Factors associated with self-reported hepatitis B virus vaccination status among men who have sex with men in the Netherlands

Background: Reducing the number of new acute hepatitis B virus (HBV) infections to zero by 2022 is an important goal in the Netherlands. Free HBV vaccination is available for population groups at higher risk of infection, including men who have sex with men (MSM). Identifying correlates of HBV vaccination among MSM can guide the development of health promotion interventions to increase coverage of HBV vaccination. Methods: We assessed factors associated with the HBV vaccination status of 4270 MSM in the Netherlands. Data were collected through the 2018 online Men & Sexuality survey. Results: Multinomial regression analysis showed that lower education level, having never tested for HIV, not recently diagnosed with a sexually transmissible infection, recently having had sex abroad and unknown HBV testing status were associated with higher odds of being unvaccinated as opposed to fully vaccinated. Living in Amsterdam and testing HBV negative were associated with lower odds of being unvaccinated as opposed to fully vaccinated. Age (25-39 years vs younger ages), living in Amsterdam and using pre-exposure prophylaxis decreased the odds to be partly vaccinated as opposed to fully vaccinated; having a migration background increased these odds. Conclusions: HBV vaccination rates among MSM will not reduce HBV transmission to zero. HBV promotion should focus on MSM outside of Amsterdam who are likely less connected with sexual health services and may be at lower (perceived) risk. The factors identified related to HBV vaccination status provide guidance for health promotion interventions to increase uptake and vaccination completion among MSM

A survey-based assessment of rates and covariates of mpox diagnosis and vaccination provides evidence to refine eligibility criteria for mpox vaccination among gay, bisexual and other men who have sex with men in the Netherlands

Background: The 2022 multicountry mpox outbreaks predominantly affected gay, bisexual and other men who have sex with men (GBMSM) in non-endemic countries, including in the Netherlands. We conducted a survey-based assessment of the alignment between the risk factors associated with mpox diagnosis among GBMSM in the Netherlands and the eligibility criteria used in 2022 for vaccinating this group, with the aim to refine these criteria. Methods: An online self-report survey was conducted among adult GBMSM in the Netherlands between 29 July and 30 August 2022, corresponding to the first month of the Dutch mpox vaccination campaign. GBMSM were recruited via advertisements on social media and gay dating apps. Participants reported on their sexual behaviour, mpox diagnosis, and/or (initial) mpox vaccination since the start of the outbreak. Covariables of mpox diagnosis and vaccination were assessed using logistic regression analyses. Results: Of the 2,460 participants, 73 (3.0%, 95% CI 2.3–3.6%) were diagnosed with mpox and 485 (19.7%, 95% CI 18.1–21.3%) had received (initial) mpox vaccination. Using sample weighting, we estimated that, of the GBMSM population aged 18–80 years in the Netherlands, 1.1% (95% CI 0.7–1.6%) had been diagnosed with mpox and 7.8% (95% CI 6.8–8.9%) had received (initial) vaccination. HIV-PrEP use, living with HIV, reporting ≥20 sex partners in the past 12 months, and sex in sex venues/parties in the past 2 months were independent risk factors for mpox diagnosis. Except for sex in sex venues/parties, these variables were also independently associated with mpox vaccination. Conclusion: This study provides novel evidence regarding the degree to which the 2022 eligibility criteria for mpox vaccination align with the risk factors for mpox among GBMSM in the Netherlands. The findings contribute to a refinement of the eligibility criteria for mpox vaccination, to which sex in sex venues/parties should be added

Factors potentially contributing to the decline of the mpox outbreak in the Netherlands, 2022 and 2023

Background: In 2022 and 2023, a global outbreak of mpox affected mostly gay, bisexual and other men having sex with men (GBMSM). Outbreak control in the Netherlands included isolation, quarantine, post-exposure prophylaxis vaccination and primary preventive vaccination (PPV). Aim: We describe the course of the outbreak, the vaccination programme, vaccine effectiveness (VE) of full vaccination against symptomatic disease, and trends in behaviour to generate hypotheses about factors that influenced the outbreak’s decline. Methods: In this observational study, we collected data from public health services on notified cases, number of PPV invitations and PPV doses administered. We calculated PPV uptake and coverage. Trends in behavioural data of GBMSM visiting sexual health centres were analysed for all consultations in 2022. We estimated VE using the screening method. Results: Until 31 December 2023, 1,294 mpox cases were reported. The outbreak peaked in early July 2022 and then declined sharply. PPV started on 25 July 2022; in total 29,851 doses were administered, 45.8% received at least one dose, 35.4% were fully vaccinated. The estimated VE was 68.2% (95% CI 4.3–89.5%). We did not observe an evident decrease in high-risk behaviour. Discussion: It is unlikely that PPV was a driver of the outbreak’s decline, as incidence started to decline well before the start of the PPV programme. The possible impact of behavioural change could not be demonstrated with the available indicators, however, the data had limitations, hampering interpretation. We hypothesise that infection-induced immunity in high-risk groups was an important factor explaining the decline

Informing the Trending Sexual Health initiative: Results from the 2017 Warming Up survey.

The findings presented in this report contribute to a betterunderstanding of the sexual health-related attitudes, practices and needs of the population of young people targeted by the Trending Sexual Health initiative. In line with the results ofthe 2016 IYLL periodic survey (Adam et al. 2017), the findings indicate that there is a needto strengthen young people’s engagement with sexual health promotion. Sexual healthmessaging should not only recommend behaviours but comprehensively address mainfactors that limit uptake of condom use and testing for STIs among young people living inAustralia. Some of these barriers have been extensively described elsewhere and possibleways to address these factors through sexual health campaigns and other activities havebeen suggested (Adam et al. 2017). Previous research found that norms around condomuse and testing for STIs were one of the major determinants of sexual health relatedbehaviours and that strengthening norms should be an important objective of sexual healthpromotion campaigns and other initiatives. In this research we also found that the socialimages of young people who use condoms and test for STIs are important aspects toconsider. There is scope for improving the social images of young people who embracesexual health promotion and making them appear trendier could contribute to social andbehavioural change. These findings provide an empirical validation of the main idea thatwas at the origin of the Trending Sexual Health initiative and offer new directions for thedevelopment and implementation of campaigns and other activities targeting young peoplein Australia