Mpox diagnosis history, behavioural risk modification, and vaccination uptake in gay, bisexual, and other men who have sex with men in the UK: findings from a large, online community cross-sectional survey (RiiSH-Mpox) undertaken November/December 2022

Mpox cases, first identified as part of the multi-country outbreak in May 2022, rapidly fell in the UK from September 2022. Public health responses included community-coordinated messaging and a targeted mpox vaccination in eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online, community survey of GBMSM (November/December 2022), we examined self-reported mpox diagnoses, behavioural risk modification, and mpox vaccination offer and uptake (≥1 dose). Thirty-five participants (2.6%, 35/1,333) were ever mpox test positive; half (53%, 707/1,333) reported behaviour modification to avoid mpox. In GBMSM considered vaccine eligible, uptake was 69% (95% CI: 65%-72%, 601/875) or 92% (95% CI: 89%-94%, 601/655) in those eligible and offered. GBMSM self-identifying as bisexual, those with lower educational qualifications, and those unemployed were less likely to be vaccinated. Equitable mpox vaccine offer and provision is needed to minimise the risk of future outbreaks and mpox-related health inequalities. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding and was conducted as part of the UKHSA public health response to mpox. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval of this study was provided by the UKHSA Research and Ethics Governance Group (REGG; ref: R&D 524). Online informed consent was received from all participants and all methods were performed in accordance with guidelines and regulations set by the UKHSA REGG. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data that support the findings of this study are available upon reasonable request from the UK Health Security Agency (UKHSA). Requests can be directed to Dr Hamish Mohammed (hamish.mohammed@ukhsa.gov.uk).