Characteristics of the Population
All individuals who were invited to participate in the study accepted and completed the questionnaire, with a response rate of 100%. Overall, 144 questionnaires were collected. The vast majority of the participants were of Italian nationality, (130;90%), of male gender (139;96.5%), and between 30 and 60 years of age (118;82%). Foreigners were mainly from South America (10;71.4%). For the majority (65;45.1%), the highest educational attainment was a high school diploma, while 34 (23.6%) participants held a bachelor’s degree. The vast majority were employed (121;84%), with the remaining individuals being either unemployed, retired, or still students.
Perception and Awareness
Almost all participants (136;94%) reported having heard about Mpox before, and more than half (80;56%) had received information about transmission. The information was perceived as complete by 14 respondents (10%). The main source of information was television and newspapers (118;82%), followed by the websites and social media (71;49%), healthcare professionals (24;16%) and finally word-of-mouth (14;10%).
The vast majority of participants (109;76%) believed that Mpox is a dangerous disease, mainly because it is an infectious disease (93;65%) and because it causes visible symptoms (28;19%), while few thought that it is incurable (7;5%). In fact, the majority (93;65%) think that there is a specific drug to cure Mpox. A third (45;31%) thought it is easy to acquire the infection, while half (76;53%) were unaware.
The majority of the cohort knew that transmission occurs through direct contact with an affected person (100;69%), and half also stated through sexual route (75;52%). The transmission route via respiratory droplets (20;14%), kissing (20;14%) and through objects (19;13%) and contaminated surfaces (2;1%) was the least selected.
Nearly half (59;41%) of respondents affirmed they thought they were at risk of getting the infection, and the majority (89;62%) were afraid to get it, mainly out of fear of a disease that is still little known, and out of social stigma and fear that the signs of infection may be visible.
The majority of participants (91; 63.2%) believe that friends and family members would react with negative emotions if they were to discover that they suffer from Mpox.
Despite the fear of the infection, the majority of participants (81;56%) responded that they did not increase the precautions they took for fear of Mpox. Indeed, most respondents (86;59.7%) declared they did not know what preventive measures to take to reduce the risk of infection.
Furthermore, less than half (61;42%) answered that using condoms could reduce the risk of infection, and the great majority (123;85%) do not think that hand washing is a proper Mpox prevention rule.
When asked if they would accept a vaccine to prevent the disease, more than a third (46;32%) of respondents expressed hesitation or complete refusal to be vaccinated. All these results are summarized in Table
1.
Table 1
Responses of participants to the questionnaire. Percentages are calculated on total participants
Sex |
Male | 139 (96.5%) |
Female | 4 (2.8%) |
Other | 1 (0.7%) |
Age |
30–60 years of age | 118 (81.9%) |
> 60 years of age | 17 (11.8%) |
Nationality |
Italian | 130 (90.3%) |
Foreign born | 14 (9.7%) |
Of which, from South America | 10 (71.4%) |
Education |
Secondary school | 41 (28.5%) |
High school | 65 (45.1%) |
Degree | 34 (23.6%) |
Occupation |
Employed | 121 (84%) |
Unemployed | 9 (6.3%) |
Retired | 11 (7.7%) |
Student | 3 (2%) |
Monkeypox perception and knowledge |
Have you ever heard about monkeypox? |
Yes | 136 (94.4%) |
No | 8 (5.6%) |
Have you ever received information about the transmission? |
Yes | 80 (55.6%) |
No | 63 (43.8%) |
What was the source? (Multiple answer) |
Health-care personnel/setting | 24 (16%) |
Web and social media | 71 (49.3%) |
Television and Newspapers | 118 (81.9%) |
Word-of-mouth | 14 (9.7%) |
