We also determined the factors that are independently associated to the vaccination intent.\u003c/p\u003e"},{"header":"2. Materials And Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Study design, setting, and participants\u003c/h2\u003e \u003cp\u003eWe conducted a cross-sectional study from November 1, 2022, to January 17, 2023, in Peru. We adhered to the STROBE checklist for cross-sectional studies (Supplementary material 1). At the start of data collection, there were 1898 reported cases of mpox in the country, which increased to 3728 by the end of the study period [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In response to the outbreak, the Peruvian Ministry of Health initiated free mpox vaccination on November 7, 2022 [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Eligible participants for our study included individuals over 18 years old, self-identified as members of the LGBTIQ\u0026thinsp;+\u0026thinsp;community, residing in the departments of Lima or Callao, not previously vaccinated against mpox, and not enrolled in a mpox clinical trial.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Sample and diffusion\u003c/h2\u003e \u003cp\u003eDue to the exploratory nature of the study, we determined the sample size based on a 50% intention to be vaccinated against mpox, a 95% confidence level, and a 5% margin of error. Using these parameters, the targeted sample size was 385 individuals. In addition, we considered 5% of possible surveys that did not meet the inclusion criteria or were incorrectly completed, so the minimum target number of completed surveys was 404. We used non-probabilistic snowball sampling. We distributed the survey through various social media platforms, including Facebook, Twitter, Instagram, and WhatsApp. In order to recruit more participants, we used Grinder, which is a social networking and online dating application targeted towards members of the gay, bisexual, transgender, and queer community. In addition, we administered the survey in-person to individuals who attended the clinics of three Community Based Organizations: \u0026ldquo;Voluntades Lima Norte'', \u0026ldquo;Diversex Lima Este'', and \u0026ldquo;Plan Camino Lima Centro'' located in the department of Lima. These organizations focus on preventing sexually transmitted infections in the LGBTIQ\u0026thinsp;+\u0026thinsp;community.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Questionnaire\u003c/h2\u003e \u003cp\u003eThe study utilized both online and printed surveys to gather data from participants (Supplementary material 2). The online survey was created using Google Forms. Meanwhile, participants surveyed in person received a printed survey. The survey sections were as follows: 1) Informed consent, 2) Inclusion criteria, 3) Sociodemographic data, 4) Perceptions about the risk of mpox infection, and 5) Perceptions about the mpox vaccine. To measure perceptions, we employed similar surveys utilized in other countries to assess the intention of the LGBTIQ\u0026thinsp;+\u0026thinsp;population to get vaccinated against mpox [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Additionally, we adapted the questions to the Peruvian reality and incorporated specific concepts of the current outbreak in the country. This survey was validated by experts in the field of infectious diseases from Peru and the United States of America.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4. Independent variables\u003c/h2\u003e \u003cp\u003eWe considered the following independent variables: age, area of residence, healthcare worker status, education level, gender, sexual orientation, number of sexual partners in the last 3 months, HIV infection, sexually transmitted infection (other than HIV) in the last 3 months, knowledge of the current outbreak, history of mpox, perceptions towards the risk of infection with mpox, and perceptions regarding the mpox vaccine.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5. Dependent variable\u003c/h2\u003e \u003cp\u003eTo define the variable \"intention to be vaccinated against mpox\", we used the following question: \"Do you plan to get vaccinated against mpox when the vaccine becomes available?\" This question had five response options: 1. \"I will get vaccinated,\" 2. \"It is likely that I will get vaccinated,\" 3. \"It is very unlikely that I will get vaccinated,\" 4. \"It is likely that I will not get vaccinated,\" and 5. \"I will not get vaccinated.\" If the respondent answered option 1 or 2, they were considered to have the intention to get vaccinated. If they answered options 3, 4, or 5, they were considered to have no intention to get vaccinated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6. Statistical analysis\u003c/h2\u003e \u003cp\u003eThe statistical analysis was conducted using RStudio version 4. We described participant characteristics using frequencies for categorical variables and mean with standard deviation for numeric variables. In the bivariate analysis, we compared characteristics between the participants who had intention to be vaccinated and those who did not. We used the Wilcoxon rank sum test, Fisher's exact test, and chi-square test of independence depending on the nature of the variable. Finally, we used Poisson regression with robust variance to create a multivariate model that included all variables with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.20 in the bivariate analysis. Variables with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant associated factors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.7. Ethical Aspects\u003c/h2\u003e \u003cp\u003e The present study was approved by the institutional ethics committee of the Universidad Peruana Uni\u0026oacute;n (Approval 2022-CE-FCS-UPeU-157) and was registered in the Proyectos de Investigaci\u0026oacute;n en Salud (PRISA, by its Spanish acronym) database of the Peruvian National Institute of Health. At the beginning of the survey, informed consent was requested from each participant, the survey was anonymous, and the data obtained were confidential.