Mpox knowledge, attitudes, beliefs, and intended behaviour in the general population and men who are gay, bisexual, and who have sex with men

ABSTRACT Objectives To investigate rates of mpox beliefs, knowledge, and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated with intended behaviours. To test the impact of motivational messages (vs a factual control) on intended behaviours. Design Cross-sectional online survey including a nested randomised controlled trial. Setting Data collected 5 September to 6 October 2022. Participants Participants were aged 18 years and over and lived in the UK (general population). In addition, GBMSM were male, and gay, bisexual or had sex with men. The general population sample was recruited through a market research company. GBMSM were recruited through a market research company, the dating app Grindr, and targeted adverts on Meta (Facebook and Instagram). Main outcome measures Intention to self-isolate, seek medical help, stop all sexual contact, share details of recent sexual contacts, and accept vaccination. Results Socio-demographic characteristics differed by sample. There was no effect of very brief motivational messaging on behavioural intentions. Respondents from Grindr and Meta were more likely to intend to seek help immediately, completely stop sexual behaviour and be vaccinated or intend to be vaccinated, but being less likely to intend to self-isolate ( p s<0.001). In the general population sample, intending to carry out protective behaviours was generally associated with being female, older, having less financial hardship, greater worry, higher perceived risk to others, and higher perceived susceptibility to and severity of mpox ( p s<0.001). There were fewer associations with behaviours in the Grindr sample, possibly due to reduced power. Conclusions GBMSM were more likely to intend to enact protective behaviours, except for self-isolation. This may reflect targeted public health efforts and engagement with this group. Associations with socio-economic factors suggests that providing financial support may encourage people to engage with protective behaviours. STRENGTHS AND LIMITATIONS Anonymous cross-sectional survey in large samples of the general population and men who are gay, bisexual, or have sex with men (recruited from a market research company, the dating app Grindr, and targeted adverts on Meta [Facebook and Instagram]). Data collection occurred over a short period (5 September to 6 October 2022) during the mpox outbreak. Responses may have been affected by social desirability or recall bias, although the anonymous nature of the survey should mitigate this somewhat. Socio-demographic characteristics differed by sample. Participants recruited from Grindr and Meta were more likely to be working, highly educated, of higher socio-economic grade, and have less financial hardship. We measured behavioural intentions. Rates of engagement with behaviours may be lower. Factors associated with intentions should still be valid.