Academic Journal
Mpox Vaccination and Diagnosis Among Sexual and Gender Diverse Populations in Brazil: Results From a Large Nationwide Online Survey.
| Τίτλος: | Mpox Vaccination and Diagnosis Among Sexual and Gender Diverse Populations in Brazil: Results From a Large Nationwide Online Survey. |
|---|---|
| Συγγραφείς: | Silva MST; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Luz PM; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Coutinho C; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Hoagland B; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Jalil EM; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Pimenta C; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Benedetti M; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Cardoso SW; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Veloso VG; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Grinsztejn B; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil., Torres TS; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. |
| Πηγή: | Journal of the International AIDS Society [J Int AIDS Soc] 2026 Jul; Vol. 29 Suppl 2, pp. e70143. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: Print Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc Original Publication: [London] : BioMed Central |
| Ιατρικοί όροι (MeSH): | Sexual and Gender Minorities*/statistics & numerical data , Vaccination*/statistics & numerical data , Mpox, Monkeypox*/diagnosis , Mpox, Monkeypox*/epidemiology , Mpox, Monkeypox*/prevention & control , Smallpox Vaccine*/administration & dosage, Brazil/epidemiology ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Cross-Sectional Studies ; Surveys and Questionnaires |
| Περίληψη: | Introduction: Since the onset of the 2022 multinational mpox outbreak, Brazil has reported one of the highest case burdens globally, disproportionately affecting sexual and gender diverse populations. Mpox vaccination efforts in Brazil have been limited by delayed procurement, restricted eligibility criteria and structural access barriers. Understanding vaccination use, correlates of uptake and characteristics of individuals previously diagnosed with mpox is essential to guide equitable prevention strategies. Methods: We conducted an online cross-sectional survey between August and December 2024 among individuals recruited through social media and dating apps. Eligible participants were aged ≥18 years, identified as a sexual and gender diverse person, and residing in Brazil. Primary outcomes were previous mpox vaccination and mpox diagnosis. Sociodemographic, behavioural, internalized LGBTQIAPN+phobia and HIV/sexually transmitted infections (STIs) variables were collected. Adjusted logistic regression models identified independent factors associated with both outcomes. Results: Of 9546 respondents, most were cisgender men (91.8%), aged >30 years (81.5%) and residing in capital cities (77.2%). Overall, mpox vaccination coverage was 4.9%; nearly half received only one dose, and one quarter were vaccinated outside Brazil. Previous mpox diagnosis was reported by 2.1% of respondents, with 76.5% seeking healthcare and 7.0% requiring hospitalization. Factors associated with previous mpox vaccination were self-identification as White (aOR = 1.36; 95% CI: 1.10-1.69), more than five sex partners (aOR = 1.29; 95% CI: 1.03-1.62), living with HIV (aOR = 3.40; 95% CI: 2.59-4.47), current/prior HIV pre-exposure prophylaxis (PrEP) use (aOR = 1.88; 95% CI: 1.41-2.53) and internalized LGBTQIAPN+phobia score (aOR = 0.80; 95% CI: 0.71-0.90). Factors associated with previous mpox diagnosis were living in capital cities (aOR = 1.88; 95% CI: 1.17-3.20), more than five sex partners (aOR = 1.93; 95% CI: 1.35-2.79), stimulant drug use (aOR = 1.61; 95% CI: 1.14-2.25), any STI diagnosis (aOR = 2.41; 95% CI: 1.74-3.33), living with HIV (aOR = 3.73; 95% CI: 2.31-6.25) and current/prior PrEP use (aOR = 2.35; 95% CI: 1.43-4.01). Conclusions: Mpox vaccination among sexual and gender diverse populations in Brazil remains critically low. Findings highlight structural barriers, including vaccine scarcity, delayed rollout and stigma, that hinder equitable vaccine access. Integrating mpox vaccination into combined HIV/STI prevention services, adopting differentiated care delivery models and partnering with community-led organizations are essential to expanding reach, improving dose completion and reducing health inequities during ongoing and future outbreaks. (© 2026 The Author(s). Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.) |