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eA survey was conducted among 450 participants (272 virtual surveys and 178 in person surveys), of whom, 49 individuals were excluded due to not meeting the inclusion criteria, and 28 participants had incomplete or conflicting survey data. Finally, our analysis was carried out with data collected from 373 (237 virtual surveys and 134 in person surveys) participants who identified themselves as members of the LGBTIQ\u0026thinsp;+\u0026thinsp;community (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe study sample comprised participants with an average age of 31 (SD: 9) years, most of them resided in central Lima (29.2%) and held university or higher education degrees (61.1%). In terms of gender, the majority self-identified as male (85.0%), while smaller proportions self-identified as female (6.2%), queer (3.2%), transgender (1.3%), transgender female (3.8%), and transgender male (0.5%). Regarding sexual orientation, the majority self-identified as homosexual man (75.3%), while smaller proportions self-identified as bisexual (14.7%), lesbian (3.2%), heterosexual (1.9%), pansexual (3.8%), and other (1.1%). In addition, 35.1% reported being infected with HIV and 24.9% had a sexually transmitted infection other than HIV within the past 3 months (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of characteristics between respondents with intention to be vaccinated and those who did not intend to be vaccinated (n\u0026thinsp;=\u0026thinsp;373).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;373\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNo intention to be vaccinated\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIntention to be vaccinated\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep-value*\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;43\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;330\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e29 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.111\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZone of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCallao\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e5 (17.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23 (82.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral Lima\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e109 (29.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100 (91.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEast Lima\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89 (23.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e10 (11.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e79 (88.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNorth Lima\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101 (27.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e18 (17.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83 (82.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth Lima\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e1 (2.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45 (97.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.838\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e326 (87.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e38 (11.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e288 (88.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (12.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e5 (10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42 (89.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78 (20.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTechnical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56 (15.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9 (16.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47 (83.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege / University\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e228 (61.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e18 (7.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e210 (92.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone of the above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e3 (27.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (72.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e317 (85.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e32 (10.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e285 (89.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (6.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e4 (17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (82.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQueer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (3.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e1 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (91.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (5.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6 (28.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (71.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual Orientation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.340\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHomosexual man\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e281 (75.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e30 (10.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e251 (89.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBisexual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55 (14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49 (89.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (9.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e7 (18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (81.