The information received were (Multiple answer) |
Completed | 14 (9.7%) |
Sufficient | 58 (40.3%) |
Insufficient | 43 (29.9%) |
Comprehensible | 21 (14.6%) |
Incomprehensible | 11 (7.7%) |
Do you think monkeypox is a dangerous disease? |
Yes | 109 (75.7%) |
No | 32 (22.2%) |
Why do you thing is a dangerous disease? (Multiple answer) | |
It is an infectious disease | 93 (64.6%) |
It is incurable | 7 (4.9%) |
It is sexually transmitted | 29 (20.1%) |
It causes visible symptoms | 28 (19.4%) |
Do you think it is pharmaceutically treatable? |
Yes | 93 (64.6%) |
No | 6 (4.1%) |
I don’t know | 44 (30.6%) |
In your opinion, is it easy to catch monkeypox? |
Yes | 45 (31.3%) |
No | 22 (15.3%) |
I don’t know | 76 (52.7%) |
How is monkeypox transmitted? (Multiple answer) |
By contact with infected persons | 100 (69.4%) |
By respiratory droplets | 20 (13.8%) |
By using contaminated items | 19 (13.2%) |
By contaminated surfaces | 2 (1.4%) |
By kissing | 20 (13.8%) |
By sex | 75 (52%) |
Do you know what preventive measures should be taken? |
Yes | 55 (38.2%) |
No | 86 (59.7%) |
How do you think it is possible to reduce the risk of monkeypox transmission? (Multiple answer) |
In no way | 7 (4.9%) |
Always using a condom | 61 (42.4%) |
Frequently washing hands | 21 (14.6%) |
Wearing a mask in public places | 16 (11.1%) |
Having only one sexual partner | 38 (26.4%) |
Avoiding casual sexual encounters | 47 (32.6%) |
Not exchanging personal items | 20 (13.9%) |
Do you usually take precautions against STIs? |
Habitually | 112 (77.8%) |
Sometimes/rarely | 20 (13.9%) |
No, never | 4 (2.8%) |
Since the emergence of monkeypox, are you taking more precautions? |
Yes | 54 (37.5%) |
No | 81 (56.3%) |
Are you afraid of being affected? |
Yes | 89 (61.8%) |
No | 30 (20.8%) |
I don’t know | 18 (12.5%) |
Have you ever thought you were at risk of getting monkeypox? |
Yes | 59 (41%) |
No | 76 (52.8%) |
How do you think family and friends would react if they knew you were affected by monkeypox? (Multiple answer) |
Negatively (they would isolate me, judge me) | 91 (63.2%) |
They would support and help me | 31 (21.5%) |
No reaction | 35 (24.1%) |
If a vaccine was available, would you get it? |
As soon as possible | 86 (59.7%) |
I would wait some time to see the effect on the people who did it | 40 (27.8%) |
I would never do that | 6 (4.2%) |
Significant differences were found in responses between participants who received medical information from health professionals and those who did not. The vast majority of those who received information from health professionals knew the preventive measures to be taken to avoid infection (15;62% vs. 40;36%,
p = 0.022). Moreover, the first group declared that since the emergence of Mpox virus they had been taking more precautions against sexually transmitted infections (14;63% vs. 38; 35%,
p = 0.017). However, we didn’t find significant differences on the acceptance or refusal of vaccinations between patients who received information about Mpox from healthcare professionals and those who did not (16;72% vs. 70; 66%,
p = 062), as well the awareness of the danger of the disease (19;82% vs. 85;75%,
p = 0.593). These results are represented in Table
2.
Table 2
Differences between answers in participants who acquired information from healthcare professionals and participants that got information elsewhere. Significance is established at p < 0.05
Monkeypox is a dangerous disease |
Healthcare personnel as source of information | 19 (82%) | p = 0.593 |
Others | 85 (75%) | |
Knowledge of the preventive measures |
Healthcare personnel as source of information | 15 (62%) | P = 0.022* |
Others | 40 (36%) | |
Taking more precautions against IST since the emergence of Mpox virus |
Healthcare personnel as source of information | 14 (63%) | P = 0.017* |
Others | 38 (35%) | |
If the smallpox vaccine becomes available, I would like to receive it as soon as possible |
Healthcare personnel as source of information | 16 (72%) | P = 0.624 |
Others | 70 (66%) | |