{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:47:38Z","timestamp":1782845258774,"version":"3.54.5"},"reference-count":29,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 2022 mpox outbreak in the United States disproportionately affected gay, bisexual, and other men who have sex with men (GBMSM). Uptake of mpox testing may be related to symptomology, sociodemographic characteristics, and behavioral characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to describe suspected mpox symptoms and testing uptake among a sample of GBMSM recruited via the internet in the United States in August 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a rapid internet-based mpox survey from August 5 to 15, 2022, among cisgender men 15 years and older who had previously participated in the 2021 American Men\u2019s Internet Survey. We estimated the prevalence of suspected mpox symptoms (fever or rash or sores with unknown cause in the last 3 mo) and uptake of mpox testing. We calculated adjusted prevalence ratios (aPRs) and 95% CIs for associations between participant characteristics and suspected mpox symptoms and summarized characteristics of GBMSM reporting mpox testing. Among symptomatic GBMSM who did not receive mpox testing, we described testing self-efficacy, barriers, and facilitators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 824 GBMSM, 126 (15.3%) reported at least 1 mpox symptom in the last 3 months; 58\/126 (46%) with rash or sores, 57 (45.2%) with fever, and 11 (8.7%) with both. Increased prevalence of suspected mpox symptoms was associated with condomless anal sex (CAS; aPR 1.53, 95% CI 1.06\u20102.20). Mpox testing was reported by 9\/824 GBMSM (1%), including 5 with symptoms. Most GBMSM reporting mpox testing were non-Hispanic White men (7\/9 vs 1 Black and 1 Hispanic or Latino man), and all 9 lived in urban areas. Most reported having an sexually transmitted infections test (8\/9), 2 or more partners (8\/9), CAS (7\/9), and group sex (6\/9) in the last 3 months. Of those tested, 3 reported living with HIV and all were on treatment, whereas the remaining 6 men without HIV reported current pre-exposure prophylaxis (PrEP) use. Of symptomatic GBMSM who did not report mpox testing, 47\/105 (44.8%) had low mpox testing self-efficacy. Among those with low self-efficacy, the most common barriers to testing were not knowing where to get tested (40\/47, 85.1%) and difficulty getting appointments (23\/47, 48.9%). Among those with high testing self-efficacy (58\/105, 55.2%), the most common facilitators to testing were knowing where to test (52\/58, 89.7%), convenient site hours (40\/58, 69%), and low-cost testing (38\/58, 65.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While all GBMSM who reported testing for mpox were linked to HIV treatment or PrEP, those with symptoms but no mpox testing reported fewer such links. This suggests targeted outreach is needed to reduce structural barriers to mpox services among GBMSM in rural areas, Black and  GBMSM, and GBMSM living with HIV. Sustaining and scaling community-tailored messaging to promote testing and vaccination represent critical interventions for mpox control among GBMSM in the United States.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/57399","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T04:39:32Z","timestamp":1737088772000},"page":"e57399-e57399","source":"Crossref","is-referenced-by-count":2,"title":["Suspected Mpox Symptoms and Testing in Men Who Have Sex With Men in the United States: Cross-Sectional Study"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8302-542X","authenticated-orcid":false,"given":"Kaitlyn","family":"Atkins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-2578","authenticated-orcid":false,"given":"Thomas","family":"Carpino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-2418","authenticated-orcid":false,"given":"Amrita","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-4762","authenticated-orcid":false,"given":"Travis","family":"Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6440-0626","authenticated-orcid":false,"given":"O Winslow","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8074-3255","authenticated-orcid":false,"given":"Marissa","family":"Hannah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7728-0587","authenticated-orcid":false,"given":"Patrick S","family":"Sullivan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-6535","authenticated-orcid":false,"given":"Yasmin P","family":"Ogale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-0154","authenticated-orcid":false,"given":"Winston E","family":"Abara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7562-7647","authenticated-orcid":false,"given":"Kevin P","family":"Delaney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5482-2419","authenticated-orcid":false,"given":"Stefan D","family":"Baral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"R1","unstructured":"Mpox. Centers for Disease Control and Prevention (CDC). 2023. 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United States, May 17-October 6, 2022","volume":"71","author":"Kava","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9","key":"R6","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad434","article-title":"Disparities in mpox vaccination among priority populations during the 2022 outbreak","volume":"10","author":"Alavian","journal-title":"Open Forum Infect Dis"},{"issue":"12","key":"R7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.47540","article-title":"HIV self-testing and risk behaviors among men who have sex with men in 23 US cities, 2017","volume":"5","author":"Bien-Gund","journal-title":"JAMA Netw Open"},{"issue":"12","key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/32846","article-title":"Patterns of SARS-CoV-2 testing preferences in a national cohort in the United States: latent class analysis of a discrete choice experiment","volume":"7","author":"Zimba","journal-title":"JMIR Public Health Surveill"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1177\/09567976231217416","article-title":"Identity