High willingness to receive a vaccine for gonorrhoea prevention among gay, bisexual, queer, and other sexuality diverse men, and non-binary people in Australia

Gonorrhoea incidence and antimicrobial resistance are increasing among gay, bisexual, queer, and other sexuality diverse men, and non-binary (GBQ+) people. Observational studies suggested that 4CMenB vaccine (Bexsero®) may provide partial protection against gonorrhoea, but recent randomised trials found no clear evidence of protection. We analysed willingness to receive 4CMenB for gonorrhoea prevention in a 2025 Australian cross-sectional survey of GBQ+ individuals aged ≥16 years. Multivariable logistic regression examined associated factors. Among 2138 participants (median age 39 years), 89.2% were willing to be vaccinated. Willingness was lower among participants aged ≥30 (aOR = 0.46;95%CI = 0.29-0.74), born outside Australia (aOR = 0.71;95%CI = 0.51-0.99), higher among those reporting recent HIV PrEP use (aOR = 2.80;95%CI = 1.30-5.99), familiarity with antimicrobial resistance (aOR = 2.26;95%CI = 1.61-3.18), and willingness to take an antibiotic pill after sex to prevent STIs (aOR = 5.42;95%CI = 3.85-7.61). Willingness was high and aligned more with prevention engagement and biomedical prevention attitudes than with sexual risk behaviours, suggesting future gonorrhoea vaccines may be acceptable in this population.