Survey of mpox knowledge, attitudes, and practices among men who have sex with men and their vaccination intention based on Protection Motivation Theory

Background: The study aimed to investigate mpox-related knowledge, attitudes, and practices (KAP) among men who have sex with men (MSM), and to examine vaccination intention and its associated factors, to provide scientific evidence for future health education in this population. Methods: A cross-sectional online survey using a self-developed questionnaire was conducted among MSM in three districts of Chongqing, China, October 2023. The questionnaire items were developed based on the Protection Motivation Theory (PMT). Factors associated with mpox knowledge and vaccination intention were examined using binary logistic regression, and associations between PMT constructs and vaccination intention were evaluated using structural equation modeling (SEM). Results: Among 829 valid responses, 160 participants (19.3%) answered all 11 mpox knowledge items correctly, and 749 (90.3%) reported willingness to receive the vaccine. In the logistic regression analysis, participants aged 18–35 years were more likely to report willingness to receive the mpox vaccine than those aged >35 years (odds ratio (OR) = 2.268, 95% confidence interval (CI): 1.320–3.897, p = 0.003). Those who reported concern about the current mpox situation were also more likely to report willingness to receive the vaccine than the ones who didn’t report concern (OR = 4.399, 95% CI: 2.590–7.473, p < 0.001). In the SEM analysis, self-efficacy and response efficacy were significantly associated with vaccination intention, whereas perceived susceptibility and perceived severity were not. Conclusions: Willingness to receive the mpox vaccine was high among the MSM, whereas their knowledge across the 11 survey items was uneven. Greater confidence in taking preventive or care-seeking action and stronger belief in the usefulness of vaccination were associated with vaccination intention. These findings may provide useful reference for future health promotion and risk communication, particularly in the early stage of an outbreak.

MSM; Mpox; Vaccination intention; Protection Motivation Theory

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