concealment may discourage health-seeking behaviors: evidence from sexual-minority men during the 2022 global mpox outbreak","volume":"35","author":"Le Forestier","journal-title":"Psychol Sci"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1007\/s11524-023-00773-4","article-title":"Mpox on Reddit: a thematic analysis of online posts on mpox on a social media platform among key populations","volume":"100","author":"Hong","journal-title":"J Urban Health"},{"issue":"3","key":"R11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0299599","article-title":"A theory-based assessment of mpox: findings from a nationally representative survey of U.S. adults","volume":"19","author":"Walsh-Buhi","journal-title":"PLoS One"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1089\/apc.2017.0244","article-title":"Correlates of never testing for HIV among sexually active internet-recruited gay, bisexual, and other men who have sex with men in the United States","volume":"32","author":"Nelson","journal-title":"AIDS Patient Care STDS"},{"issue":"9","key":"R13","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1097\/OLQ.0000000000001032","article-title":"Self-reported extragenital chlamydia and gonorrhea testing in the past 12 months among men who have sex with men in the United States-American Men\u2019s Internet Survey, 2017","volume":"46","author":"de Voux","journal-title":"Sex Transm Dis"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1097\/OLQ.0000000000001889","article-title":"Modifications to sexual behaviors associated with mpox (monkeypox) virus transmission among persons presenting for mpox vaccination, Washington, DC, August\u2013October, 2022","volume":"51","author":"Copen","journal-title":"Sex Transm Dis"},{"issue":"8","key":"R15","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1136\/sextrans-2023-055901","article-title":"Egocentric sexual network analysis among gay and bisexual men who have sex with men with and without mpox infection","volume":"99","author":"S\u00f6nmez","journal-title":"Sex Transm Infect"},{"issue":"2","key":"R16","doi-asserted-by":"publisher","first-page":"37","DOI":"10.15585\/mmwr.mm7302a3","article-title":"Detecting mpox cases through wastewater surveillance \u2014 United States, August 2022\u2013May 2023","volume":"73","author":"Adams","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"3","key":"R17","doi-asserted-by":"publisher","DOI":"10.2196\/21812","article-title":"The annual American Men\u2019s Internet Survey of behaviors of men who have sex with men in the United States: Key Indicators Report 2018","volume":"7","author":"Wiatrek","journal-title":"JMIR Public Health Surveill"},{"key":"R18","unstructured":"NCHS Urban-Rural Classification Scheme for counties. Centers for Disease Control and Prevention (CDC). 2014. URL: https:\/\/www.cdc.gov\/nchs\/data-analysis-tools\/urban-rural.html#:~:text=A%20key%20feature%20of%20the,%E2%80%9D%20metro%20(akin%20to%20suburbs) [Accessed 06-01-2025]"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/QAI.0000000000001867","article-title":"Stimulant use and viral suppression in the era of universal antiretroviral therapy","volume":"80","author":"Carrico","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1002\/bimj.200410165","article-title":"Parameter estimation and goodness-of-fit in log binomial regression","volume":"48","author":"Blizzard","journal-title":"Biom J"},{"key":"R21","unstructured":"New in Stata 15. StataCorp. 2017. URL: https:\/\/www.stata.com\/stata15\/ [Accessed 06-01-2025]"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.2196\/46489","article-title":"Evaluation of mpox knowledge, stigma, and willingness to vaccinate for mpox: cross-sectional web-based survey among sexual and gender minorities","volume":"9","author":"Torres","journal-title":"JMIR Public Health Surveill"},{"key":"R23","unstructured":"HHS monkeypox letter. Infectious Diseases Society of America. Jul22, 2022. URL: https:\/\/www.idsociety.org\/globalassets\/bb-complex-pages\/hhs-monkeypox-letter-july-2022-final.pdf [Accessed 06-01-2025]"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2022.100372","article-title":"Monkeypox: where are the racial disparities?","volume":"17","author":"Nsoesie","journal-title":"Lancet Reg Health Am"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1111\/jrh.12726","article-title":"Rural-urban differences in monkeypox behaviors and attitudes among men who have sex with men in the United States","volume":"39","author":"Owens","journal-title":"J Rural Health"},{"issue":"12","key":"R26","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17124279","article-title":"Systematic review of clinical insights into novel coronavirus (CoVID-19) pandemic: persisting challenges in U.S. rural population","volume":"17","author":"Lakhani","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"R27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/QCO.0000000000000994","article-title":"Mpox in people living with HIV","volume":"37","author":"Maan","journal-title":"Curr Opin Infect Dis"},{"issue":"10380","key":"R28","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S0140-6736(23)00273-8","article-title":"Mpox in people with advanced HIV infection: a global case series","volume":"401","author":"Mitj\u00e0","journal-title":"Lancet"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","first-page":"22799036231160624","DOI":"10.1177\/22799036231160624","article-title":"Patient income level and health insurance correlate with differences in health care utilization during the COVID-19 pandemic","volume":"12","author":"Wiefels","journal-title":"J Public Health Res"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2025\/1\/e57399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:47:59Z","timestamp":1782841679000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2025\/1\/e57399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":29,"URL":"https:\/\/doi.org\/10.2196\/57399","relation":{},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,16]]},"article-number":"v11i1e57399"}}