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual partners in the last 3 months, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e7 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.475\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e242 (64.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e30 (12.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e212 (87.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131 (35.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (9.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e118 (90.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexually transmitted infection in the last 3 months (other than HIV)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e280 (75.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e27 (9.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e253 (90.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93 (24.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e16 (17.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77 (82.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge about the current mpox outbreak\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (8.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e3 (10.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (90.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e343 (92.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e40 (11.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e303 (88.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of mpox disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e329 (88.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e35 (10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e294 (89.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (11.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e8 (18.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36 (81.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceptions about mpox\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eDo you think mpox is a very contagious disease?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (13.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e15 (30.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34 (69.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e324 (86.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e28 (8.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e296 (91.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMpox is transmitted by direct contact with the skin lesions of a sick person.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e335 (89.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e35 (10.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e300 (89.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (8.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e7 (23.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23 (76.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e1 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 (87.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMonkeypox can be transmitted by talking with a sick person.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.875\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123 (33.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e110 (89.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69 (18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60 (87.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e181 (48.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e21 (11.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e160 (88.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMpox is transmitted by semen.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.734\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e194 (52.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e20 (10.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e174 (89.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (30.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e15 (13.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e99 (86.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65 (17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e8 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57 (87.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMpox is transmitted by saliva.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e199 (53.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e17 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e182 (91.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101 (27.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e16 (15.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e85 (84.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (19.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e10 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63 (86.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMonkeypox is a disease that mainly affects gay or bisexual men.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.293\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138 (37.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e19 (13.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e119 (86.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81 (21.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11 (13.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70 (86.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e154 (41.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (8.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e141 (91.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eFear of contracting mpox disease.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107 (28.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e21 (19.