Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA 22030, USA.
Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA.
Int J Environ Res Public Health. 2023 Jul 8;20(14):6324. doi: 10.3390/ijerph20146324.
The U.S. monkeypox (mpox) outbreak of 2022 was a unique emergent public health crisis disproportionately affecting Black sexual minority men (BSMM). Similar to other stigmas, mpox-related stigma may have adverse effects on BSMM, including deterring HIV prevention such as PrEP.
Our study investigated the experiences and perceptions of BSMM related to mpox, including mpox-associated stigma, and PrEP engagement among BSMM. We conducted qualitative interviews of 24 BSMM attending HIV prevention-related events in the greater D.C. Metropolitan area. In-depth interviews were conducted via phone, and responses to questions specific to the mpox outbreak were analyzed using thematic analysis.
We identified three key themes from the analysis: Mpox-related stigma, Mpox vaccine availability concerns, and Mpox vaccine hesitancy. Participants also described relationships between each of these three themes and PrEP use. Mpox stigma was particularly relevant as it is related to sexual stigma and is a deterrent to PrEP use. A sense of health system neglect of BSMM, especially related to low mpox vaccine availability, was also described.
We identified mpox stigma and challenges related to mpox vaccination as key themes among BSMM, with implications for PrEP use. Future research exploring medical mistrust among BSMM, particularly related to HIV prevention, is recommended.
2022 年美国猴痘（mpox）疫情是一场独特的突发公共卫生危机， disproportionately affecting Black sexual minority men（BSMM）。与其他污名一样，mpox 相关的污名将对 BSMM 产生不利影响，包括阻止 HIV 预防措施，如 PrEP。
我们的研究调查了 BSMM 与 mpox 相关的经历和看法，包括 mpox 相关的污名、BSMM 中 PrEP 的使用情况。我们对在大华盛顿都会区参加与 HIV 预防相关活动的 24 名 BSMM 进行了定性访谈。通过电话进行深入访谈，并使用主题分析对针对 mpox 疫情爆发的问题的回答进行分析。
我们从分析中确定了三个主要主题：mpox 相关污名、mpox 疫苗供应问题和 mpox 疫苗犹豫。参与者还描述了这三个主题之间的关系与 PrEP 的使用。mpox 污名尤其重要，因为它与性污名有关，是 PrEP 使用的障碍。还描述了参与者对 BSMM 中健康系统忽视的看法，尤其是与 mpox 疫苗供应不足有关的看法。
我们确定了 mpox 污名和与 mpox 疫苗接种相关的挑战是 BSMM 的关键主题，这对 PrEP 的使用有影响。建议未来探索 BSMM 中的医疗不信任，特别是与 HIV 预防有关的医疗不信任。
