COVID-19 Vaccine Uptake and Its Impacts in a Cohort of Gay and Bisexual Men in Australia

Restrictions imposed due to COVID-19 have constrained social interactions, including sexual contacts. COVID-19 vaccine hesitancy restricts population-level vaccine coverage. Many gay and bisexual men (GBM) have successfully employed biomedical forms of HIV risk-reduction, which may predispose them to vaccination against COVID-19, which may, in turn, affect their sexual behavior. Australian GBM provided weekly data on the impact of COVID-19 for a prospective observational study. A total of 622 men reported their vaccination history, sexual behaviour, and social connectedness between 17 January 2021 and 22 June 2021. We describe rates and types of vaccination over time, identify factors associated with vaccination, and compare sexual behavior before and since vaccination. Mean age was 47·3 years (SD 14·0). Most identified as gay (89·5%) and 9·2% were HIV-positive. At least one-dose vaccination coverage had reached 57·2%, and 61·3% reported that the majority of their friends intended to be vaccinated. Vaccinated men were older (aOR=1·07; 95%CI=1·05-1·09) and tested more often for COVID-19 (aOR=1·15; 95%CI=1·05-1·25). Men who were not vaccinated were more sceptical about COVID-19 vaccines. Vaccinated men reported a mean of 1·11 (SD=2·10) non-relationship sex partners before vaccination and 1·62 (SD=3·42) partners following vaccination (p=0·030). GBM, and their peer networks, demonstrated high confidence in COVID-19 vaccines. Men who were less sceptical of the safety of the vaccines were more likely to vaccinate. Men were also more likely to increase sexual activity following vaccination suggesting that greater sexual freedom may be a specific motivation for vaccine uptake among some men. Funding Information: The Kirby Institute, Centre for Social Research in Health, and the Australian Research Centre in Sex, Health and Society are funded by the Australian Government Department of Health. The Flux study has received funding from the Australian Research Council (2014-2018) and the New South Wales Ministry of Health, via the BBV and STI Research, Intervention and Strategic Evaluation (BRISE) program, STIs and Viral Hepatitis. In 2018, Flux was partly funded by the Gilead Sciences Australia Fellowship Research Grants Program. LM, BRB, BH are supported by the award of a NHMRC Research Fellowship. Declaration of Interests: The authors have no conflicts of interest to disclose. Ethics Approval Statement: Participants provided online informed consent, and enrolment was verified upon activating a link via email. Ethical approval was granted from UNSW Sydney.