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e86 (80.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e266 (71.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e22 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e244 (91.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eDo you think you are at risk of contracting mpox?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e211 (56.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e18 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e193 (91.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99 (26.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e88 (88.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63 (16.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e14 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49 (77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eDo you believe mpox is a serious or dangerous disease?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e125 (33.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e24 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e101 (80.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e248 (66.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e19 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e229 (92.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eCondoms prevent the spread of mpox.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.164\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116 (31.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e17 (14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e99 (85.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (25.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (13.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e81 (86.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163 (43.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (8.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e150 (92.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eHaving many sexual partners increases the risk of contracting mpox.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e304 (81.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e28 (9.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e276 (90.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9 (21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33 (78.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 (77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eThe Ministry of Health of Peru is adequately informing the population about mpox.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.975\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115 (30.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e102 (88.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99 (26.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e88 (88.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e159 (42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e19 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e140 (88.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceptions about the mpox vaccine\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eIs there a vaccine to prevent mpox?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (5.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e4 (20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don't know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e108 (29.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e16 (14.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92 (85.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e245 (65.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e23 (9.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e222 (90.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eDo you think that the vaccine against mpox would protect your health?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51 (13.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e18 (35.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33 (64.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e322 (86.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e25 (7.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e297 (92.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eHow safe do you think the mpox vaccine would be?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot safe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55 (14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e19 (34.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36 (65.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSafe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e318 (85.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e24 (7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e294 (92.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eSD: standard deviation\u003c/p\u003e \u003cp\u003e*Statistically significant \u003cem\u003ep-values\u003c/em\u003e are in bold.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe majority (92.0%) were aware of the mpox outbreak, with 11.8% reporting having experienced the disease. In terms of sources of information about mpox, the most common sources were television or radio (65.9%), social networks (64.7%), websites from official health institutions (MINSA, CDC, WHO, etc.) (46.9%), and conversations with friends (28.0%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn terms of intention to be vaccinated against mpox, we found that 56.0% reported that they would get vaccinated, while an additional 32.4% reported that they would likely get vaccinated. A minority of participants reported that they would likely not get vaccinated or would not receive the vaccine (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFurthermore, 54.4% of the participants reported that they would get vaccinated immediately. On the other hand, 32.4% indicated that they would wait to determine if the vaccine is safe before being vaccinated. A smaller proportion (7.2%) expressed they would only consider being vaccinated if it were mandatory, while 0.8% reported that they would never get vaccinated. Additionally, 5.1% of the respondents reported that they have not yet decided on vaccination.