Assessment of knowledge, attitudes, and behaviors regarding vaccinations among LGBTQIA+ community in Italy

Lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexually and gender-diverse populations (LGBTQIA+) are at risk for sexually transmitted infections (STIs). This survey assessed knowledge, attitudes, and vaccinations coverage for Human Papillomavirus (HPV), hepatitis A (HAV), hepatitis B (HBV), monkeypox (Mpox) and the associated determinants among 1944 LGBTQIA+ individuals in Italy. The survey was conducted between May and July 2025, through an internet-based questionnaire. Only 14.2% correctly identified HPV, HBV, HAV, and Mpox as STIs. Those younger, with university degree, in non-monogamous relationship, men who have sex with men, those with a chronic condition, with higher number of sexual partners in the last 12 months, those who were not binary, and who received information from healthcare workers (HCWs) were more knowledgeable. Only 31.7% considered all four vaccinations very useful, and this was more likely among those with university degree, in non-monogamous relationship, in homosexual, who received information from HCWs, who did not need additional information, who knew the sexual transmission of the infections, and reported condom use every time. Only 7.4% received all four vaccinations, while 39.6% received none. Younger age, having been tested for STIs, considering all vaccinations very useful, and having received information from HCWs were associated with higher uptake. Only 46.9% were willing to receive missing vaccinations. Younger age, non-monogamous relationship status, no prior testing for STIs, considering all four vaccinations very useful, higher perceived risk of being infected, having received one to three vaccinations, and needing additional information were associated with willingness. These findings highlight the role of HCWs in delivering information and prevention recommendations to improve knowledge and vaccination uptake.