Abstract
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected sexual minorities including men who have sex with men (MSM). This study investigated factors associated with the uptake of COVID-19 vaccination among MSM in China.MethodsInclusion criteria were: (1) born biologically male, (2) had oral or anal sex with men in the past year, (3) aged at least 18 years, and (4) lived in Shenzhen, China. Prospective participants were recruited through outreach in gay bars and saunas, online recruitment, and peer referrals. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. Logistic regression models were fitted for data analysis.ResultsAmong 420 participants who completed the baseline survey, 303 completed the follow-up survey. Among participants being followed up, 113 (37%) received at least one dose of COVID-19 vaccination during the study period. After adjusting for significant sociodemographic characteristics, five baseline predisposing factors predicted COVID-19 vaccination uptake during the follow-up period, including asking whether their partners had COVID-19 symptoms [adjusted odds ratio (AOR): 1.17, 95% confidence interval (CI): 1.00–1.38], washing hands before and after sex (AOR: 1.23, 95% CI: 1.03–1.46), sanitizing before and after sex (AOR: 1.17, 95% CI: 1.00–1.37), perceived higher risk of COVID-19 transmission through sexual behaviors (AOR: 1.28, 95% CI: 1.04–1.58), and panic about COVID-19 (AOR: 1.48, 95% CI: 1.16–1.89). Regarding enabling factors, receiving testing for sexually transmitted infections (STI) (AOR: 2.19, 95% CI: 1.25–3.85) and other prevention measures for human immunodeficiency virus (HIV)/STI (AOR: 2.61, 95% CI: 1.56–4.37) 6 months prior to the baseline survey were associated with higher uptake of COVID-19 vaccination.ConclusionMSM’s uptake rate of COVID-19 vaccination was comparable to that of the general population in Shenzhen, China. This study offered an overview for us to identify tapping points that can encourage COVID-19 vaccination uptake among Chinese MSM.
Highlights
Coronavirus disease 2019 (COVID-19) imposes a heavy disease burden and an unprecedented challenge to the healthcare system
Sanitizing before and after sex Perceptions related to COVID-19, n (%) agree/strongly agree The risk of COVID-19 transmission through sexual behavior is high The risk of COVID-19 transmission through other intimate behaviors is high Asymptomatic patients have a high risk of transmitting COVID-19 Your regular male sex partner would transmit COVID-19 to you Your non-regular male sex partner would transmit COVID-19 to you You concern about COVID-19 infection when taking up human immunodeficiency virus (HIV) testing Psychological variables, mean (SD) Level of panic about COVID-19 CESD-10 Enabling factors Service utilization in the past 6 months, n (%) Yes Any type of HIV testing Testing for sexually transmitted infection (STI) Other HIV/STI prevention services1 Experiences related to COVID-19, n (%) Yes Friends/family members infected with COVID-19 History of COVID-19 infection Centralized/home quarantine
For experiences related to COVID-19, 1.2, 1.7, and 15.7% reported having friends/family members infected with COVID-19, history of COVID-19 infection, and centralized/home quarantine, respectively (Table 1)
Summary
Coronavirus disease 2019 (COVID-19) imposes a heavy disease burden and an unprecedented challenge to the healthcare system. China initiated the nationwide COVID-19 vaccination program in December 2020. In Shenzhen where the study was conducted, people could make an appointment to receive a COVID-19 vaccination. People first downloaded a smartphone application developed by the health bureau. After logging in, they could choose the time and location to receive the vaccine. At the beginning of rollout, only two types of inactivated COVID19 vaccines were available in China (Sinopharm, and Sinovac CoronaVac). The number of available vaccines increased to six in July 2021, including four inactivated vaccines (Sinopharm, Sinovac CoronaVac, Minhai KCONVAC, and Covidful), one adenovirus vector vaccine (CanSino: Ad5-nCoV), and one subunit vaccine (Zhifei Bio-tech: ZIFIVAX) [3–5]. This study investigated factors associated with the uptake of COVID-19 vaccination among MSM in China
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