\u003c/p\u003e \u003cp\u003eThe intention to be vaccinated was significantly higher among participants who lived in South Lima (p\u0026thinsp;=\u0026thinsp;0.029), had a university degree or higher education level (p\u0026thinsp;=\u0026thinsp;0.022), did not report a history of sexually transmitted infection in the last 3 months (p\u0026thinsp;=\u0026thinsp;0.048), believed that mpox was a highly contagious disease (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), who were afraid of contracting mpox (p\u0026thinsp;=\u0026thinsp;0.002), believed they were at risk of contracting mpox (p\u0026thinsp;=\u0026thinsp;0.011), considered mpox as a severe or dangerous disease (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), thought that having many sexual partners increased the risk of acquiring mpox (p\u0026thinsp;=\u0026thinsp;0.014), believed the vaccine would protect their health (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and believed the vaccine would be safe (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the multivariable model, we observed a positive association between the belief that the vaccine was safe and the intention to get vaccinated against mpox, which was statistically significant (aPR: 1.24; 95% CI: 1.02 to 1.50; p\u0026thinsp;=\u0026thinsp;0.028) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis is the first study in Latin America that targeted the LGBTIQ\u0026thinsp;+\u0026thinsp;community to determine perceptions about mpox and vaccination intent. The overall intention to get vaccinated against mpox in the LGBTIQ\u0026thinsp;+\u0026thinsp;community in our study was 88.4%, which is one of the highest reported in the literature. One of the first studies on the LGBTIQ\u0026thinsp;+\u0026thinsp;community was conducted by Wang et al. in the Netherlands, who reported a high intention to get vaccinated (70%). This study was conducted before the start of targeted mpox vaccination in the Netherlands and included 394 MSM [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. These findings were in line with another Dutch study conducted around the early roll-out of pre-exposure mpox vaccination, which showed an 81.5% vaccination acceptance [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. A large-scale European survey observed 85\u0026ndash;90% (northern countries) and 83\u0026ndash;88% (western countries) intention to get vaccinated. This high vaccination acceptance was related to the perception of increased severity and transmission risk for mpox during this outbreak [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. In addition, studies with a similar design were conducted in the United Kingdom [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] and China [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], which also reported a high rate of vaccination acceptance with 86% and 90.2% respectively. According to these studies, the LGBTIQ\u0026thinsp;+\u0026thinsp;community has a high intention to get vaccinated against mpox, which was also observed in our study.\u003c/p\u003e \u003cp\u003eRegarding the factors independently associated to the intention to be vaccinated against mpox in the LGBTIQ\u0026thinsp;+\u0026thinsp;community, we found that 85.3% (n\u0026thinsp;=\u0026thinsp;318) of the respondents considered the mpox vaccine to be safe. Furthermore, in adjusted multivariate analysis, believing that the vaccine was safe increased the intention of being vaccinated in 24%. There are few studies evaluating the association between the perception of safety and vaccination intent. In a study conducted in the Netherlands, it was reported that 45.1% of people eligible for pre-exposure vaccination (PPV) and 45% of people for non-pre-exposure vaccination (non-PPV) believed that the vaccine has no unpleasant adverse effects, and this factor increased the willingness to be vaccinated against mpox [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In a study conducted in Ghana on the general population, one of the main determinants of vaccine acceptance was confidence in the vaccine, which increased the odds of mpox vaccine acceptance (aOR: 2.45, 95% CI, 1.93\u0026ndash;3.15, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Furthermore, in a study from China, one of the predictors of willingness to get the mpox vaccine among MSM living with HIV was to believe that mpox vaccine was safe (aOR: 6.6, CI 95%: 2.7\u0026ndash;16.4)[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. It is worth mentioning that the mpox vaccine safety has been demonstrated in pre-licensure studies, such as the phase 3 study conducted in 2019 on the modified vaccinia Ankara vaccine [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Also, the CDC considers MVA-BN a safe vaccine, as it only generates mild adverse effects such as pain, redness, and itching in the inoculation site. Severe allergic reactions are extremely rare [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Several authors have theorized that the high acceptance of mpox vaccine may be due to the fact the population witnessed a worldwide decline in mortality during the COVID-19 pandemic following the implementation of COVID-19 vaccines [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. We postulate that the good safety profile of COVID vaccines observed in many countries including Peru could have contributed to the perception of safety for the mpox vaccine in our study.