Assessing Mpox Knowledge, Attitude, and Willingness to Accept the Mpox Vaccine Among People Living with HIV and Men Who Have Sex with Men in Rivers State, Nigeria

Limited data exist on knowledge and attitudes towards mpox and the willingness to accept the mpox vaccine among vulnerable populations, such as people living with HIV and men who have sex with men (MSM), in countries facing intersecting HIV and mpox epidemics, like Nigeria. This study assessed the knowledge, attitudes, and willingness of these groups to receive the mpox vaccine in Rivers State. A cross-sectional study was conducted from August 26, 2024, to September 30, 2024, involving 300 people living with HIV (PLWH) and 14 MSM at two selected health facilities in Rivers State, Nigeria, using systematic and snowball sampling techniques, respectively. Data were collected via a self-administered, web-based Google form covering sociodemographic information, knowledge of mpox, attitudes towards the disease, and vaccine willingness. The chi-square test explored the relationships between sociodemographic factors and vaccine acceptance. Multivariate logistic regression identified determinants of vaccination willingness. Although most participants (72.7%; 221) were aware of mpox, 54.3% (165) demonstrated poor knowledge of the disease. While 60.5% (184) perceived mpox as a serious illness, 60.2% (182) expressed willingness to accept the vaccine; however, concerns about side effects and mistrust in health systems served as key barriers. Willingness to vaccinate was significantly associated with age ({chi}{superscript 2} = 9.781; p < 0.007) and knowledge of mpox ({chi}{superscript 2} = 7.272; p < 0.027). Additionally, sex ({chi}{superscript 2} = 16.19, p < 0.001), level of education completed ({chi}{superscript 2} = 37.63, p < 0.001), and marital status ({chi}{superscript 2} = 15.01, p < 0.001) showed significant associations with mpox knowledge. The study revealed a concerning level of poor knowledge, limited perceived risk, and suboptimal vaccine acceptance, despite high awareness among PLWH and MSM. Vaccine acceptance was higher among younger individuals and those with good knowledge of mpox. Targeted public health education and confidence-building strategies are crucial for enhancing vaccine uptake among these at-risk groups. Summary boxO_LILimited data exist on the knowledge, attitudes towards mpox, and willingness to accept the mpox vaccine among vulnerable populations, such as people living with HIV (PLHIV) and men who have sex with men (MSM) in countries with overlapping HIV and mpox epidemics, like Nigeria. C_LIO_LIVaccination remains a vital public health tool for controlling infectious diseases, such as mpox, within communities. However, factors affecting vaccine uptake include individual awareness, cultural beliefs, trust in healthcare, and the stigma associated with vaccination. These elements are especially important in Nigeria, where PLHIV and MSM often face systemic discrimination in healthcare settings. C_LIO_LIOur study data reveal a concerning level of poor knowledge about mpox, low perceived risk, and suboptimal vaccine acceptance, despite high awareness of the disease among PLHIV and the MSM community. C_LIO_LIVaccine acceptance was influenced by younger age and a good knowledge of mpox. C_LIO_LITargeted public health education and confidence-building strategies are essential for increasing vaccine uptake among these at-risk groups. C_LI