Background:
Stigma related to identity, behavior, and HIV status can manifest in multiple domains of life. In the 2022 mpox outbreak, gay, bisexual, and other men who have sex with men (MSM) and non-Hispanic Black and Hispanic men have represented overly large proportions of reported cases. Because these groups also regularly face stigma in their lives, there was potential for messaging about the mpox outbreak to increase stigma for these already marginalized groups. However, CDC sought to promote non-stigmatizing, sex positive harm reduction messages from the beginning of the outbreak.
Methods:
To understand prevalence and impact of mpox-related stigma amongst MSM in the United States, we conducted a study within the American Men’s Internet Survey, which enrolled 824 cisgender MSM aged 15+ from August 5-15, 2022. We administered 10 mpox-related stigma items; we retained 9 after exploratory factor analysis and pooled these 9 into a binary variable for “any reported stigma” which was used in subsequent bivariate and multivariate logistic regression analyses.
Results:
1.9% (n=15) of participants felt excluded from their family because of fear they may have mpox, with 1.1% (n=9) unsure. 1.8% (n=14) of participants felt excluded from friends or were unsure 1.8% (n=14). Regarding discriminatory remarks or gossip from family, 3.5% (n=28) felt some level of discrimination, with another 3.8% (n=30) unsure. Overall, 1.3% (n=10) felt worried about going to their doctor because of being diagnosed with mpox. In total, 1.0% (n=8) of participants reported being verbally harassed because someone thought they had mpox, with another 0.6% (n=5) unsure. Overall, 6.6% (n=54) reported experiencing any mpox-related stigma. In bivariate analyses, reporting any mpox-related stigma was associated with knowing someone who tested for mpox (OR=4.15; 95% CI=1.99,8.69), knowing someone who was vaccinated for mpox (OR=1.97; 95% CI=1.12, 3.47), and having an unexplained rash in the 3 months prior to survey administration (OR=4.01; 95% CI= 2.05, 7.83). Multivariable logistic regression models with potential intersecting determinants such as race/ethnicity, age group, and region did not significantly affect the presented relationships.
Conclusions:
There was low overall prevalence of mpox-related stigma among MSM in August 2022. These data suggest that messages developed by CDC and others about mpox and how to protect oneself from mpox infection did not lead to widespread stigma for this sample of MSM in the US.