\u003c/p\u003e \u003cp\u003eRegarding the place of residence, our study showed that the area with the highest intention of vaccination was South Lima. The reason behind that may have been that the vaccination campaign was initiated in East and South Lima, so people in those areas were probably better informed about the safety profile and efficacy of the vaccine [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Other studies have also reported differences in vaccination intent depending on the place of residence. Ahmed et al. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] revealed that there were significant differences in knowledge and acceptance in the Kurdistan region of Iraq. Kurdistan is divided into four regions: Sulaymaniyah, Erbil, Duhok, and Halabja, where Sulaymaniyah demonstrated the highest level of knowledge, positive attitude, and concern towards mpox.\u003c/p\u003e \u003cp\u003eIn the bivariate analysis of our study, we observed that mpox vaccination intent was significantly higher among participants who believed that mpox was a highly contagious disease (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). This important finding has not been reported in the current literature and should be considered in future studies on mpox vaccine acceptance. Mpox is a contagious disease that is transmitted primarily through sexual contact [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]; however, transmission can also occur through other exposures, including non-sexual contact with active skin lesions and less commonly via direct contact (face to face) with saliva or upper respiratory secretions [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Of note, mpox is less contagious than smallpox and usually causes a less severe illness [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe also found a higher vaccination intent in participants that believed they were at higher risk of contracting mpox. A recent study performed in France showed that among MSM on pre-exposure prophylaxis (PrEP) or living with HIV, 54% of participants felt at risk of being infected with mpox. The authors also found that feeling at risk was an independent determinant of vaccine acceptance [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. It is important to know that the current data have demonstrated that gay, bisexual, and other men who have sex with men (MSM) made up the majority of cases in the current mpox outbreak [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. A case series across 16 countries identified several distinct features of the early 2022 mpox outbreak, in which 95% of the transmission was sexual contact and mostly in gay or bisexual men [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. In Peru, 71.5% of monkeypox cases were mainly MSM and 55% living with HIV [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Also, of all the patients hospitalized with mpox, 94% were MSM [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe present study also revealed that the intention to be vaccinated against mpox was higher in people who believed that the vaccine would protect their health (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). These findings are similar to those reported by Ghazy et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] who found that confidence was significantly associated with mpox vaccine acceptance in the Ghanaian population. In their study, they defined confidence as \"trust in the vaccine\u0026rsquo;s dependability and effectiveness, in the health system, and the healthcare personnel'' [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. The vaccines proposed by WHO for mpox were initially designed for the prevention of smallpox [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], so evidence of their efficacy and effectiveness against mpox at the beginning of the current outbreak was sparse. However, observational studies on the effectiveness of the MVA-BN vaccine have been recently published. Payne et al. [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e] analyzed weekly reports from 43 U.S. jurisdictions and found that the incidence of mpox in unvaccinated adult men was 7,4-fold higher compared with adult men who received only 1 dose of MVA-BN vaccine and 9,6-fold higher compared with men who received 2 doses. Similarly, Wolff Sagy et al. [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] conducted a retrospective analysis in 2054 Israeli adults with risk factors for mpox infection, where they found that vaccination with one dose of MVA-BN was associated with an 86% reduction in the risk of mpox. These real-world data demonstrated that the MVA-BN vaccine effectively protects against mpox infection.\u003c/p\u003e \u003cp\u003eAnother important finding of our study was that mpox vaccination intent was higher among respondents who considered mpox to be a severe or dangerous disease (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Before the current mpox outbreak, WHO reported mpox mortality rates of up to 11% [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. In addition, at the beginning of the current outbreak, different studies reported that the main affected group was MSM [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], who have a higher HIV prevalence compared to the general population [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] and were the predominant group of reported cases with mpox and HIV coinfection [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. In response, in July 2022, the Peruvian government issued a guideline for the prevention and management of patients with mpox, which considered HIV\u0026thinsp;+\u0026thinsp;and immunosuppressed patients to be at risk of developing more severe disease and mpox complications [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. Likewise, the Ministry of Health of Peru organized multiple information campaigns on the prevention of mpox infection, mainly among vulnerable populations such as people with HIV and MSM [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. This data provided by the Ministry of Health during the current outbreak alerted the LGBTQ\u0026thinsp;+\u0026thinsp;community and may explain our results.