Background: Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups. Objectives: This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM. Methods: A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression. Results: The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using “glory holes” (aOR: 19.82; 95% CI: 1.60–245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52–16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72–9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27–7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13–3.30) also showed a higher likelihood of vaccine hesitancy. Conclusion: Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Background: In Brazil, men who have sex with men (MSM) are disproportionately affected by the HIV epidemic, mirroring global trends. Despite advancements in HIV prevention, such as pre-exposure prophylaxis (PrEP), uptake remains uneven among different MSM age groups, influenced by various sexual behaviors, risk perceptions, and social stigmas. Objective: This study aimed to investigate factors associated with PrEP intentions among Brazilian MSM across different age groups. Methods: A cross-sectional electronic survey was conducted with Brazilian MSM aged 18 years and above. Results: PrEP intentions were expressed by 55.1% (2390/4341) of participants. Among those under 25 years old, frequent barebacking was associated with a 25.4-fold higher prevalence of PrEP intentions (95% CI 18.18‐35.48). Conversely, having one or more casual sexual partners in the last 30 days (2164/3838) was associated with a 22% lower frequency of PrEP intentions (95% CI 0.72‐0.85). The practice of chemsex was also associated with a lower prevalence of PrEP intentions (adjusted prevalence ratio [aPR] 0.96; 95% CI 0.94‐0.98). Among individuals aged 25‐49 years, the practice of double penetration was associated with a higher prevalence of PrEP intentions (aPR 1.22; 95% CI .13‐1.32), as was being a receptive or versatile partner (aPR 1.27; 95% CI 1.04‐1.55 and aPR 1.23; 95% CI 1.01‐1.49). In addition, within this age range, a higher prevalence of PrEP intentions (over 10% 258/429]) was found among those with specific characteristics, such as a previous diagnosis of syphilis (aPR 1.12; 95% CI 1.03‐1.22). However, being single (aPR 0.90; 95% CI 0.83‐0.97) and having a partner who used PrEP (aPR 0.82; 95% CI 0.72‐0.93) were associated with a lower prevalence of PrEP intentions. For MSM aged ≥50 years, a higher prevalence of PrEP intentions was associated with the practice of double penetration (aPR 1.31; 95% CI 1.20‐1.43), as well as being a receptive (aPR 1.27; 95% CI 1.04‐1.55) or versatile partner (aPR 1.23; 95% CI 1.01‐1.50). The practice of group sex was independently associated with a lower prevalence of PrEP intentions exclusively among MSM aged ≥50 years (aPR 0.82; 95% CI 0.75‐0.89). Conclusions: The study highlights significant generational differences in factors influencing PrEP intentions among Brazilian MSM. It underscores the need for tailored HIV prevention strategies that consider the unique behaviors and perceptions of different age groups. By addressing these nuances, public health initiatives can more effectively promote PrEP use, catering to the diverse needs of the MSM community and contributing to the reduction of HIV infection rates.

