Development and validation of Mpox healthcare seeking barriers scale for MSM based on a multicenter study in China

China is one of the ten countries most severely affected by the monkeypox outbreak. Over 90% of Mpox cases are MSM, primarily identified through proactive healthcare visits. Mpox medical visit worries are barriers to MSM proactively seeking medical assistance. However, there are currently no tools available to measure the barriers of MSM regarding seeking medical care for Mpox. A total of 2347 MSM were recruited for this study from six cities in China. Factor analysis was used to explore and validate the factor structure of the 14-item MMHSBS, which utilizes a 5-point Likert scale. The model's structural validity was evaluated and compared using GFI, NFI, RFI, IFI, TLI, CFI, SRMR and RMSEA. Split-half reliability, Cronbach's α, and McDonald's ω were used to assess the reliability of MMHSBS. The three-factor structure model of MMHSBS performed best, comprising medical distrust, perceived costs, and interpersonal damage. The indices were as follows: GFI = 0.937, NFI = 0.926, RFI = 0.952, IFI = 0.967, TLI = 0.959, CFI = 0.967, SRMR = 0.046, RMSEA = 0.073. Split-half reliability was 0.844, Cronbach's α was 0.949, and McDonald's ω was 0.950. The three-factor structure of the MMHSBS demonstrated good reliability and validity among Chinese MSM. Chinese men who have sex with men face relatively strong barriers to seeking healthcare for Mpox, with the most prominent barrier being the impact on their personal social image.