Abstract
INTRODUCTION AND AIMS: In 2024, in response to a re-surge in mpox transmission in New South Wales, Australia, Kirketon Road Centre (KRC) partnered with an HIV and LGBTQI+ community organisation, ACON, to conduct outreach vaccination in two sex-on-premises venues (SOPVs), also known as "saunas". SOPV attendees were approached by an ACON peer worker who offered health education and referral to on-site mpox vaccination (Jynneos®) by a registered nurse. We aim to describe the scope, the acceptability, and the outcomes of mpox vaccination outreach at SOPVs in Sydney, and compare characteristics of people who received mpox vaccination at SOPVs to those who were vaccinated for mpox at a KRC's fixed-site vaccination clinic. METHODS: In addition to a descriptive analysis of service records, we matched individual-level records with Australian Immunisation Register (AIR) and ran (comparative) descriptive and multivariate analyses; a subset of people who were matched on AIR was analysed. RESULTS: During the outreach period, KRC administered 639 mpox vaccines at its fixed-site and conducted 22 outreach sessions at SOPVs in collaboration with ACON. These sessions resulted in 840 engagements; 522 individuals were eligible for mpox vaccination, 407 (78%) accepted referral to a nurse vaccinating onsite at SOPV, and n = 359 received mpox vaccine at SOPV. Among individuals who were matched on AIR, 77% at KRC's fixed-site and 66% at SOPV received two doses of mpox vaccine at some point. People who received at least one mpox vaccine at an SOPV were older (mean 46 vs. 39 years) and were less likely to: reside locally (34% vs. 51%), to have Medicare (57% vs. 74%), or to have an AIR record (60% vs. 67%) than people who were vaccinated at KRC's fixed site only. In a multivariate model, vaccine completion was not associated with receiving SOPV vs. KRC's fixed-site. CONCLUSION: Mpox outreach vaccination done in collaboration between nurses and LGBTQI+ peer-workers at SOPVs proved feasible, acceptable, and beneficial in terms of reaching people who may be out of area and not routinely engaged with sexual health services. Models of care that circumnavigate traditional geographic and local health service barriers should be considered during outbreaks, particularly those that build on established rapport within the communities at risk, such as MSM.