| References: | WHO, Monkeypox Data [Internet], [citado 6 de setembro de 2022]. Disponível em: (2022), https://extranet.who.int/publicemergency/#. M. S. T. Silva, C. Coutinho, and T. S. Torres, “Exploring the Resurgence of a Neglected Disease: Lessons From the 2023–2024 Mpox Outbreak in Rio de Janeiro, Brazil,” Clinical Infectious Diseases 79, no. 3 (2024): 656–659, https://doi.org/10.1093/cid/ciae290. C. Coutinho, M. Secco Torres Silva, T. S. Torres, et al., “Characteristics of Women Diagnosed With Mpox Infection Compared to Men: A Case Series From Brazil,” Travel Medicine and Infectious Disease 56 (2023): 102663, https://doi.org/10.1016/j.tmaid.2023.102663. J. P. Thornhill, R. Palich, and J. Ghosn, “Human Monkeypox Virus Infection in Women and Non‐Binary Individuals During the 2022 Outbreaks: A Global Case Series,” Lancet 400, no. 10367 (2022): 1953–1965, https://doi.org/10.1016/S0140‐6736(22)02187‐0. T. S. Torres, M. S. T. Silva, and C. Coutinho, “Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross‐Sectional Web‐Based Survey Among Sexual and Gender Minorities,” JMIR Public Health and Surveillance 9 (2023): e46489, https://doi.org/10.2196/46489. J. Cruz Neto, A. C. Maia, and V. M. De Siqueira Holanda, “From HIV to Mpox: Socio‐Discursive Analysis of Communicable Diseases, Stigma, and Pathologization in Sexual Minorities in Brazil,” Archives of Sexual Behavior 53, no. 10 (2024): 3809–3824, https://doi.org/10.1007/s10508‐024‐02968‐5. C. Da Silva Bulcão, P. E. G. Prates, and I. M. B. Pedrosa, “Exploring Self‐Care Practices and Health Beliefs Among Men in the Context of Emerging Infectious Diseases: Lessons From the Mpox Pandemic in Brazil,” Nursing Inquiry 31, no. 3 (2024): e12635, https://doi.org/10.1111/nin.12635. S. Paparini, I. Whelan, and C. Mwendera, “Prevention of Sexual Transmission of Mpox: A Systematic Review and Qualitative Evidence Synthesis of Approaches,” Infectious Diseases 56, no. 8 (2024): 589–605, https://doi.org/10.1080/23744235.2024.2364801. L. Pischel, B. A. Martini, and N. Yu, “Vaccine Effectiveness of 3rd Generation Mpox Vaccines Against Mpox and Disease Severity: A Systematic Review and Meta‐Analysis,” Vaccine 42, no. 25 (2024): 126053, https://doi.org/10.1016/j.vaccine.2024.06.021. J. Crandell, V. S. Monteiro, and L. Pischel, “The Impact of Orthopoxvirus Vaccination and Mpox Infection on Cross‐Protective Immunity: A Multicohort Observational Study,” Lancet Microbe 6, no. 7 (2025): 101098, https://doi.org/10.1016/j.lanmic.2025.101098. N. Tavares, A. Santos, and M. Carvalho, “Análise da situação Vacinal contra a Mpox em Pessoas Vivendo com HIV/Aids: Estudo Ecológico,” Revista Brasileira De Enfermagem 77, no. 5 (2024): e20230234, https://doi.org/10.1590/0034‐7167‐2023‐0234pt. R. M. A. Silva, C. D. Kobayashi, and A. F. Martins, “Estudo Descritivo dos Eventos Supostamente Atribuíveis à Vacinação contra a mpox no Brasil em 2023,” Cad Saúde Pública 40, no. 10 (2024): e00006624, https://doi.org/10.1590/0102‐311xpt006624. G. Santos, C. J. N. Ribeiro, and J. Santos Júnior, “Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex With Men: A National Cross‐Sectional Study,” Vaccines 12, no. 11 (2024): 1229, https://doi.org/10.3390/vaccines12111229. V. G. Veloso, C. F. Cáceres, and B. Hoagland, “Same‐Day Initiation of Oral Pre‐Exposure Prophylaxis Among Gay, Bisexual, and Other Cisgender Men Who Have Sex With Men and Transgender Women in Brazil, Mexico, and Peru (ImPrEP): A Prospective, Single‐Arm, Open‐Label, Multicentre Implementation Study,” Lancet HIV 10, no. 2 (2023): e84–96, https://doi.org/10.1016/S2352‐3018(22)00331‐9. A. W. Meade and S. B. Craig, “Identifying Careless Responses in Survey Data,” Psychological Methods 17, no. 3 (2012): 437–455, https://doi.org/10.1037/a0028085. T. S. Torres, L. M. S. Marins, V. G. Veloso, B. Grinsztejn, and P. M. Luz, “How Heterogeneous Are MSM From Brazilian Cities? An Analysis of Sexual Behavior and Perceived Risk and a Description of Trends in Awareness and Willingness to Use Pre‐Exposure Prophylaxis,” BMC Infectious Diseases [Electronic Resource] 19, no. 1 (2019): 1067, https://doi.org/10.1186/s12879‐019‐4704‐x. M. S. T. Silva, P. M. Luz, and K. A. Konda, “Doxy‐PEP Interest, Awareness, and Use Among Sexual and Gender Minorities in