\u003c/p\u003e \u003cp\u003eIt is important to note that most participants in our study (92.0%) were aware of the mpox outbreak. The main source of information was television or radio (65.9%), followed by social networks (64.7%), and web pages of official health institutions (MINSA, CDC, WHO, etc.) (46.9%). The dissemination of truthful information with simple and easy-to-understand language by the competent entities is key, as this factor probably contributed to a high acceptance of the mpox vaccine. However, when asked about the information provided by the Peruvian Ministry of Health, only 30.8% of participants claimed that this institution was adequately informing about mpox, which is concerning because it may lead to the development of conspiracy theories about the vaccine in the community [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. This is clearly an aspect that the central government should improve, providing transparency and effective factual correction on the fake news spread through different media.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e4.1. Limitations and Strengths\u003c/h2\u003e \u003cp\u003eOur study has some limitations. Despite having a good sample size, it is not representative of the LGBTQ\u0026thinsp;+\u0026thinsp;population from Peru because we used non-probability snowball sampling. Also, it is possible that there was a response bias, as respondents probably wanted to give a socially accepted answer [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e] in the context of the disinformation campaigns carried out in Peru [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]. Finally, most of the surveys were online, in which there was no face-to-face control of the completion, so different factors could have affected the veracity of the answers given, such as the search for information and the completion of the same survey by two or more people. Regarding strengths, to our knowledge, this study is the first one in Latin America to assess mpox vaccination intent among the LGBTIQ\u0026thinsp;+\u0026thinsp;community during the 2022 mpox outbreak. In addition, the survey (beginning: November 1st) was conducted at the beginning of the vaccination campaign in Peru on November 7th, 2022 [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], which would probably reflect more accurately a defined opinion of the participants regarding their willingness to receive the mpox vaccine [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eOur study showed a high intention to be vaccinated against mpox among the LGBTIQ\u0026thinsp;+\u0026thinsp;community in the departments of Lima and Callao in Peru, a finding that is related to the perception for this population to be at higher risk of contracting mpox, which is believed to be severe and very contagious disease according to the study participants. We found that the perception of safety for the mpox vaccine was the only factor independently associated to the intention to be vaccinated; thus, this factor should be considered and reinforced in educational campaigns, which could potentially lead to an increase in the rate of vaccination. Despite the high percentage of mpox vaccine awareness found in our study, there are still concerns about the information adequacy provided by the central government, which is a problem that should be addressed to avoid the development of conspiracy theories and misconceptions about the vaccine, especially in areas where the acceptance has been lower, such as Callao and East Lima.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e J.M.A.-S., B.O.-S., and J.A.G.-Z. participated in the conceptualization of the study. J.M.A.-S., B.O.-S., J.A., and J.A.G.-Z. designed the study. J.M.A.-S. and L.P.-R. participated in the recruitment of study participants and data collection. D.R.S.-M. and A.N.S. performed the data analyses. J.M.A.-S., B.O.-S., L.P.-R., D.R.S.-M., J.A., and J.A.G.-Z. wrote the manuscript. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The study did not have any funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement:\u0026nbsp;\u003c/strong\u003eThe study was conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee of the Universidad Peruana Uni\u0026oacute;n (Protocol code: 2022-CE-FCS-UPeU-157| Date: October 18th, 2022).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u0026nbsp;\u003c/strong\u003eInformed consent was obtained from all subjects involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e Research data is not available due to privacy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e We are grateful to the following people for their support in the recruitment of study participants: Dr. Katty Chong-Chinchay, Luis O. Castro-Asencios, Alberto E. S\u0026aacute;nchez-Delgado, Gabriel M. Castro Jim\u0026eacute;nez, Carlos Campos-Urteaga, and Cesar Grados- Casalino.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e The authors declare that they do not have any conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLum, F.-M.; Torres-Ruesta, A.; Tay, M.Z.; Lin, R.T.P.; Lye, D.C.; R\u0026eacute;nia, L.; Ng, L.F.P. Monkeypox: Disease Epidemiology, Host Immunity and Clinical Interventions. \u003cem\u003eNat Rev Immunol\u003c/em\u003e \u003cstrong\u003e2022\u003c/strong\u003e, \u003cem\u003e22\u003c/em\u003e, 597\u0026ndash;613, doi:10.1038/s41577-022-00775-4.\u003c/li\u003e\n\u003cli\u003eHuhn, G.D.; Bauer, A.M.; Yorita, K.; Graham, M.B.; Sejvar, J.; Likos, A.; Damon, I.K.; Reynolds, M.G.; Kuehnert, M.J. 