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Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging

Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging
Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging
Background: the 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to control transmission, multiple public health measures were implemented, including vaccination, contact tracing and isolation. This study examines knowledge, attitudes, and perceptions of mpox among a sample of GBMSM during the 2022-23 outbreak in the UK, including facilitators for and barriers to the uptake of public health measures.

Methods: interviews were conducted with 44 GBMSM between May and December 2022. Data were analysed using reflexive thematic analysis. Positive and negative comments pertaining to public health measures were collated in a modified version of a ‘table of changes’ to inform optimisations to public health messages and guidance.

Results: most interviewees were well informed about mpox transmission mechanisms and were either willing to or currently adhering to public health measures, despite low perceptions of mpox severity. Measures that aligned with existing sexual health practices and norms were considered most acceptable. Connections to GBMSM networks and social media channels were found to increase exposure to sexual health information and norms influencing protective behaviours. Those excluded or marginalized from these networks found some measures challenging to perform or adhere to. Although social media was a key mode of information sharing, there were preferences for timely information from official sources to dispel exaggerated or misleading information.

Conclusions: there are differential needs, preferences, and experiences of GBMSM that limit the acceptability of some mitigation and prevention measures. Future public health interventions and campaigns should be co-designed in consultation with key groups and communities to ensure greater acceptability and credibility in different contexts and communities.
GBMSM, Mpox, qualitative, sexually transmitted infections, Qualitative, Sexually transmitted Infections
1471-2458
May, Tom
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Towler, Lauren
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Smith, Louise E.
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Horwood, Jeremy
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Denford, Sarah
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Rubin, G. James
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Hickman, Matthew
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Amlôt, Richard
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Oliver, Isabel
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Yardley, Lucy
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May, Tom
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Towler, Lauren
ebb4fb4e-703f-4e52-a9dc-53e72ca68e8f
Smith, Louise E.
4cfb9721-9982-4c96-b170-db664248117b
Horwood, Jeremy
17a93c97-cc9f-4914-ab17-9fdb7dc034e4
Denford, Sarah
8970b5a7-8cad-4356-ad0e-88297b67db37
Rubin, G. James
a1b1aed4-81d0-4a77-9731-988d6e242344
Hickman, Matthew
947802c5-28fe-4362-a583-092f8a043f11
Amlôt, Richard
d93f5263-ea24-4b12-b505-f51694220b8e
Oliver, Isabel
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Yardley, Lucy
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May, Tom, Towler, Lauren, Smith, Louise E., Horwood, Jeremy, Denford, Sarah, Rubin, G. James, Hickman, Matthew, Amlôt, Richard, Oliver, Isabel and Yardley, Lucy (2023) Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging. BMC Public Health, 23, [2265]. (doi:10.1186/s12889-023-17196-0).

Record type: Article

Abstract

Background: the 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to control transmission, multiple public health measures were implemented, including vaccination, contact tracing and isolation. This study examines knowledge, attitudes, and perceptions of mpox among a sample of GBMSM during the 2022-23 outbreak in the UK, including facilitators for and barriers to the uptake of public health measures.

Methods: interviews were conducted with 44 GBMSM between May and December 2022. Data were analysed using reflexive thematic analysis. Positive and negative comments pertaining to public health measures were collated in a modified version of a ‘table of changes’ to inform optimisations to public health messages and guidance.

Results: most interviewees were well informed about mpox transmission mechanisms and were either willing to or currently adhering to public health measures, despite low perceptions of mpox severity. Measures that aligned with existing sexual health practices and norms were considered most acceptable. Connections to GBMSM networks and social media channels were found to increase exposure to sexual health information and norms influencing protective behaviours. Those excluded or marginalized from these networks found some measures challenging to perform or adhere to. Although social media was a key mode of information sharing, there were preferences for timely information from official sources to dispel exaggerated or misleading information.

Conclusions: there are differential needs, preferences, and experiences of GBMSM that limit the acceptability of some mitigation and prevention measures. Future public health interventions and campaigns should be co-designed in consultation with key groups and communities to ensure greater acceptability and credibility in different contexts and communities.

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MAY 2023 - BMC Public Health - Mpox Knowledge Behaviours - Version of Record
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Accepted/In Press date: 9 November 2023
e-pub ahead of print date: 17 November 2023
Additional Information: Funding Information: TM, SD, JH, MH, RA, IO and LY are funded by the NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between UKHSA and the University of Bristol. LS, GJR and RA are funded by the NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response at King’s College London, a partnership between UKHSA and Kings College London. LY is an NIHR Senior Investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit (HPRU) for Behavioural Science and Evaluation, and the NIHR Southampton Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the NIHR, UKHSA, or the Department of Health and Social Care. We would like to thank the Terrence Higgins Trust and PrEPster for their support with participant recruitment. Funding Information: the study was funded by the NIHR (NIHR200877) and supported by the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, in partnership with UK Health Security Agency (UKHSA). Funding Information: TM, SD, JH, MH, RA, IO and LY are funded by the NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between UKHSA and the University of Bristol. LS, GJR and RA are funded by the NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response at King’s College London, a partnership between UKHSA and Kings College London. LY is an NIHR Senior Investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit (HPRU) for Behavioural Science and Evaluation, and the NIHR Southampton Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the NIHR, UKHSA, or the Department of Health and Social Care. We would like to thank the Terrence Higgins Trust and PrEPster for their support with participant recruitment.
Keywords: GBMSM, Mpox, qualitative, sexually transmitted infections, Qualitative, Sexually transmitted Infections

Identifiers

Local EPrints ID: 484917
URI: http://eprints.soton.ac.uk/id/eprint/484917
ISSN: 1471-2458
PURE UUID: e7714dd8-f9f0-4a1b-b06a-3fc734c29621
ORCID for Lauren Towler: ORCID iD orcid.org/0000-0002-6597-0927
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 24 Nov 2023 17:38
Last modified: 24 Apr 2024 01:52

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Contributors

Author: Tom May
Author: Lauren Towler ORCID iD
Author: Louise E. Smith
Author: Jeremy Horwood
Author: Sarah Denford
Author: G. James Rubin
Author: Matthew Hickman
Author: Richard Amlôt
Author: Isabel Oliver
Author: Lucy Yardley ORCID iD

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