Brazil, Mexico, and Peru: Findings From a Web‐Based Survey,” Lancet Regional Health–Americas 56 (2026): 101433, https://doi.org/10.1016/j.lana.2026.101433. D. J. Smolenski, P. M. Diamond, M. W. Ross, and B. R. S. Rosser, “Revision, Criterion Validity, and Multigroup Assessment of the Reactions to Homosexuality Scale,” Journal of Personality Assessment 92, no. 6 (2010): 568–576, https://doi.org/10.1080/00223891.2010.513300. T. S. Torres, P. M. Luz, and D. R. B. Bezerra, “Translation and Validation in Brazilian Portuguese of the Reactions to Homosexuality Scale,” Psychology, Health and Medicine 26, no. sup1 (2021): 20–36, https://doi.org/10.1080/13548506.2021.1936580. M. S. T. Silva, E. M. Jalil, and Torres, “Monkeypox and Transgender Women: The Need for a Global Initiative,” Travel Medicine and Infectious Disease 50 (2022): 102479, https://doi.org/10.1016/j.tmaid.2022.102479. L. Razek, R. S. Henry, and E. M. Jalil, “Factors Associated With Transgender‐Based Discrimination Among Travestis and Transgender Women in Rio de Janeiro, Brazil,” Transgender Health 9, no. 6 (2024): 582–590, https://doi.org/10.1089/trgh.2023.0002. L. A. Freitas, C. Coutinho, and D. Castanheira, “Racial Disparities in HIV Incidence and PrEP Non‐Adherence Among Gay, Bisexual and Other Men Who Have Sex With Men (MSM) and Transgender Women Using Oral PrEP in Brazil: Results From the ImPrEP Study,” Brazilian Journal of Infectious Diseases 30, no. 2 (2026): 104614, https://doi.org/10.1016/j.bjid.2026.104614. J. Heskin, M. Dickinson, and N. Brown, “Rapid Reconfiguration of Sexual Health Services in Response to UK Autochthonous Transmission of Mpox (Monkeypox),” Sexually Transmitted Infections 99 (2022): 81–84, https://doi.org/10.1136/sextrans‐2022‐055558. M. S. T. Silva, T. S. Torres, and C. Coutinho, “Mpox, Sexually Transmitted Infections and Combination Prevention: Insights From a Major Cohort in Rio de Janeiro, Brazil,” AIDS 38, no. 13 (2024): 1845–1849, https://doi.org/10.1097/QAD.0000000000003991. L. E. Owens, D. W. Currie, and E. A. Kramarow, “JYNNEOS Vaccination Coverage Among Persons at Risk for Mpox — United States, May 22, 2022–January 31, 2023,” MMWR Morbidity and Mortality Weekly Report 72, no. 13 (2023): 342–347, https://doi.org/10.15585/mmwr.mm7213a4. I. O. Ogunkola, O. E. Abiodun, and B. I. Bale, “Monkeypox Vaccination in the Global South: Fighting a War Without a Weapon,” Clinical Epidemiology and Global Health 22 (2023): 101313, https://doi.org/10.1016/j.cegh.2023.101313. M. R. Tovani‐Palone, N. Doshi, and P. Pedersini, “Inequity in the Global Distribution of Monkeypox Vaccines,” World Journal of Clinical Cases 11, no. 19 (2023): 4498–4503, https://doi.org/10.12998/wjcc.v11.i19.4498. L. Freitas, T. S. Torres, and B. Hoagland, “Discriminatory Experiences Among Gay, Bisexual, and Other Men Who Have Sex With Men, and Transgender and Non‐Binary Individuals: A Cross Sectional Analysis,” Lancet Regional Health–Americas 33 (2024): 100737, https://doi.org/10.1016/j.lana.2024.100737. T. S. Torres, L. Freitas, and M. S. T. Silva, “Analyzing the Intersection of Race and Income on Perceived Discrimination Among Sexual and Gender Diverse Persons in Brazil: A Nationwide Cross‐Sectional Study,” BMC Public Health [Electronic Resource] 26, no. 1 (2026): 1686, https://doi.org/10.1186/s12889‐026‐27313‐4. Brasil, Sistema de Informação do Programa Nacional de Imunizações (SI‐PNI): Vacinação Calendário Nacional—cobertura e Ocorrência [Internet]. Ministério da Saúde; 2026 [citado 15 de maio de 2026]. Disponível em: https://infoms.saude.gov.br/extensions/SEIDIGI_DEMAS_VACINACAO_CALENDARIO_NACIONAL_COBERTURA_OCORRENCIA/SEIDIGI_DEMAS_VACINACAO_CALENDARIO_NACIONAL_COBERTURA_OCORRENCIA.html. |
| Grant Information: | 313265/2023-2 National Council of Technological and Scientific Development (CNPq); 304417/2025-4 CNPq; 405558/2025-2 CNPq; 307000/2025-7 CNPq; E.26/200.946/2022 Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ); E-26/201.270/2022 FAPERJ; E-26/204.203/2024 FAPERJ |
| Contributed Indexing: | Keywords: Brazil; mpox; sexually transmitted infections; vaccination |
| Substance Nomenclature: | 0 (Smallpox Vaccine) |
| Entry Date(s): | Date Created: 20260725 Date Completed: 20260725 Latest Revision: 20260803 |
| Update Code: | 20260803 |
| PubMed Central ID: | PMC13400969 |
| DOI: | 10.1002/jia2.70143 |
| PMID: | 42499160 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!