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Prevalence of Mpox vaccine acceptance and hesitancy among people living with HIV: a comprehensive systematic review and meta-analysis

AIDS Res Ther. 2025 Mar 8;22(1):31. doi: 10.1186/s12981-025-00726-8.

ABSTRACT

BACKGROUND: Vaccine acceptance among People Living with HIV (PLWH) is crucial for managing and mitigating the spread of infectious diseases, including Mpox. This systematic review and meta-analysis assess the rate of vaccine acceptance for Mpox among PLWH and identify factors influencing these rates.

METHODS: We searched major databases including PubMed, Embase, and Web of Science up to 30 August 2024 for observational studies involving PLWH that reported on mpox vaccine acceptance rates. A random-effects model was employed for the meta-analysis, utilizing R software version 4.4. Heterogeneity among the studies was quantified using the I² statistic, and the methodological quality of each study was assessed using a modified version of the Newcastle-Ottawa Scale.

RESULTS: Out of 1,123 articles identified, 17 studies met the inclusion criteria and included 7,248 participants. The pooled estimate of the Mpox vaccine acceptance rate was 61.1% (95% CI: 44.2-75.7%), with high heterogeneity (I² = 99%). Additionally, a pooled vaccine hesitancy prevalence was 13.2%, (95% CI: 2.4-48.6%), reflecting substantial variability and had high heterogeneity (I² = 98%).

CONCLUSION: This systematic review and meta-analysis reveal moderate Mpox vaccine acceptance and considerable hesitancy among PLWH. To further increase vaccine uptake and address any remaining hesitancy in this at-risk population, targeted public health strategies and ongoing research are necessary. Strengthening vaccine acceptance is critical to safeguarding PLWH against emerging infectious diseases such as Mpox.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40057788 | DOI:10.1186/s12981-025-00726-8

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