Objetivo: descrever experiências relacionadas à vivência de cuidadoras sobre o cuidado de crianças com microcefalia associada ao Zika vírus. Método: trata-se de um estudo qualitativo, descritivo, exploratório, realizado com o apoio de duas participantes/cuidadoras de crianças com microcefalia, por meio de entrevistas semiestruturadas e analisadas pelo software IRAMUTEQ, que gerou a nuvem de palavras e a árvore de similitude. Resultados: evidenciou-se o termo “filho” nos relatos como de suma importância na vida das cuidadoras. Percebeu-se que a figura paterna e/ou os familiares não estavam vinculados ao processo de cuidado e a assistência governamental direcionada às cuidadoras era falha devido à carência de atividades específicas de promoção de saúde. Aponta-se que as mães enfrentaram mudanças drásticas em suas trajetórias de vida e se sentiram sozinhas. Conclusão: constata-se que as experiências revelaram a sobrecarga, as responsabilidades e a ressignificação da identidade feminina com a autopercepção, prioritariamente, voltada para o papel social de mãe/cuidadora da criança com microcefalia. Descritores: Microcefalia; Zika Vírus; Cuidadores; Criança; Enfermagem; Pesquisa Qualitativa.AbstractObjective: to describe experiences related to female caregivers' experience regarding the care of children with microcephaly associated with the Zika virus. Method: this is a qualitative, descriptive, exploratory study, conducted with the support of two female participants/caregivers of children with microcephaly, through semi-structured interviews and analyzed by the IRAMUTEQ software, which generated the word cloud and the similarity tree. Results: the term “child” was evidenced in the reports as of paramount importance in the female caregivers' lives. It was noticed that the father figure and/or family members were not linked to the care process and the governmental assistance directed to the female caregivers was flawed due to the lack of specific health promotion activities. It is pointed out that mothers faced drastic changes in their life trajectories and felt alone. Conclusion: it can be seen that the experiences revealed the overload, the responsibilities and the resignification of the female identity with self-perception, primarily focused on the social role of mother/female caregiver of the child with microcephaly. Descriptors: Microcephaly; Zika vírus; Female Caregivers; Child; Nurse; Qualitative Research.ResumenObjetivo: describir las experiencias relacionadas con la experiencia de los cuidadores con respecto al cuidado de niños con microcefalia asociada al virus del Zika. Método: este es un estudio cualitativo, descriptivo, exploratorio, realizado con el apoyo de dos participantes/cuidadores de niños con microcefalia, a través de entrevistas semiestructuradas y analizadas por el software IRAMUTEQ, que generó la nube de palabras y el árbol de similitud. Resultados: el término "hijo" se evidenció en los informes como de suma importancia en la vida de los cuidadores. Se observó que la figura paterna y/o los miembros de la familia no estaban vinculados al proceso de atención y que la asistencia gubernamental dirigida a los cuidadores era defectuosa debido a la falta de actividades específicas de promoción de la salud. Se señala que las madres enfrentaron cambios drásticos en sus trayectorias de vida y se sintieron solas. Conclusión: se encontró que las experiencias revelaron la sobrecarga, las responsabilidades y la resignificación de la identidad femenina con la autopercepción, principalmente enfocada en el papel social de la madre/cuidadora del niño con microcefalia. Descriptores: Microcefalia; Virus Zika; Cuidadores; Niño; Enfermería; Investigácion Cualitativa.

Background: In 2022, Mpox presented significant challenges globally, particularly in Brazil, where cases surged among men who have sex with men (MSM). Health literacy (HL) is essential for promoting health within this group. Objective: To analyze the HL of MSM in the context of Mpox transmission in Brazil. Methods: This was a national cross-sectional study conducted in a virtual setting. An electronic survey was carried out from September to December 2022. A translated and adapted version of the Health Literacy Scale (HLS-14) and a questionnaire containing sociodemographic information, sexual behaviors, and knowledge and beliefs about Mpox were administered. The distribution of predictor variables across health literacy (HL) levels was explored descriptively. Associations between predictors and HL were analyzed using Pearson’s Chi-square test (p < 0.20 for inclusion in multivariate analysis). A generalized linear Poisson model with robust variance was used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals. Model fit was assessed with the omnibus test and information criteria (AIC, deviance, log-likelihood). Significance was set at p <0.05. Results: The final sample included 1,449 MSM, with an overall prevalence of 53.83% (n = 780) for satisfactory HL. In the bivariate analysis, 15 of the 27 variables met the statistical criterion (p <0.20) for inclusion in the multivariate model, with six retained in the final model. Reporting non-adherence to treatment if diagnosed with Mpox (aPR: 1.73; 95% CI: 1.44–2.07), a prior Mpox diagnosis (aPR: 1.17; 95% CI: 1.04–1.32), having a basic education level (aPR: 1.15; 95% CI: 1.02–1.31), using apps to seek sex (aPR: 1.15; 95% CI: 1.04–1.27), and seeking sex at parties and clubs (aPR: 1.14; 95% CI: 1.04–1.26) were independently associated with a higher prevalence of satisfactory HL. Conclusion: HL levels among MSM during the Mpox public health emergency in Brazil were low, shaped by individual, economic, and social factors. The findings can guide nursing practice regarding how MSM deal with information and make decisions in contexts of episodic health events, as well as the HL strategies to be implemented in nursing therapy.