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Epidemiologic Characteristics and Clinical Features of Patients with Monkeypox Virus Infection from a Hospital in Peru between July and September 2022. \u003cem\u003eInternational Journal of Infectious Diseases\u003c/em\u003e \u003cstrong\u003e2023\u003c/strong\u003e, \u003cem\u003e129\u003c/em\u003e, 175\u0026ndash;180, doi:10.1016/j.ijid.2023.01.045.\u003c/li\u003e\n\u003cli\u003ePayne, A.B.; Ray, L.C.; Cole, M.M.; Canning, M.; Houck, K.; Shah, H.J.; Farrar, J.L.; Lewis, N.M.; Fothergill, A.; White, E.B.; et al. Reduced Risk for Mpox After Receipt of 1 or 2 Doses of JYNNEOS Vaccine Compared with Risk Among Unvaccinated Persons \u0026mdash; 43 U.S. Jurisdictions, July 31\u0026ndash;October 1, 2022. \u003cem\u003eMMWR Morb. Mortal. Wkly. 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Making Sense of Monkeypox Death Rates. \u003cem\u003eCMAJ\u003c/em\u003e \u003cstrong\u003e2022\u003c/strong\u003e, \u003cem\u003e194\u003c/em\u003e, E1097\u0026ndash;E1097, doi:10.1503/cmaj.1096012.\u003c/li\u003e\n\u003cli\u003eSu\u0026aacute;rez Rodr\u0026iacute;guez, B.; Guzm\u0026aacute;n Herrador, B.R.; D\u0026iacute;az Franco, A.; S\u0026aacute;nchez-Seco Fari\u0026ntilde;as, M.P.; del Amo Valero, J.; Aginagalde Llorente, A.H.; de Agreda, J.P.A.P.; Malonda, R.C.; Castrillejo, D.; Chirlaque L\u0026oacute;pez, M.D.; et al. Epidemiologic Features and Control Measures during Monkeypox Outbreak, Spain, June 2022. \u003cem\u003eEmerg. Infect. 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Epidemiologic Situation of HIV and Monkeypox Coinfection: A Systematic Review. \u003cem\u003eVaccines\u003c/em\u003e \u003cstrong\u003e2023\u003c/strong\u003e, \u003cem\u003e11\u003c/em\u003e, 246, doi:10.3390/vaccines11020246.\u003c/li\u003e\n\u003cli\u003eMinisterio de Salud del Peru. Norma Tecnica de Salud Para La Prevenci\u0026oacute;n y Manejo de Los Pacientes Afectados Por Viruela Del Mono (Viruela S\u0026iacute;mica) - Monkeypox. Available online: https://cdn.www.gob.pe/uploads/document/file/3346360/Norma%20T%C3%A9cnica%20de%20Salud%20para%20la%20Prevenci%C3%B3n%20y%20Manejo%20de%20los%20Pacientes%20Afectados%20por%20Viruela%20del%20Mono.pdf?v=1656858737.\u003c/li\u003e\n\u003cli\u003eMinisterio de Salud del Peru. Minsa Promueve Cartilla Informativa Sobre Prevenci\u0026oacute;n de Viruela Del Mono Para Poblaciones Vulnerables. 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Available online: https://elperuano.pe/noticia/192793-el-otro-reto-vacunar-contra-la-desinformacion.\u003c/li\u003e\n\u003cli\u003eGonzales-Zamora, J.A.; Soriano-Moreno, D.R.; Soriano, A.N.; Ponce-Rosas, L.; De-Los-Rios-Pinto, A.; Murrieta-Ruiz, V.; Morocho-Alburqueque, N.; Caira-Chuquineyra, B.; Alave, J. Percepciones e Intenci\u0026oacute;n de Los Padres de Vacunar a Sus Hijos Bajo 12 A\u0026ntilde;os de Edad Contra La COVID-19: Estudio Transversal En Per\u0026uacute;. \u003cem\u003eRev. chil. infectol.\u003c/em\u003e \u003cstrong\u003e2022\u003c/strong\u003e, \u003cem\u003e39\u003c/em\u003e, 273\u0026ndash;286, doi:10.4067/s0716-10182022000200273.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Peruvian American Medical Society","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Monkeypox, Vaccination, Public health, Perception, Intention, Bisexuality, Homosexuality, Peru","lastPublishedDoi":"10.21203/rs.3.rs-2795799/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2795799/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eIntroduction:\u003c/b\u003e\u003c/p\u003e \u003cp\u003eVaccination against mpox can control the outbreak by targeting high-risk groups, such as the LGTBIQ\u0026thinsp;+\u0026thinsp;community. The aim of the study was to evaluate the perception and intention to get vaccinated against mpox among the LGTBIQ\u0026thinsp;+\u0026thinsp;community in Peru.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWe conducted a cross-sectional study from November 1, 2022, to January 17, 2023, in Peru. We included individuals over 18 years old, belonging to the LGBTIQ\u0026thinsp;+\u0026thinsp;community, and residing in the departments of Lima and Callao. To evaluate the factors associated with the intention to be vaccinated, we used Poisson regression with robust variance to create a multivariate model.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe study comprised 373 individuals who self-identified as members of the LGBTIQ\u0026thinsp;+\u0026thinsp;community. The participants had a mean age of 31 years (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;9), with 85.0% of males, and 75.3% reporting to be homosexual men. The majority (88.5%) expressed their intention to receive the vaccine against mpox. Believing that the vaccine is safe was associated with a higher intention to be vaccinated (aPR: 1.24; 95% CI: 1.02 to 1.50; p\u0026thinsp;=\u0026thinsp;0.028).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eOur study population showed a high level of mpox vaccination intent. Educational campaigns reinforcing the concept of vaccine safety should be conducted to increase the intention and possibly the vaccination rate in the LGTBIQ\u0026thinsp;+\u0026thinsp;community.\u003c/p\u003e","manuscriptTitle":"Perceptions and Intention to get vaccinated against Mpox among the LGTBIQ+ Community during the 2022 outbreak: A Cross-Sectional Study in Peru","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-04-11 18:58:21","doi":"10.21203/rs.3.rs-2795799/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"529f2724-4d80-4ada-b126-f0d4c975a28b","owner":[],"postedDate":"April 11th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-04-11T18:58:21+00:00","versionOfRecord":[],"versionCreatedAt":"2023-04-11 18:58:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2795799","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2795799","identity":"rs-2795799","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}